Peter Harbage on a Public Health Insurance Plan

Why do we need a public health insurance plan?

We need a public health insurance plan in order to create a more competitive marketplace. Right now we have a situation where there’s a small number of private health insurers that everyone has to go to in order to purchase their insurance, and if you look around the country you have markets that are sometimes dominated by one and maybe two insurance companies. Public health insurance plan is an opportunity to change that. It’s an opportunity to create the competition that everybody, regardless of where on the political spectrum they fall, should want to see. And it’s an opportunity to create choice so that you have more health plans for businesses and individuals to choose from so that they can get the health plan that really helps them.

What would an effective public health insurance plan look like?

An effective public health plan outwardly is going to look a lot like private insurances that exist today. You’ll be able to, your employer and you will be able to, have the choice of enrolling in the public plan. You’ll see a lot of the same sort of basic processes where you go to your doctor and they bill the public plan and the bill’s paid. So outwardly, you’re looking at something that’s similar. What’s really truly different is the design and the philosophy on the inside. Right now today, too much of the health insurance industry is simply focused on their profit and trying to deny care in order to maintain their profits, and they do this by creating a whole series of administrative barriers like prior authorization and making doctors submit form after from and document after document in order to be paid. The public health insurance plan is going to focus on delivering care and promoting health and getting physicians to focus more on primary care, preventative care, and chronic disease management—all of those things that we don’t do very well with the current system because those incentives aren’t built in to the system for providers and insurers to pay for that.

How would this public health insurance plan help make health care more affordable for all?

The public health insurance plan is going to help make health care more affordable overall through a whole series of steps by creating a more competitive marketplace. Right now, we have a situation where a small number of insurers are responsible for the bulk of what’s happening in the marketplace. It’s not competitive, and Americans of all political persuasions understand that to have a free marketplace, it means that you need a choice of competitors. You need people out there who are competing against each other. The public health insurance plan will introduce that competition, and by doing that we can expect to see what happens in any market when you do that. Prices will come down naturally through the marketplace. The public health insurance plan is going to be able to bring in costs through bulk purchasing. By having a national health plan that’s going to be contracting with doctors and hospitals all over the country and by having a large number of people in that plan, it will be possible to bring down payments because you have that ability in the marketplace. You have that consumer that wants to be, that’s chosen to be, in the public health insurance plan and will be able to negotiate a better set of rates with doctors and hospitals.