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NRO’s health-care blog.

Bringing Back the Lightning Rod: The ‘Public Option’ Returns



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After leaving the “public option” on the back burner for a couple of months, during which time the public outcry against Obamacare has somewhat softened, the Democrats are now ready to invite more of what they got in August. The Senate Finance Committee bill was extremely politically vulnerable, particularly for having been brazen enough to propose paying for itself largely by pilfering from Medicare. But its opponents failed to gain sufficient traction against it.  
But the “public option” is another story. Once again, the Trojan horse is being offered as a “gift” to the American people — only this time with the wrinkle that each state will allegedly get to decide for itself whether or not to open its gates.
Four months ago, former Health and Human Services secretary Mike Leavitt and I co-wrote “The President’s Trojan Horse.” Now, over at NationalJournal.com, Leavitt responds to the Trojan horse’s upcoming encore appearance:

The public plan is pitched as if it would simply encourage competition and provide another choice for consumers.  But a government-run plan is not just another plan, offering just another choice.  It is designed to undercut private insurance.

A government-run plan is dangerous for three reasons:  One, it would be cheaper for employers to stop offering private insurance and [instead] funnel their employees into the government-run plan….Two, the government-run plan would use the coercive force of government to dictate the prices that could be charged by others — by doctors, nurses, and hospitals — in a way that private entities cannot.  Three, the government-run plan would be subsidized by American taxpayers, while private plans are not.

Let no one be deceived into thinking that Congress would not subsidize the government-run plan.  Once in place, Congress would favor it with all kinds of innovative provisions….HR 3200, for example, would offer low-income subsidies — but only for those who choose the government-run plan.

Financial subsidies for a public plan…would be financed…by taxpayers in all fifty states.  States would not be allowed to opt out of having their residents pay these federal taxes.  They would only be allowed to opt out of receiving their share of the federal subsidies….What state legislator would vote to do that?

The state “opt-in” is a transparently false choice.

As Leavitt highlights, there is only one gate, not 50, though which the Trojan horse must pass. If it does so, a two-tiered health-care system would emerge, to the detriment of the middle class: The very rich would continue to get the care they want, by paying for it out of their own pockets. The rest of us would get in line and wait for rationed care.


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