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A public option that destroys all options

By Richard E. Ralston
web posted August 10, 2009

George Orwell is alive and writing new fiction about Congress legislating expanded government control of health care. Or at least it seems that way.

A growing and ominous trend lately is the inversion of language to couch further government intervention in the name of liberating "reform."

For instance, if you want to eliminate the secret ballot in union-organized elections and force workers to vote in clear sight of their employer and a union enforcer, call it "The Employee Freedom of Choice Act."

There are many more flagrant examples of doublethink in the debate on health care. And it becomes increasingly difficult to have a sane discussion when too many words are used as the opposite of their proper meaning. It can even confuse journalists.

When the government has made a mess of medical care by increasing its control from 10 percent to 50 percent over the last forty years, driving up costs by shifting them to private insurers, and when state regulators have driven up the cost of the other half of care, mandating coverage that makes private insurance unnecessarily expensive, we are told that "reform" means giving government complete control of whatever is left.

Their "reform," then, amounts to more of the same poison that has been killing us.

President Obama has frequently reassured us that, if we are happy with our present insurance, there is no cause for alarm—our right to keep it will not be denied. Of course, it will no longer exist in a few years, so the right to keep it is pointless. A new "public option" would provide employers with a strong financial incentive to drop insurance for their employees, to give way to the public plan.

If you have an individual insurance policy, your right to keep it will be meaningless when it cannot compete with government insurance. Private insurers will be forced out of the game as the public plan draws unlimited credit from a government cashier playing with a stacked deck from a dealer who forces the other players to cover the government's bets. Yet this is the solution offered to head off the so-called "predatory" nature of a free market, in the name of promoting "healthy competition."

Evidently competition is good in doublespeak—when it means eliminating competition.

If some "balanced model" of competition would be beneficial, why not turn over the Medicare taxes taken from citizens to a fund they could use to pay premiums to the private insurance company of their choice? Wouldn't that be healthy competition for Medicare? Not if what they are calling competition is really just more government.

Another blatant deception is that government insurance, such as Medicare, is more efficient and has lower administrative costs. The trouble is that Medicare does not have to collect any premiums but relies on the IRS to provide income and a couple of hundred thousand employees of the Social Security Administration. That does not cost anything, does it? Medicare does not even process any claims but hires those "inefficient" private insurance companies to do it for them. Medicare does not care what anything costs, because they have an unlimited source of tax revenue—or government debt, and it can force providers to accept reimbursements lower than their costs. Medicare also does little to manage fraud, which insurance companies cannot afford to ignore. Yet this "efficient" Medicare is now going broke.

We are also told that Medicare is very popular with senior citizens, so most Americans will embrace the public option even if it destroys the other options. If that is true, why is every retiree, after a lifetime of paying Social Security and Medicare taxes, denied his Social Security pension if he does not participate in Medicare Part A insurance? Medicare is so popular that anyone who declines to participate has his monthly Social Security payments taken away. That government use of the word "popular" is just what Orwell had in mind.

What should we think of the claim that a public option will be more efficient and less expensive than private insurance? That is less complicated and less Orwellian. It is just a lie.

Indeed, sometimes the proponents of government control resort to lies in plain English, such as when they say that a public option emulates the Federal Employee Health Benefit Program. But that plan offers only a choice of private insurers—it does not offer a public option. Members of Congress who benefit from this plan apparently do not care for a public option for their own insurance. Maybe that is because they know what the option really means?

Deeper than a contradictory use of language, at the bottom of the deception is a destruction of the concept of individual rights. Why, in a free country, should the government be allowed to seize control of any part of the health care industry? Because, we are told, everyone has a "right" to health care. By this they mean the exact opposite: no one has the right to any health care at all—it is granted as an entitlement and received by permission, as dictated by government legislation. The word "right" is used to destroy any true right—the freedom of individuals to pursue or provide health care in a market without coercion.

Government intervention requires tyranny, because the government cannot give anyone health care unless it takes it from someone else or forces someone to supply it.

A public option really means the destruction of options. That is why some politicians yearn for it so earnestly. ESR

Richard E. Ralston is Executive Director of Americans for Free Choice in Medicine, Newport Beach, California.  Copyright © 2009 Americans for Free Choice in Medicine. All rights reserved.


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