Since government doesn't work well, there should be no fear of the public option. Sounds like it will tank and no one will choose it.
The problem is is that it is no option for the people: If it is your employer who is deciding which health plan, public or private, which he is going to offer you..... then his decision is ruled by the economics of what works best for him...... not you...... and what will satisfy enough workers to find people who will work for him. As long as unemployment is high... he virtually has an open playing field to hire from. On the other hand, if you're out of work and needing a job just to pay for food, housing and necessity for you and yours, you may have no choice but to opt for the employer who will hire you, regardless of quality of benefits or conditions.
If your employer has a choice between a private insurance with great benefits, and the government offered package: you think this is balanced? The government controls the rules by which it REGULATES the private insurance companies...... while at the same time it can waive the same restrictions and enforcement upon itself: If it chooses to, the government can add taxes to the private insurance companies.... but will it tax itself and pass those expenses on as a private insurer would have to do? If an insurance company underestimates its expenses to balance revenues.... it has no choice but to borrow or increase rates: The government can 'subsidize' at least for a while, its risks of cost overruns, and extend the time before it has to increase its rates: Another way the government can subsidize its care is through educational incentives and tuition forgiveness to medical practioners/doctors with the understanding that their practice will be paid at reduced rates by government contract..... which the private insurance sector can't compete with: While a private insurer will look carefully at a doctors' credentials, experience, and history before including him as a 'preferred provider', the government can actually protect those who may be short in their credentials, of relative inexperience, and little or no track record of history.
With the private sector, viable and competitive, the public is protected somewhat by the avenue of litigation should a doctor or practice step too far beyond the 'standards of care' in attending to and treatment of a medical condition.
Already, in some government funded programs (yes, some medically funded programs do exist to help the uninsured and poor obtain necessary health care), the citizen/participant in the program makes several agreements with 'the government' regarding their care.... which private insurers are not able to demand and keep their custormer base happy: Namely, the government dependant patient may have to sign contracts agreeing that he will see whatever doctor or specialist gets assigned to him and will not have a choice of who it is that sees him, nor to obtain a second opinion; that such doctors and specialists working under the government are acting as agents for the government and are not subject to litigation for malpractice, even if it is believed that a mistake has been made; and a patient agrees, by accepting this care, that he will comply with treatment prescribed by the doctor, whether or not that he agrees with the treatment, nor will he attempt to influence the doctor with unnecessary tests or treatments which are not prescribe by his care team.
Note here:
I've had 3 what could be VERY SERIOUS conditions diagnosed regarding my health..... but in each of these 3, I.....not the doctor, was the initiator: I was sent to a rhematologist about leg/joint pain and insurance would cover labs and everything but the one thing which I requested.... which was a TSH level. That was the very thing which came back skewed.... and treatment for low thyroid corrected my condition. Payment for lab was out of pocket, even though it resulted in successful diagnosis and treatment. But Government intervention might not even allow me this avenue. In a routine physical, I requested a mamogram which found a very curable beginning stage cancer. Fortunately I had COBRA at the time and it covered all but deductible expenses. Recently, I made a visit to the doctor and requested a TSH lab as my medication was increased last year and I wanted confirmation that it was good...... plus I also requested an EKG for a baseline, as I wondered if heart might be involved in my feelings of fatique over the last several years......... and it came back abnormal with a 'old MI'. A silent heart attack! I've seen a doctor at least twice every year since my cancer surgery... and complained each every time about feeling tired 'all the time'..... but not one had checked my heart even when I asked if that could be involved!....... Now what if this had been government care and because the 'consult' was taking part within a government program, the doctors had refused to grant my request? I might be left with untreated medical conditions which were getting worse or die without anyone knowing why unless an autopsy was performed!
As it is now with HMO's and PCP, an insured patient MAY have occassional out of pocket expenses/disputes with his insurance carrier for request concerning his care..... but he still has the option of making the request or going to another doctor in the program until he finds one that will follow through. But, with government contracted care, ..... everything from when one gets seen to who will be seeing you may be the 'luck of the draw' and if you don't agree with your doctor.... it may be like some insurance plans are beginning to go to..... that any change with providers may require a period between request and confirmation and a waiting length of time before the new provider can see one, while their medical care gets stuck in limbo...... if government permits a change at all.
