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Prospects Dim for Public Plan

Cheryl Clark, for HealthLeaders Media, June 26, 2009

The public option may be in danger of winding up in the healthcare reform scrapheap—next to Hillarycare.

House Speaker Nancy Pelosi said Thursday no health reform proposal will get a vote from the House without this essential main ingredient, but Senate Finance Committee's ranking Republican Charles Grassley, firmly stood his ground that his bipartisan committee is making "sure that there's no public option" in the final package.

In an interview on MSNBC Thursday, Grassley, whose bipartisan effort is key to a reform passage this year, said emphatically: "We don't need any more government into medicine. We got government into medicine through Medicare and Medicaid up to 45% right now and it hasn't been a good experiment from the standpoint of government price setting."

Instead, Grassley said he would rather that millions of low-income uninsured Americans have their health insurance premiums subsidized by the government so they can buy coverage through traditional means, a choice of insurance plans, or a cooperative.

Insurance companies, he said, would have to change their ways. "We're going to do it through the reform of the private insurance system," Grassley said.

Patients no longer will have to "wait until they get sick and go to the doctor because that's the most expensive form of medicine and we're going to be able to save money because of it," Grassley said with assurance.  He added that the public option "shouldn't have been brought up in the first place."

A cooperative may be allowed to substitute for the so-called public plan, as long as "it isn't dominated by Washington and follows a traditional co-op plan," Grassley said.

Grassley said he is dead set against what most Democrats and the White House want, which is to get "the government more involved in the practice of medicine.  They want to get a government bureaucrat between you and your doctor. And the power to tax of government is the power to destroy and it's unfair competition."

Against all this, even President Barack Obama may be starting to back off of the public option, which he had previously said was essential to health reform. His chief of staff, Rahm Emanuel, reportedly said Thursday that the public option is "not non-negotiable."

Meaning that now, a bipartisan plan may make it negotiable.

Support for public plan

There are still many who are just as insistent that a movement away from a government-run health program similar to Medicaid and Medicare, which would be made available to employees as well as the unemployed, is the only way to keep private health insurance plans in line.

Speaking before the annual meeting of America's Health Insurance Plans earlier this month, former Democratic presidential candidate Howard Dean said that without a public option, "I don't think health reform is worth doing."

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