On Fox News Sunday this morning, Sen. Tom Coburn (R-OK) trashed the idea of including a new public health insurance plan as part of health care reform, saying “that is exactly the opposite way” to improve health care in America. “We don’t need more money,” said Coburn. “What we need is true markets that will allocate this resource and create a way for everyone to have access.”
Host Chris Wallace then asked Sen. Evan Bayh (D-IN) about “private sector” concerns that a public option would mean “that everybody will end up in the government program.” Bayh replied that he was “agnostic” about including a public plan in reform:
WALLACE: But the one big concern a lot of the private sector has is the president, in his program, has as a — supposedly as a provider of last resort a government program, and the concern is they’ll be able to do it so much more cheaply, or at least in terms of the cost, that everybody will end up in the government program.
BAYH: Well, it’s a debate we need to have, Chris. And I’m agnostic on that as we sit here this morning.
Coburn argues that the main problem with health care in America today is that “we haven’t allowed market forces to allocate resources.” But as former Gov. Howard Dean (D-VT) told ThinkProgress recently, “the free market does not work in health care, except in very perverse ways. So, you have to find a system that works better in addition to the free market.” This is why Dean argues that health reform “rises and falls on whether the public is allowed to choose” a public option.
Indeed, as Center for American Progress Action Fund Senior Fellow Peter Harbage and Director of Health Policy Karen Davenport recently wrote, “there’s no question a public plan within a public exchange is necessary“:
Fortunately, our nation’s health insurance market can be fixed with a big dose of what fixes most sectors of our economy—healthy, well-supervised competition. One of the best ways to introduce this much-needed competition is for the federal government to offer a public health insurance plan that can compete with private insurers within an insurance “exchange” that ensures public and private health insurance plans compete equally and transparently in the public marketplace.
By saying that he is “agnostic” about a public plan, Bayh appears to be aligning himself with Senate Finance Committee Chairman Max Baucus (D-MT), who told The Wonk Room’s Igor Volsky last month that he believes health care reform can be accomplished “without” a public plan. “But we may have to have it, [Dean] may be right. Just don’t know yet,” conceded Baucus.
COBURN: What we have is a very inefficient system, and we haven’t allowed market forces to allocate resources.
We also haven’t emphasized prevention. Three-quarters of the money that we spend in this money are on five chronic diseases that are preventable.
If we really want to improve access — and I think everybody should have access — and control costs, then we need to emphasize prevention, and we need to have real market forces. And we don’t have that today. And that’s one of the reason that everybody wants to see us change it.
But the ultimate plan, a public plan, ultimately results in a Medicare program for everybody. And that is exactly the opposite way.
One other point I’d make — we spend twice as much on health care as any other nation in the world with the exception of Switzerland, and we — and we have great physicians, great care, great hospitals and great research, but we can’t afford to continue to spend 17 percent of our GDP. And the Obama plan moves it to 19 percent.
So we don’t need more money. What we need is true markets that will allocate this resource and create a way for everyone to have access.
WALLACE: I want to bring Senator Bayh in.
And I want to ask you — because there really does seem to be momentum, bipartisan momentum, and even from the industry, from health care providers, from insurance companies, to do something this year about health care reform.
But the one big concern a lot of the private sector has is the president, in his program, has as a — supposedly as a provider of last resort a government program, and the concern is they’ll be able to do it so much more cheaply, or at least in terms of the cost, that everybody will end up in the government program.
BAYH: Well, it’s a debate we need to have, Chris. And I’m agnostic on that as we sit here this morning. I think in the Medicare Part D — to use plain English, the drug program for senior citizens…
WALLACE: The prescription drug benefit.
BAYH: … there was a provision that some people were concerned about that allowed the government to step in and offer that coverage in areas of the country where private — you know, the private sector did not step forward and offer the coverage.
So it has not had the kind of adverse impacts that some had been concerned about. We need to have a debate about that.
My own preference would be — and you may have found common ground here this morning on Easter, which is appropriate — deal with the inefficiencies, figure out a way to make the private marketplace accomplish our public good, only have the government role as a backstop, as a last resort, if the private sector has just failed to meet the challenge.