In the ongoing debate on health care reform, it has become clear that this is a competition between two very different philosophies of government.  On one hand, there are those who believe government ought to be the primary sponsor of almost everything, including America’s health care system.  The other philosophy is held by those of us who realize that government is too big, too inefficient, and has a poor track record when it comes to running things.  We do not believe the federal government should – or for that matter, is capable of – running the American health care system.

It is in adherence to this philosophy that I have growing concern about the so-called “public plan,” or “public option,” which would create a government health insurer to compete against private insurers.  The public plan being pushed as part of the so-called reform bills before Congress is a classic bait and switch tactic that would kill the private insurance market and inevitably lead to a single-payer, government-run health care system in America. 

                        SINGLE-PAYER PROBLEMS
As described by its supporters, a public insurance option would simply compete with private insurance providers, presenting no threat to the millions of Americans who are happy with their present health coverage.  The reality is that a government-run insurance provider – one subsidized by our tax dollars – would eventually run private insurers out of business.

Scott Harrington, a professor of health care management at the University of Pennsylvania’s Wharton School of Business, one of our country’s most prestigious business schools, recently said it was “impossible” for a government health insurer to compete fairly in the private insurance market.  “An ostensibly competing public plan would make a single-payer system inevitable.  Health care providers and other Americans should recognize this reality and be prepared for the consequences,” he said. 

Exactly what are those consequences?  To get an idea, one only needs to look at the single-payer, government-run health care systems in two of our closest allies, Canada and Great Britain.  Canadian and British patients wait about twice as long – sometimes more than a year – to see a specialist.  More than 800,000 people currently are waiting for some sort of procedure in Canada, while 1.8 million patients in England are waiting for a hospital admission or outpatient treatment.

Facts like these led a member of the British House of Commons to tell me recently, “Whatever you do, do not do what we did in the United Kingdom.”  I had a similar conversation not long ago that was just as instructive.  I spoke with a resident of a country that is a major U.S. ally.  He espoused the benefits of his country’s government-run health system.  But then I posed a question: “What happens in your country if you get cancer?”  He smiled and said, “If I get cancer, I am going to the United States.”    

                              BAIT AND SWITCH
Leading congressional Democrats – those pushing the so-called public plan – realize the American public does not want a single-payer health plan like the ones in Canada or Great Britain.  So instead of trying to sell such a plan, many are deceptively pushing a government insurance option that they claim would only be another choice for consumers. 

However, if you listen carefully, many of these members of Congress will admit in their unguarded moments that a single-payer government takeover of health care is their ultimate goal.  One leading Democrat advocate of the public option recently said that “this is a fight about strategy” about ultimately getting to a single-payer system.  “And I believe we will,” this senior lawmaker said. 

                              BETTER PATH FORWARD
As the debate over health care reform continues, Americans need to be careful to ask whether a public insurance plan would lead to a one-size-fits-all Washington takeover of health care, with results similar to those in Canada, Great Britain, and other European countries.  My assessment is that it would, with the result being a stifling of innovation, a rationing of care, and long waits for treatments.  That is not the direction America wants to go.

There is a better way forward.  It is not too late for the president and congressional Democrats to go back to the drawing board and devise a truly bipartisan measure that would offer positive reforms to our health care system.  Common ground does exist that will protect the doctor-patient relationship, make health care more affordable and accessible, and keep the United States the world leader in health care quality.  For the good of our country, I hope that is the path that is chosen.