Here is the section of Bernie Sanders’ response at the Edward M. Kennedy Institute on March 31, 2017.
We can also make some important improvements in the affordable care act, for example there are parts of this country where there is maybe one insurance company. I think we should have a public option in 50 states in this country.
I think this is where Bernie Sanders negated every good thing he said before. If only he had not said this, I would have gone away remembering why I was such a fervent supporter of Bernie Sanders.
If there is a problem with the private insurance company options on the ACA state marketplaces, and we add a public option, then there will be an almost inevitable adverse selection process. What the private insurance companies always want to do is to insure the people who are least likely to need the insurance, and therefore be the most profitable customers. They will do everything they can to discourage the sick and expensive customers, and give them up to the Public option. The ACA has limited the private insurance companies’ abilities to do this, but you can bet they will find a way. So the costs for medical care for those on the Public Option will necessarily be higher than the ones in the private insurance companies. The politicians who want to cut many people out of the health care system will use these statistics to deceptively convince people that publicly funded health care is inherently more costly than private insurance.
If these politicians manage to convince voters with these deceptive number, they will convince voters to vote against Medicare-for-all, thinking it will be more expensive. However, Medicare insurance premiums will be mandatory for all, and there will be no adverse selection problem with Medicare.
Why should Democrats fight for an interim program that is almost certain to sink their vision for the ultimate program? This is why I specifically went to this event with my placard.
April 2, 2017 – 11:00 PM
Maybe there is a way to put in a public option that will be inoculated from the Republicans claim that it is more expensive than private insurance.This needs a lot of discussion, because I am not sure it will work, but it is an idea.
Explicitly say that the public option is intended to siphon off the high risk people from the private insurance market. This will allow the private market to sell their insurance cheaper. Surely the private insurance companies would be glad to not have to insure the most expensive clients. Also, since private insurance has much higher overhead expenses than the public insurance option, these high risk patients will be treated at less expense to the health care system than if they were insured privately. Every time the Republicans would claim that the costs per capita for the public option were higher (if they were) than the private insurance, we could say, “Yes, we know. That was the intention to take the higher cost patients out of the private market. You want to put the expensive patients that the private market does not want back into the private market?”
Perhaps the private insurance companies will
bribe encourage the Republicans not to torpedo the public option.
I have posted this article to the Health Over Profit for Everyone – HOPE Facebook page to see what they think of the idea. They were the ones to raise the issue of the deleterious effects of adverse selection on a public option.