In case you missed this

California legislator caught on microphone bragging about sex ("a lot") with two lobbyists.  Naturally, he was a "family values" Republican.  Good stuff:

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Do we need the public option?

Not exactly, but it's a smart policy idea and it would sure be better to have it than not to.  Is it worth giving up in exchange for the remainder of a reform program that will insure millions of currently uninsured Americans and stop the worst abuses of assurance companies?  You bet.  I'd love to see a good, solid public option, but as my health policy guru has repeatedly pointed out, it is not the end all and be all of health care reform.

In fact, Switzerland has a system of universal coverage relying on a variety of private/non-profit insurers with no publicly-financed insurance.  A.lot of health economists have suggested we should look to the Swiss model. 

 In his blog at the Times, Princeton economist Uwe Reinhardt explains you don't need the public option:

As I have argued in earlier posts to this blog, the choice of a public,
government-run standard health insurance plan would certainly go a long
way toward reaching that, but it is not a necessary condition for doing so.
Germany, the Netherlands and Switzerland all do offer their citizens
permanent, portable and stable financial security in health care
without the inclusion of a government-run health plan in the mix. That
achievement, however, requires fairly heavy regulation of the industry.

His earlier linked (above) post explains in some detail how this works in Germany.  Regardless of the country, though, the key to this approach is heavy regulation of the insurance industry.  For example, insurers are not allowed to make a profit on selling basic policies in Switzerland– they make their money on selling additional coverage.  Imagine trying that in the United States.  

After detailing how these countries make the system work: Reinhardt concludes:

All three countries offer their citizens reliable, portable health
insurance based on the principle of social solidarity, but without a
government-run health insurance plan like Medicare. The $64,000
question is whether America’s private health insurers would be willing
to countenance the tight regulation required for that approach.

Seriously, though, that's not a $64,000 question.  More like a $0.64 question.  There's absolutely no way America's insurers, or the members of Congress they own, would accept this level of regulation.  In which case, from an effective policy perspective, you really do need the public option.  

Political Science professor extraordinaire and sort-of-godfather of the public option, makes the case for why you really do need the public option in a nice interview in Salon.  Here's his fairly succint explanation of why we need a public option:

 

I think it's pretty clear why if you look at what's happened over
the last generation in American health insurance. Private insurance
plans have basically failed us, and we need to have competition between
a new nonprofit public health insurance plan that puts patients first
and not private insurance companies.

I've argued that the public
insurance plan really achieves three critical goals. It serves as a
backup for people who want to have a good plan that's available in all
parts of the country and that provides them with a broad choice of
providers. It provides a benchmark for the private insurance plans,
encouraging them to improve the delivery and cost effectiveness of care
and keep their premiums down. And it offers, finally, a cost control
backstop because public health insurance in the United States has
actually done a better job than private plans of keeping costs down
over time, and it could do a much better job in the future if it were
given the authority to innovate in the payment for, and delivery of,
care.

So, we don't need a public option, but if we want the smartest, most efficient policy, we should definitely have one.  Of course, smart, efficient policy is not exactly a hallmark of the U.S. Congress.  I'd love the public option with high subsidies and robust insurance exchanges, I'll settle for near universal coverage and getting some of the structures in place to make more reform easier in the future.

 

My research in Polish

So, I recently linked to the news release about my recent research.  Did a little searching today and found out that I actually made it into Polish media:

Rodzicielstwo zdaje si? pog??bia? polityczn? przepa??
mi?dzy p?ciami – zw?aszcza w odniesieniu do wydatków rz?du na opiek?
spo?eczn? – gdy? u kobiet nasila liberalizm, a u m??czyzn konserwatyzm
– komentuje wspó?autor pracy, dr Steven Greene.

And, as far as American media goes, I made it into a blog that I actually read from time-to-time, which was super-cool. Andrew Leonard's "How the World Works."  Twice!!   The follow-up is really interesting and definitely worth a read. 

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