In his column today, E.J. Dionne comes about as close as he can to conceding that the ultimate goal of passing some kind of comprehensive health care reform this year is to put America on the pathway to government-run health care.
Many liberals believe our entire health-care system should be scrapped in favor a government-run single-payer plan along Canadian or British lines. The problem is that single-payer is not only politically impossible; it would also cause significant disruptions in the existing system. The public-option idea is a clever halfway house. It would allow the United States to move gradually toward a government-run system if — and only if — a substantial number of consumers freely chose to join such a plan. The market would test the idea’s strength.
Private insurers hate the idea because they think the public plan would undercut them in the marketplace. This argument is, in some ways, self-refuting. If the private insurers are right that the government would actually provide health coverage more cheaply than the private companies, why shouldn’t that option be available? Since the government would be ponying up to help people buy insurance, wouldn’t this save taxpayers money in the long run?
This is precisely how the ideas being kicked around by Obama and Democrats will lead to the type of rationing of care we see in single-payer systems. Once they can make taxpayers “pony up” for something, it creates the opening for them to argue that additional government control is required to save taxpayer money. And the only way that government can save real money is to ration care.
Furthermore, as I wrote at greater length earlier this month, the government-run option doesn’t represent free choice, as Dionne and its other proponents argue, it represents a false choice. Government would be setting the regulations on private insurance and running the national health care exchange from which Americans would be purchasing coverage. While private insurance companies have to either turn a profit or go out of business, the government does not face such a choice, because it has access to taxpayer funds.
Dionne goes on to discuss some of the compromise versions of a public option being floated around, before concluding, “If a bill passes this year, enhancements in the program down the road will not be seen as controversial but as inevitable.”
He may be a liberal, but Dionne is an astute political analyst who understands that once a national health-care program is on the books, there is no turning back, and America will be on the path to government control of our entire health care system.
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