The Health Care Problem

We need a public health plan. I seriously doubt we are going to get the version we need.

Obama on Health Reform: The Dog That Didn't Bark

The only troubling thing about the President's statements today concerning health care reform was what he did not say: that he wanted a any health plan that emerges from Congress to include a public insurance option for Americans who do not want to buy private insurance. But without this option, there will be no pressure on private insurers to adopt all the other reforms to control costs or give all Americans access to affordable care.

Every other reform proposal announced to date -- electronic medical records, comparative effectiveness research, prevention of chronic disease, payments for services rather than for outcomes, and so on -- has been talked about for years. The reason none have been adopted is health providers and insurers can make more money without them. Only with a government plan that competes with private insurers, and offers Americans lower costs if the providers and insurers fail to reform themselves, will the system be genuinely reformed.

Hopefully, the President's failure to mention a public insurance option today was not intended to signal to Congress that the White House is no longer especially interested in it. The Administration should quickly inform policymakers how important this option is as a spur to real change.