The current Washington debate about creating a public health plan has a lot of fuzzy arguments. I think everybody can agree that a government insurance company would have lots of cost advantages over private insurers -- lower or no reserve requirements; avoiding regulatory requirements of the states; and, with regard to the for-profit companies, not paying taxes and trying to meet the expectations of equity shareholders.
So, if Congress wants to do this, it must be for the express purpose, first, of giving access to insurance to people at a lower cost, thereby reducing the amount of appropriations needed for subsidies of lower income people. And, second, over time, using those cost advantages to cause more and more people to migrate to the public plan.
If the purpose were just to provide access to people, the existing insurers could be ordered to provide it in much the way the Netherlands has, and also the way Massachusetts has. Then, the full amount of public subsidies for low income people would require appropriations and would be evident to all.
So, I think the proponents of a public health plan really want two things. They want to hide the cost of universal health care access. And, ultimately, they want a greater and greater percentage of the population to be on the public plan.
Thus, the arguments you see about a public plan being set up to encourage more competition among health insurers just don't hold water. So, let's be more direct about the real purposes and vote those up or down.
