Should a health reform package include a government-backed public insurance plan? The question of the so-called "public option" has clearly become the greatest obstacle to passing a bipartisan health reform package.
It took center stage at a hearing on health reform proposals in the House of Representatives' Ways and Means Committee yesterday. Chairman Charles Rangel (D-N.Y.) was mild in his support for a public option compared to previous statements he made (which include saying he'd never support a reform bill without a public plan).
Rangel largely floated above the fray and let his Republican and Democratic colleagues respectively attack and defend the public option. The intense debate carried over to the testimony from a panel of expert witnesses, some of whom supported the option and some who didn't.
David Gratzer MD, a practicing psychiatrist and a senior fellow with the Manhattan Institute, said the public plan would lead "inevitably" to a single-payer health care system. Such a system would be bad for patients, Dr. Gratzer said, because similar systems in Canada and Britain force patients to wait weeks or months for access to a physician.
John Holahan, director of the Health Policy Center at The Urban Institute, argued in favor of a public plan, saying that "having a competitor to private plans, under a fair set of market rules, will provide more choice and place substantial cost containment pressure on the health care system."
The partisan debate carried over to these experts, whom the politicians used as proxies. Republicans grilled Holahan but generally pitched softball questions to Dr. Gratzer. Democrats barely questioned Holahan but focused their fire on Dr. Gratzer, forcing him to concede that Medicare, the country's current public insurance plan, has had a "transformative effect" and changed "millions of lives ... for the better," in the words of Rep. John Yarmuth (D-K.Y.).
As the hearing drew to a close, Rangel turned to the Republicans, grinned and said, "I think all of you have done a pretty good job trashing the public plan... and Canada and Britain in general." Everybody laughed and the mood lightened - if only for a moment.
For more on how the issue of the public option is stalling the push for health reform, read my full story on the hearing in Part B News.