PULLMAN – The so-called public option that many want to see included in healthcare-reform legislation would not keep the insurance industry honest, as some have claimed, but would bankrupt private health insurance companies and result in a single-payer system.
That was one nugget gleaned from a dense, hour-long lecture by Robert V. O’Brien Jr., titled “The Great American Health Care Debate.” O’Brien, executive vice president, Health Plan Division of Group Health Cooperative, delivered the 2009 Walton Lecture sponsored by WSU’s Risk Management and Insurance program in the College of Business Monday afternoon at WSU Pullman.
According to O’Brien, $90 billion to $100 billion is shifted from Medicare to private providers annually because of the government’s low reimbursement rates. If people were offered a government-run public option that set similar rates, he said, the entire industry would go bankrupt.
“End of competition, hello single payer,” he said.
While O’Brien came out strongly against the public option, he focused most of his lecture on the history of healthcare reform in the United States, taking his audience on a tightly packed tour of significant people, cultural shifts and legislation that have brought us to where we are today.
Mark McNamara, the WSU Mutual of Enumclaw/Field Professor of Insurance, said O’Brien’s lecture was a great opportunity for students and community members to better understand the current debate in Congress.
“I thought Bob O’Brien did a fine job tracing the healthcare debate in the United States from the 1930s through today and exploring the complexities of the issue,” he said.
The issues are complex, O’Brien said, but the current debate has been “notable for its absence of reason or fact.” Still, he said, the current system is unsustainable. The United States spends twice what other developed nations spend on health care, but ranks 37th in terms of health outcomes.
Still, O’Brien said he is optimistic that the legislation being debated – and voted on today – in the Senate Finance Committee is a step in the right direction. In response to a question at the end of his talk, he said reading through a draft of the plan reminded him of reading through Hillary Clinton’s plan in the early 1990s.
“I didn’t like everything I saw,” he said, “but I am impressed.”
Payment reform is a promising avenue for cost savings, he said, as is shared decision-making – giving consumers information about costs and outcomes so they can make more rational decisions about care. O’Brien said another direction to pursue would be creation of more cooperative nonprofit health systems, similar to Group Health or plans that have been implemented in Arizona and Massachusetts.
The two extremes of the healthcare debate were embodied by senators Edward Kennedy and Barry Goldwater, O’Brien said. Kennedy argued that universal healthcare is a moral imperative and Goldwater argued that freedom from government intrusion trumps all else.
The answer, O’Brien said, lies somewhere in between. Americans feel strongly about individual freedom and individual choice, he said, “but there is nothing in our character that says we cannot get this done.”
