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Mike Huckabee's Public Option

If you watched HBOā€™s Real Time with Bill Maher on November 12th, you heard Mike Huckabee propose a public option as part of a health reform fix.  With ā€œrepeal, revise, and replaceā€ stories in the news every day, shouldnā€™t this be worth at least one national headline? 
Governor Huckabee didnā€™t just flirt with the public option; he married it to his opposition to requiring insurers to cover people with pre-existing conditions.    
Defending his position, Huckabee argued ā€œwhen you buy insurance youā€™re buying something in the private sector.  Now maybe thereā€™s a place to say if youā€™re really, really sick and you canā€™t access a traditional marketplace then should we have some form of safety net?  Yeah. Iā€™ve said that; I did that when I was Governor.ā€  
He called for ā€œa partnership between government and the private sectorā€ to insure people with pre-existing conditions. So what did Mr. Huckabee propose? 
He cited the Arkansas TEFRA program he started for families of children with serious chronic conditions as the model safety net program he would favor for people with serious illnesses.  In that program, Arkansas allowed families earning between $25,000 and $200,000 per year the option of buying into the stateā€™s Medicaid program by paying annual premiums of between $504 and $5,500.  After the family paid the premium, the state and federal government paid the cost of the care.
If you expand the Medicaid program and use means testing to include people with serious illnesses, this is about as public an option as you can get ā€“ even if you pass it off as just a ā€œsafety net.ā€
How Many People Have Serious Chronic Conditions?
How many people could this public option affect?  The answer is surprising ā€“ well over 100 million if he covered just those with serious medical conditions, and up to half of all Americans if he offered the option to all those with chronic conditions. 
Iā€™m one of them.  Like 55 million other adults, I suffer from chronic back pain.  In the past twenty years, Iā€™ve been to doctors, hospitals, and physical therapists for it, and taken prescriptions and over-the-counter pain medications.   
Back pain is inconvenient, but hardly life-threatening.  It could be different for me.  I could be one of the almost 75 million Americans with hypertension.  They may not have outward symptoms like I do.  But if they donā€™t manage their condition, it could lead to serious health consequences for them. 
Or things could be worse.  My condition could be serious and costly.  I could be one of the 100 million or so Americans with at least one serious and even life-threatening condition who need ongoing treatment.
I could be one of the 34 million with asthma, the 30 million with heart disease, the 24 million with diabetes, the 14 million with serious mental illness, or the 12 million with cancer. 
Death Sentences?
When insurance companies refuse to insure these people because of their conditions, they give some of them a death sentence. 
This isnā€™t an exaggeration.  Without insurance, many people canā€™t even afford the tests for their chronic conditions, much less the treatment. 
Consider this:  A member of my family had a bout with cancer a few years ago, and the treatment cost well over $100,000.  She now has annual diagnostic tests to make sure the cancer hasnā€™t returned.  The price of this yearā€™s tests was exactly $3,171.20.
If she were uninsured, she would have had to find the money for the treatment and the tests.  If she couldnā€™t afford the treatment, why do the tests?  If she couldnā€™t even afford the tests, then she would be gambling with her life.   
Why Sick People Need Insurance the Most
Insurance does two things for us when weā€™re sick, and this is why the sickest people need insurance.
It doesnā€™t just pay most of the cost; it also negotiates down the price for tests and treatment.  My family memberā€™s insurer negotiated the price of this yearā€™s tests down from over $3,100 to just over $1,400.
Taking on both roles costs insurers money.  Thatā€™s why requiring insurers to cover people with chronic conditions draws opposition from Mr. Huckabee.  He prefers a publicly-funded safety net.
This past summer, insurance commissioners in Florida, California, Michigan, Virginia, and Nebraska all said that they did not have the authority to enforce the consumer protection provisions of the health reform law. 
If they donā€™t enforce these protections, or if Mr. Huckabee were to convince Congress to repeal some of them, then what will people with pre-existing conditions do?  Their only alternative would be something like Mr. Huckabeeā€™s public option.  As a credible conservative voice and leading Republican Presidential candidate, will he be willing to sell this public option to a broad national audience, or was this just a one-night stand for him? 

Comments

  1. Mike Huckabee did not start TEFRA in Arkansas, it already existed, aka the Katie Becket Waiver. Then governor Huckabee actually tried to get rid of it, but after a huge backlash from Arkansas families, he came up with this option. If Huckabee had his way, it would no longer exist. Huckabee is a moron, in my opinion.

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