Without a public option, I feel like I’ve got a gun to my head telling me that I am forced by law to pay some CEO’s obscene salary with no guarantee that I’m not going to get the shaft if I get sick. Regulation alone, subject to K Street influence and corporate whores in the congress, will not get the job done.
How does this fit with Krugman’s point that a public option is not really necessary?
Look, it is possible to have universal care without a public option; Switzerland does. But there are some good reasons for the prominence of the public option in our debate.
One is substantive: to have a workable system without the public option, you need to have effective regulation of the insurers. Given the realities of our money-dominated politics, you really have to worry whether that can be done — which is a reason to have a more or less automatic mechanism for disciplining the industry.
Well, of course he doesn’t claim it can work without regulation, which both he and Digby agree isn’t likely to be enough. I agree, too, for what it’s worth. Why couldn’t regulation work? What Krugman doesn’t mention is that, at least in Germany (and I imagine something similar is true of Switzerland), “effective regulation” = price control. I cannot envision a scenario in which price controls are debated in Congress and the big insurance companies do not immediately spend (profit – epsilon) in order to kill it. Meaning it will never happen.
What I really don’t understand is how the same people who think the government can’t do anything (non-military) right also think the government would be able to run a medical coverage plan that is so competitive with existing insurance plans that it destroys them. If it were so bad, who would opt in?