President Barack Obama and former top Obamacare official Dr. Ezekiel Emanuel are now floating the idea of a public option as an answer to the seemingly inevitable collapse of Obama’s landmark health care legislation.
Obamacare has seen better days: It’s had 16 health care co-ops go kaput, including in New York, some major health care providers are pulling out, and analysts have almost nothing rosy to say about the legislation in both the near and long term. As a result, Obama and his surrogates are scrambling to shore up the sinking ship.
For his part, Emanuel wrote a piece for the Washington Post Aug. 22 in which he acknowledged there were problems with Obamacare and provided a five-prong solution to fixing them. Most important of these solutions, a public option to the healthcare exchanges. He says that “we should consider a public option,” because “consumers should never be subject to the whims of insurer withdrawals or withdrawal threats.”
Emanuel’s sentiment was an echo of Obama’s own words in an Aug. 2 piece for the Journal of the American Medical Association. He said the path to continued progress is through “continuing to implement the Health Insurance Marketplaces and delivery system reform, increasing federal financial assistance for Marketplace enrollees,” and by “introducing a public plan option in areas lacking individual market competition.”
The president and his former chief healthcare adviser are right to be concerned.
The Tennessee health commissioner recently said that the exchanges in her state are at a “near collapse.” (RELATED: Obamacare ‘Near Collapse’ In Tennessee, Says Insurance Regulator). In fact, most of the south and parts of the mid-west will have just one insurance provider in 2017, according to a new study by the Kaiser Family Foundation.
A public option would essentially “be a government-sponsored and government-run insurance plan, probably modeled on the traditional Medicare program, which would be offered to customers on the exchanges as an alternative to the private-insurance plans,” according to AEI.
Unlike private insurers, who have to set prices through negotiating with hospitals and physicians, publicly run insurance plans would not have the necessity to negotiate. Rather, a public option would be in the business of setting prices, not market equilibrium.
Dr. Joseph Antos, a healthcare policy analyst for the American Enterprise Institute, thinks a public option would “create a new problem by imposing another set of government rules,” rather than fix any problems within the healthcare marketplace.
James C. Capretta, a resident fellow at the American Enterprise Institute, says that “the goal all along has been government-run health care, even if they haven’t always been willing to admit that.”
Emanuel, brother of Rahm Emanuel, is a physician, bioethicist, author, the chair of the Department of Medical Ethics and Health Policy at the University of Pennsylvania, and most importantly, a former healthcare adviser to President Barack Obama from 2009 to 2011. Emanuel has published work on “who should get medical care, who should decide, and whose life is worth saving,” the Journal reports.
The Aug. 22 WaPo piece isn’t the first time that Emanuel has pushed for a public option, and he has even gone so far as to call for full government takeover of the healthcare market.
Emanuel hinted in a 2014 New York Times interview that a public option could be the solution to a potential problem that may arise if employers decide not to provide health coverage.
Emanuel, in 2016, said that the original co-ops created by Obamacare are “not doing great,” and that the solution could very well be to create a public option on the exchanges, according to Quartz.
Emanuel is on record favoring the rationing of care once a public option is in place, proposing a system that “prioritizes younger people” in a 2009 paper published with Lancet wherein he argued that healthcare should be distributed based on age.
“Unlike allocation by sex or race, allocation by age is not invidious discrimination; every person lives through different states rather than being a single age. Even if 25-year-olds receive priority over 65-year-olds,everyone who is 65 years now was previously 25 years,” according to Lancet.
Obama has been a vocal supporter of the public option for more than a decade.
In a video recorded at an Obama fundraising event hosted by the AFL-CIO in 2003, he expressed his support for a single-payer healthcare system. Obama told the crowd, “I happen to be a proponent of a single-payer universal healthcare plan.”
At the SEIU Health Care Forum in 2007, Obama said “my commitment is to make sure that we have universal healthcare, for all Americans, by the end of my first term as president.”
Interestingly, when Obama laid out his healthcare plan in a 2007 address in Iowa he did not mention either a public option or universal healthcare a single time. While Obama insists that he “didn’t campaign on the public option,” he did mention it as part of his original campaign platform.
Just two years later, in 2009, we saw what appear to be the president’s true feelings on the national stage. Obama told the Washington Post that he thought a public option would provide the most Americans the greatest access to healthcare.
That same year, in an interview with Univision, Obama said a public option in the exchanges is “something that we can still include as part of a comprehensive reform effort.”
At the 2013 CEO Conference in Washington D.C., Obama ardently defended Obamacare against claims of socialism and stated that his “health care reform is based on the private marketplace.”
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