Give Americans a real health care choice, say advocates

'Don't cut the heart out of President Obama's health care reform plan' is the message many people will be delivering to their members of Congress this week as part of a national effort to push for meaningful health care reform.

National groups and coalitions such as MoveOn.org, Democracy for America and , a coalition of labor and community advocacy groups, are demanding congressional support for a reform model that gives Americans a choice between affordable access to private insurance and a 'public option.'

'People need to have a real choice,' said Jacob Hacker, a health policy expert that has advised presidential campaigns and is the author of a new study from the Institute for America's Future titled 'Healthy Competition.' On a teleconference with reporters, Hacker noted, 'They have to have a choice of a plan that is guaranteed, that's affordable, that will provide quality care wherever they live in the nation.'

In Hacker's view, Americans should have access to a national health care exchange that provides a menu of options. At least one of those options should be publicly financed plan based on Medicare's 'infrastructure' where the government pays doctors, hospitals and pharmacies.

Other reform proposals that exclude this public option are little more than massive taxpayer subsidies to help people buy expensive or inadequate insurance.

Roger Hickey, director of the Institute for America's Future, which published the report, said that private-only reform proposals simply will not be able to control costs, the essential ingredient of affordable, quality universal reform. Excluding a public option will result in 'either very low-quality health care plans or very unaffordable health care plans for a lot of people, and a lot of resentment,' Hickey pointed out.

Hacker's report detailed some basic reasons why giving Americans the choice of a public option is a must. First, the competition created between a public plan and the private market will likely get private insurers to adjust how they provide insurance. They will be under pressure to stop unfair practices such as excluding higher risk customers or limiting coverage for higher cost medical procedures. Simply put, in order to compete they will have to simply provide better coverage at more affordable rates to a larger number of people, he argued.

Private insurers will have to change current practices in order to keep customers who might otherwise be dissatisfied with their service and prices and choose to move to the public option.

Hacker rejected the idea that providing general access to the existing federal employees' benefit program is not a satisfactory substitute for a public option. While it should be among the new options given to all Americans, this option alone will not help control costs or guarantee meaningful coverage on a universal basis.

Hacker's proposal does not eliminate the private market nor does it eliminate incentives for employers to continue to sponsor health care coverage for their employees. It simply adds more options for Americans who struggle to pay for coverage or who are dissatisfied with the quality of their existing health insurance plan.

The push for a 'public option' is a goal shared by more than seven in 10 Americans, including more than six in 10 people who identify themselves as Republicans, according to a conducted for the Center for American Progress Action Fund.

While some media reports indicate that Senate Democrats are increasingly willing to exclude a public option from a final reform plan, other congressional Democrats have drawn a line in the sand. A by the leaders of the Congressional Progressive Caucus (CPC) indicated that most members of that 77-person group in the House will refuse to vote for a health care reform plan that excludes a public option. 'We have polled CPC Members very carefully in recent weeks,' CPC co-Chairs Reps. Raul Grijalva (D-Ariz.) and Lynn Woolsey (D-Calif.) said, 'and a strong majority will only support comprehensive health care reform legislation which includes a public plan option on a level playing field with private health insurance plans.”

Without strong support from the CPC, any health care reform proposal will have difficulty passing in the House.