Sebelius: Public Option Would Ensure Healthcare for All Americans

Like your healthcare? Keep it … as the rest of America finds care it can live with

Posted July 13, 2009

What do you think? Is a public option a good idea for healthcare reform?

Kathleen Sebelius is secretary of the Department of Health and Human Services and the former governor of Kansas.

Today, when many Americans try to choose their healthcare plans, they are left with no choice at all. Health insurance premiums have skyrocketed, putting many insurance plans out of reach for working families. In many parts of the country, particularly rural areas, there is one dominant insurance company that controls more than 70 percent of the market. When Americans are offered care by their employers, they still struggle to pay ever increasing deductibles and out-of-pocket costs. In the end, millions of Americans are left without health insurance. Millions more have coverage they can barely afford and that does not meet their needs.

Health reform and the creation of a public health insurance option will help solve these problems and finally give the American people the choices they need and deserve. As more and more families, businesses, and local and state governments struggle under the burden of escalating healthcare costs, reform can't come soon enough.

The healthcare status quo is unsustainable and unacceptable. All you have to do is look at current economic indicators and talk to the experts in government and the private sector to see that healthcare reform is no longer just a moral imperative but also a financial imperative. Since 2000, employer-sponsored health insurance premiums have nearly doubled, and healthcare premiums in general have grown three times as fast as wages. Healthcare costs have grown by $1.5 trillion in the past 16 years and, if left alone, will plunge the country deeper and deeper into debt. Without reform, families, businesses, and the government will be overwhelmed by rising healthcare costs that will consume 34 percent of the U.S. economy by the year 2040.

Nearly 46 million Americans are uninsured. If we continue on the course we're on, in just over 20 years, 72 million Americans will go without insurance. Even for people with coverage, all it takes is one stroke of bad luck to join the ranks of the uninsured—or the millions who have coverage and struggle to pay the bills.

Under the status quo, where you live often determines the choices you have. Only 33 percent of rural workers are given a choice in health plans through their employers, compared with 43 percent of urban workers. In states like my home state of Kansas, one insurance company has a monopoly in much of the state. For too many Americans, the very moment they need health insurance, they are denied because they have a pre-existing medical condition.

These statistics are more than just numbers on a page. They tell the story of a system that is denying Americans the care, the quality, and the choices they deserve. After decades of false starts and debate, it is time for us to act. President Obama believes we have to protect what works about healthcare and fix what's broken. The president believes we need reforms that ensure that if you like your healthcare, you can keep it. No one will force you to change doctors or insurance plans, and government will not come between you and the doctor you know and trust. Any claims to the contrary are simply untrue.

Reform will help ensure that all Americans have real healthcare choices. President Obama has proposed creating a health insurance exchange, a one-stop marketplace that will give Americans the opportunity to compare benefits, prices, and performance and choose the plan that works best for them. The plans available in the exchange would offer different benefits and services, but each plan would be required to meet certain basic standards.

One choice that should be available in the exchange is a public health insurance option. It will create competition that will bring premiums down and make care affordable. It will keep insurance companies honest and help cut waste from the system. It will provide needed stability and security, so you will always have an affordable healthcare option even if you lose your job, change jobs, move, or have a pre-existing medical condition. Perhaps most important, it will be one of several plans consumers could choose. No one would be forced to choose the public option.

Those who oppose creating a public health insurance option want you to believe it is a step toward a single-payer system. Nothing could be further from the truth. The president believes in the principle of choice, and the public option would simply offer consumers additional choices. The president wants to build on and strengthen our existing employer-based system. Single-payer systems may work in some nations, but we face a uniquely American problem, and it deserves a uniquely American solution.

Other opponents of reform claim that competition in the exchange and a public health insurance option will lead to the demise of private health insurance as we know it. Ironically, this argument comes from the same defenders of the status quo who believe government can do no right. If the government plan does not offer a good product, people won't choose it.

This line of reasoning simply does not make sense, and it rings hollow because public health insurance options have been offered before, with great success. In several states, state employees can choose between a public health insurance option and private insurance companies. These public health insurance options negotiate their own provider networks and determine their own premiums. The side-by-side competition has not destroyed the private market, nor has it led to a single-payer system.

A health insurance exchange with a public option will use market strategies—competition rather than regulation—to cut costs, give more Americans more choices, and improve the quality of care we all receive. It's an important component that will help deliver the reforms we need.

We cannot afford to wait. The American people have struggled under the weight of high healthcare costs for too long. It is time for all of us—Democrats and Republicans, business and labor, doctors and patients—to work together to make reform a reality.