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Health Care For Everyone

A closer look at the public option

Jun. 20, 2017
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Photo Credit: United Workers (Flickr CC)

The Issue of the Week expresses the Shepherd Express’ opinion on an important issue in the news. It is usually written by the Shepherds editor, but at times we invite someone outside of the paper who is either working in the field or has some other level of expertise.

Almost every American shares a common belief that the U.S. health system must immediately change from where we are now. And deep down, most of us believe that our health system suffers from too many for-profit entities seeking their cut. But a simple solution is now out there: Bring back the public option.

One of the Affordable Care Act’s biggest problems is that we have left our health care too much in the hands of private companies. Health insurance companies jack up premiums faster than inflation, confident that tax credits will still ensure enrollment. Insurers pick and choose which markets and counties they sell in, a form of redlining that leaves us at their mercy. Pharmaceutical corporations increase drug prices, knowing that we don’t have the leverage to negotiate. Something must give, and our democracy holds an answer.

During the original debate over the Affordable Care Act, many progressives fought for a “Public Option”—a government-run not-for-profit coverage option to compete with private insurance—as a way to rein in prices through competition. They argued it would hold insurance companies accountable, challenge skyrocketing prices and ensure that consumers weren’t at the mercy of where insurers felt like selling. Many argued it would be a way to get to a “Medicare-for-All” system by outcompeting the private market itself. These progressive visionaries were right. We’ve been suffering as a society without the public option. Finally, this option would not cost Wisconsin taxpayers a nickel; actually the state would get paid for administering it.


There’s still time, even in Trump’s America

How do we know that public coverage would do a better job? Because every day in every Wisconsin community public coverage like BadgerCare provides care at a fraction of the cost of private insurance. Today, more than 700,000 are enrolled through BadgerCare, Wisconsin’s Medicaid program for children and moderate-income families that was signed into law by Republican Gov. Tommy Thompson. It’s time to open it up to everyone. 

Wisconsin Democrats led by State Rep. Eric Genrich (D-Green Bay) will be introducing legislation to open BadgerCare to all. To allow any individual and any small business no matter their income to enroll in BadgerCare as a public option. It’s an idea whose time has come.

It turns out it’s not difficult; Wisconsin law already allows for BadgerCare to be purchased by those over the poverty line but it is complicated and few do it. But with one word change to state law, we can make BadgerCare into a public option available to the vast majority of our state’s residents. This is a perfect example of the states taking the lead. Currently, states including Nevada and Minnesota are taking steps in this direction.

The benefits would be immediate. Every community would have a new not-for-profit government-run health plan with a long history of success. BadgerCare already negotiates with pharmaceutical corporations for lower prices, has much lower out-of-pocket costs, and costs far less per month than private insurance. This public option would ensure that every county in Wisconsin would have at least one plan and, again, it wouldn’t cost state taxpayers anything.

We could even further use our democracy’s power through a public option to drive better care. Other states are using their Medicaid programs (like BadgerCare) to drive a calcified hospital industry forward and ensure front-line health workers are paid a living wage. We can never expect to see any of these results by relying on the private sector alone to gift it to us; we must use the strength of our democratic government to point to a better world and begin the steps toward it.

Doing nothing means leaving healthcare in the hands of corporate boards. Repeal means sabotaging the freedom of 23 million Americans. But treating the Affordable Care Act as the foundation that is in place to build upon, we can make the ACA successful by instituting bold solutions such as a BadgerCare Public Option available to all!

Kevin Kane is the organizing director at Citizen Action of Wisconsin.


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