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Dueling Op-Eds: New York Times vs. Washington Post |
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Some of the largest and most influential newspapers in the country, The New York Times and the Washington Post, have weighed in on the public health insurance option. They both start from similar places, and yet they end up with completely different conclusions.
Both the Times and the Post start with the premise that there is more to health care reform than just the public health insurance option (like regulation on the insurance industry, affordability provisions, universal coverage). Both agree that the public health insurance option is likely to be a big political fight, and both note that progressives and conservatives are squaring off around the issue.
Now for the differences.
The most notable difference, really, is that the Times editorial endorsing the idea of a public health insurance plan relies on facts for its arguments, while the Post relies on misleading statistics.
Central to the argument the Post makes is the right-wing creation called cost-shifting:
It is difficult to imagine a truly level playing field that would simultaneously produce benefits from a government-run system. While prescription drugs are not a perfect comparison, the experience of competing plans in the Medicare prescription drug arena suggests that a government-run option is not essential to energize a competitive system that has turned out to cost less than expected. Insurers and private companies have been at least as innovative as the federal government in recent years in finding ways to provide quality care at lower costs. Medicare keeps costs under control in part because of its 800-pound-gorilla capacity to dictate prices — in effect, to force the private sector to subsidize it.
First, Medicare prescription drugs. There’s not much to say here, except that it’s well known that these plans pay an estimated 13% more for drugs and services than they have to. So we’re just giving away 13% of the money we spend to private insurance. Good looking out for the corporate world, Washington Post.
But onto the real misleading argument: cost shifting. The insurance industry argues that the prices Medicare pays are so low, doctors are forced to “shift costs” and raise the prices they charge people with private insurance. It’s a load of bull.
The non-partisan Medicare Payment Advisory Commission studies the phenomenon and concluded that cost-shifting is actually a cover for inefficient providers [pdf]. Hospitals that are the least efficient at controlling costs for everyone claim they have the greatest “losses” when it comes to Medicare. Hospitals that control costs more effectively not only have higher quality care, but have less “losses.” So really, when you hear cost-shifting, remember that’s just inefficient providers complaining Medicare doesn’t want to pay inflated prices for lower quality care.
Representative Becerra neatly took down the cost shifting argument a few months ago:
The Times, on the other hand, concludes, rightly, that fears of unfair competition are hyperbole:
What many critics seem to fear most is that a new public plan would sweep away its private competitors and evolve over time into a full-fledged single-payer system (sometimes called Medicare for all). No matter how fair the competition between public and private plans might be at the start, they warn that the government would find it irresistible to rig the outcome through its regulatory and pricing powers and its ability, in a pinch, to subsidize the public plan with taxpayers’ money.
That fear seems overblown. Innovative, nimble private plans with well-integrated service systems might outperform any government plan, just as some now outperform Medicare through better coordination of services, stronger preventive care and broader benefits.
The reality is, private insurance convinced this country it could control costs and provide coverage almost two decades ago, as our National Campaign Director, Richard Kirsch, and Congresswoman Jan Schakowsky explain:
Fifteen years ago the private health insurance industry told Congress and the nation that it could fix the health care mess if government got out of the way. The insurers said that they would control costs for American families and businesses and improve the quality of care. The American people, American business and the Congress aren’t about to buy that line again.
We’ve already tried it their way. And they’ve proved that they will always put profits over people. This time, let’s get some real competition from an honest broker. That’s why we need a public health insurance option, so real people have a real choice.
(also posted at the NOW! blog)
