Politics: The question of "the public option" in health insurance

Some critics of the health bill say, it doesn't go far enough because there is no public option.

Well, there is a new public item in the form of a long-term health care program. Excerpt:

As Kristen Gerencher writes on her Health Matters blog, in the health-reform bill that President Obama signed into law on Tuesday is a provision for a new long-term-care insurance pool. Once the program starts, unless you opt out, your employer will automatically deduct funds from your paycheck to pay for long-term-care insurance. Then, when the time comes to pay for a nursing home, home-health aide or similar services, people who've participated in this insurance pool for at least five years will enjoy a minimum $50-per-day benefit to help cover those costs.

Since I don't make my living tracking what is in legislation, I have to trust the media to point things out and this item flew under the radar. I have no idea how big this program will be or how it will work but it goes to show you what happens with giant legislation that things go in that get little attention.

Speaking of big, it was recently pointed out to me that we already do have some form of public option in Medicare and Medicaid. These programs are not available to all people but they have a large footprint in the health care system of America.

Can you guess how many $$$ were spent on Medicare? Medicaid?

Check it out here and here.

FY2007 Medicaid expense was $320 billion.
FY2008 Medicare expense was $468 billion.

For comparison, the total revenue of the top 10 for-profit insurance companies combined was $279 billion.

I have no idea how many non-profit health entities like Kaiser exist in the USA.

I see from a Kaiser web page that they are the biggest.
excerpt:

After the war, Kaiser Permanente opened to the public and quickly grew to become the largest delivery system of its kind in the United States—a distinction it holds to this day with more than 8.6 million members.

According to Wikipedia, their recent annual revenue was $34.4 billion.

The challenge in organizing any public option is that it exists in a different environment than for-profit insurance companies or even a non-profit like Kaiser. Big or small insurance companies and non-profit systems like Kaiser ultimately still have to pay their bills or they go bankrupt. In contrast, public options can reach into the tax coffers to bail themselves out if they run over budget. Medicare is going broke (in 2017) and Medicaid is busting many state government budgets. Thus, I don't think adding more public options are the "magic bullet" their supporters claim them to be. We should fix the one's we have already before adding more.