Obama, where's the pressure on health insurers?

If the president's healthcare reforms don't include the option of government-funded insurance, there's no reason to think the private firms will really change their behavior.

Published May 12, 2009 11:16PM (EDT)

The only troubling thing about the President's statements today concerning health care reform was what he did not say: that he wanted any health plan that emerges from Congress to include a public insurance option for Americans who do not want to buy private insurance. But without this option, there will be no pressure on private insurers to adopt all the other reforms to control costs or give all Americans access to affordable care.

Every other reform proposal announced to date -- electronic medical records, comparative effectiveness research, prevention of chronic disease, payments for services rather than for outcomes, and so on -- has been talked about for years. The reason none have been adopted is health providers and insurers can make more money without them. Only with a government plan that competes with private insurers, and offers Americans lower costs if the providers and insurers fail to reform themselves, will the system be genuinely reformed.

Hopefully, the President's failure to mention a public insurance option today was not intended to signal to Congress that the White House is no longer especially interested in it. The Administration should quickly inform policymakers how important this option is as a spur to real change.


By Robert Reich

Robert B. Reich is Chancellor's Professor of Public Policy at the University of California at Berkeley and Senior Fellow at the Blum Center for Developing Economies. He served as Secretary of Labor in the Clinton administration, for which Time Magazine named him one of the ten most effective cabinet secretaries of the twentieth century. He has written 15 books, including the best sellers "Aftershock", "The Work of Nations," and"Beyond Outrage," and, his most recent, "The Common Good." He is also a founding editor of the American Prospect magazine, chairman of Common Cause, a member of the American Academy of Arts and Sciences, and co-creator of the award-winning documentary, "Inequality For All." He's also co-creator of the Netflix original documentary "Saving Capitalism."

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