SZD Health Law Scan : Health Care Lawyers & Attorneys : Schottenstein Zox & Dunn Law Firm : Strategic Planning, Managed Care, Insurance : Columbus, Cleveland, Cincinnati, Central Ohio

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The loudest objection we hear to a government funded public option is that it would compete unfairly with the private plans and eventually cause many employers to drop coverage for their employees. But despite extreme views on either side of this issue, some health policy experts believe that the health insurance marketplace could be structured so that both public and private health plans compete on a level playing field. See "A Modest Proposal for a Competing Public Health Plan" by Len M. Nichols and John M. Bertko of the New American Foundation (2008).

At a minimum, it would require that all rules apply equally, i.e., benefit package requirements, insurance regulations and pricing for risk adjustment. There is some precedent for this in other areas of the economy (e.g., federal flood insurance and private homeowners insurance; high risk state insurance pools). A level playing field would also require both providers and payers to seriously address the issue of cost containment, once and for all. By using the most modern health information technology, clinically proven "best practices" and other protocols, as well as incentives for patients to achieve and maintain good health care, it is not unreasonable to argue that the United States could re-allocate what it currently spends on health care to cover virtually all Americans without the need for burdensome taxes or rationing. Like any issue of this importance, there will always be winners and losers no matter how the health reform debate concludes. Those who oppose the co-existence of public and private plans in principle would do better to direct their criticism toward any proposal that fails to address the underlying causes of our health care dilemma.