Defining Single Payer vs Public Option
In response to stlo7’s question regarding Public Option,
What exactly is the “public option?”
This certainly is movement - but in the end the details will be very important.
Here is my take- While Single Payer indicates having only one form of health care coverage, which would be publicly funded, as in Medicare for all (HR676) paid for by tax dollars, Public Option refers to a choice you would have. You could choose a private, for profit health insurance where you can pick and choose your coverage according to your individual needs funded by you, personally. Or you could choose the, “Public Option”, also (I would hope) paid for by tax dollars (as opposed to Schumer’s idear.)
Here is Howard Dean’s explanation:
Single Payer=that’s all she wrote, everybody gets the same coverage.
Public Option=offered as a choice with private health insurance still available.
That’s my take. Anybody with other information, please comment away…..
Related posts:
As I understand it, under a Single payer system all the money we spend on healthcare now (premiums, employer contributions, copays) would be replaced by some kind of tax system. Hopefully progressive. So it would be possible to cover all the uninsured without increasing the total amount we have been spending since we no longer have to pay the cost of profits for the private administrators and the costs of denial of care and the cost of mutliple forms for multiple administators. So Single payer should not icrease the cost of healthcare and should cover all. Great!
But with a public option, I do not understand how that gets paid for. If the profits are still going to the insurance cos. where does the money come from for the public option? If I choose to keep my private insurance, with all the costs that involves, it is not likely I would be happy to also pay more taxes to cover those who choose the public option.
Thus the public option could be painted as the villain and would be targeted as the cause of failure of the reform. Then leaving us again at the mercy of the private profiteers!
Am I missing something????
No, I think you’ve probably hit the nail on the head.
[...] We wrote a lot about health care leading up to the huge forum we helped sponsor Saturday night. Let’s start with Bill Moyers and discussion of a Single Payer system. We flash back to the red herring arguments about drug safety from imported drugs. Discovered that Max Baucus may move on Health Care as he inches towards a “public option”. I suppose there are two kinds of public options “viable” and “nonviable.” We just aren’t sure which one we are inching towards. Senator Chuck Schumer - he sits on the committee with Max “single payer is off the table” Baucus weighed in as well. There was an attempt to define public option vs single payer. [...]
During his conference call kicking off “Stand With Dr. Dean,” Dr. Dean emphasized that just as every First World country except the United States has single payer health care, they also have functioning private insurance companies. People can buy additional coverage to differentiate the coverage they get from the state.
So I believe “single payer” versus “public option” is a distinction without a difference. The questions we should be asking are things like, Will it be funded federally and delegated to the states (McDermott’s HR1200, Sanders’s S703) or federally funded and administered (HR676)? We should be discussing what health care reform will look like rather than hair-splitting over terminology.
Nicholas,
I understand what you’re saying, but I think the difference lies with primary vs supplemental private insurance. I tend to agree with Blue Skies above. People who are paying for a private primary policy are not going to want to pay extra taxes for the “Public Option” when they are not using it. On the other hand, if everyone has the same primary policy (single-payer) those who want more coverage can still subscribe to a supplemental private insurance.
I believe there is a difference and I believe that difference can make or break the whole health-care system.
>People who are paying for a private primary policy are not going to want to pay extra taxes for the “Public Option” when they are not using it.
That dog won’t hunt. According to this line of reasoning, we would have difficulty enacting school taxes, Social Security and Medicare because they are largely funded by people who are not eligible for their benefits.
>if everyone has the same primary policy (single-payer) those who want more coverage can still subscribe to a supplemental private insurance.
If a single payer public option is implemented properly, there should be a natural inclination for people to migrate to the public option (per your earlier point about taxpayers wanting to get the services they pay for) and for insurance providers to transition their businesses accordingly. Supplemental insurance is an obvious business opportunity in that business environment, albeit one with a much smaller TAM (total addressible market).
“According to this line of reasoning, we would have difficulty enacting school taxes,”
Hence, the perpetual quest for school vouchers.
We will have to agree to disagree here.
“If a single payer public option is implemented properly, there should be a natural inclination for people to migrate to the public option (per your earlier point about taxpayers wanting to get the services they pay for) and for insurance providers to transition their businesses accordingly. Supplemental insurance is an obvious business opportunity in that business environment, albeit one with a much smaller TAM (total addressible market).”
We are, somewhat agreeing here. But, I still maintain that “single-payer” means one public program-hence the term. Public option means you still have multiple payers, one of which is the public option. Private primary policies would exist side by side with the public option. I do see how it could morph into single-payer when people realize the benefits, but it is not one in the same.
By bringing up school vouchers, you are missing the point. People with no children and people with grown children still pay taxes that fund schools. Personally I have been paying Social Security and Medicare taxes for >20 years and won’t be eligible (hopefully) for the benefits for another 25. But I don’t spend any time lobbying my representatives to repeal Social Security and Medicare - it would be a waste of everyone’s time. At its core, I don’t think the opposition can get much mileage from the argument that people only want to pay for government services from which they directly benefit because there is so much precedent to the contrary.
>I still maintain that “single-payer” means one public program-hence the term.
But no one is proposing reform that resembles what you call “single payer.” Eric Massa is as vocal a single payer proponent as you can find; yet he has specifically said that any health care reform bill would allow people to keep their existing coverage if they’re happy with it. Given that HR676 would not prohibit private health insurance companies from existing, and given that HR676 is universally referred to as a “single payer” bill, your “single payer”/”public option” distinction seems like a strawman.
“Personally I have been paying Social Security and Medicare taxes for >20 years and won’t be eligible (hopefully) for the benefits for another 25. But I don’t spend any time lobbying my representatives to repeal Social Security and Medicare”
Nor do I, nor would I. Ultimately, we will benefit from them and that is why we pay into them now. Ultimately,the people who choose private health insurance will not benefit from single payer (granted-from my perspective) and I can see where their complaint would originate from. It is not people like you and I who would be complaining. It is the people like the LTE guy at Elmira Star Gazette. God knows there are a lot of the walking brain-dead out there.
I am not suggesting that private should not exist anymore. I am just saying that it should be there as a supplemental option.
Ladkiddo,
The United States government is currently providing a tax subsidy to Insurance companies to encourage them to provide health insurance. 56.9% or $3643 which is the Public payout (taxes) out of a total of $6400 per capita for health care which includes the portion that is a tax subsidy to private Insurance companies. (OECD 2007 Health affairs 21(4).88 data for 2005.
This is corporate welfare and it exists today. To implement coverage for all a slight increase in your taxes would occur but under HR-676 you would actually see a 4.5% increase in your take home pay and a similar cost savings to employers while receiving full health care, one sized risk pool - everyone is in - no exclusions for prior anything.
Why, partially because Medicaid would not be needed anymore and because you would not experience the co-pays, cover the no-pays and pay ever increasing higher insurance premiums for health care by eliminating corporate welfare and the excessive cost of private administration. Yes, the government is far more efficient than private industry at delivering health care. That is except for Medicare Part D which was legislation passed during the Bush administration and written by big pharma.
This is the difference and informing people of these facts will make the difference for health care. Health care is either a right or an option. I choose a right just like our police, fire, water, sewer and highway departments and post office. HR-676 is a publicly financed and privately delivered solution which restores the patient-doctor relationship and it has the support of PnHP, California Nurses Association, UAW, countless other grass roots organizations, 77 congressional individuals and us. HR-676 does not prevent private insurance companies from existing. HR-676 is a win for Americans and American businesses especially American Small Businesses which employe the largest number of people in this country.
Carl,
Thanks so much for the information. I see it as something that each of us would be paying into and would be available to all. We would not have to pay extra for it, it would already be covered by the taxes taken out of our pay,correct?
I think it’s been a long time coming.
Go HR676!
[...] a Huff Post piece which seems to confirm my definitions of single-payer vs public option. (My bold): The public option allows Americans to choose between private insurance and a public [...]