Reporters pressed health care policy experts to address that question at a health reform panel in light of White House senior advisor David Axelrod’s assertions that President Barack Obama’s joint session next week will lay out a health care overhaul that could forgo the contentious government-run insurance option.
For Gail Wilensky, a senior fellow at Project Hope, the public option is “clearly” not dead. “It is the most contentious issue and unfortunately the administration has dug itself [into a difficult situation] by having the public plan become a prized position that is hard to negotiate around,” Wilensky told health care journalists this week at a National Press Club event by the Alliance for Health Care Reform.
Wilensky noted House Speaker Nancy Pelosi, and other members of Congress have said they will not support health care legislation that does not include a public plan.
“I’m worried with a public plan that when the government needs money [for the health program] it will go after benefits, populations served or whack reimbursements to physicians, which would be antithetical to the delivery improvements we’ve been talking about that are needed,” she said.
Heritage data from the Lewin Group also has shown that a government-run health care plan would create major changes in the current health care system, with more than 88 million Americans at risk of having their employer-sponsored health coverage disappear.
“The congressional left has made it clear that the public option is the key ingredient to what they consider ‘real health reform,”’ said Robert Moffit, director of Heritage’s Center for Health Policy Studies.
“They properly see the public option as means of eroding private health insurance, destroying the private health insurance markets and creating a single-payer system with a government monopoly. Underlying this entire debate has been a profound and irreconcilable conflict over the role of government in health care.”
“This is a fight over control,” Moffit added. “Control by government officials or by individuals and families. Don’t expect the left to surrender.”
Additionally, a public plan modeled after Medicare could still leave 16.5 million uninsured Americans without coverage, according to Lewin’s analysis of the House health care bill H.R. 3200.
Rather than focus on the public plan as being the “holy grail,” panelists at the Alliance for Health Reform event said Congress should focus on the components in health reform that have bipartisan support. “We all agree that we want our health care system to move toward universal coverage,” said panelist Ken Thorpe, with Emory University who used to work for the Clinton administration during the health care reform push in the early 90s.
Moffit noted that there also is wide bipartisan support for programs to provide direct assistance to low-income workers to help them buy private health insurance, which could be in the form of premium support for private insurance, vouchers or refundable tax credits.
The second area of agreement is promoting a larger role for the states in reforming health insurance markets. “States should have a greater role in that and securing access to affordable care for the poorest and sickest of our fellow citizens,” Moffit said.