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July 5, 2015

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health care column:

Don’t allow states to opt out of public health care option

What good is any bill that purports to reform health care if states can opt out of the public option?

Now that the House has passed its version of reform, the Senate is shaping its bill, one that is expected to offer the option to opt out.

The public option is supported by many who think the government-run plan would be a means to reining in health care costs.

How can we, as a country, lower health care costs, if some states decide they don’t want to participate? What, then, will the measure be for calculating success?

There should only be a mandate if there is a public option, too. I don’t think health insurers should exclusively get the tens of millions of new customers, and then be able to charge what they want. What will their new excuse be for rising premiums? That they have to cover people with preexisting conditions? I would think all the healthy new people on their rolls would balance that out.

Rep. Dina Titus told me that she thinks those who are pushing for a vote to opt Nevada out of the public option would be surprised at the outcome. She thinks Nevada would vote that measure down.

But that is besides the point. Either have effective health care reform that includes a public option or don’t. Don’t leave people out because of where they live.

Now that the House has passed its bill, the Senate is working on its own version. After that, a conference committee crafts a compromise bill followed by another vote in the House and Senate, and if the stars align right, President Barack Obama could have a bill to sign before Christmas. But that is optimistic. Most don’t expect a bill passed and signed before the new year.

As I’ve stated before in my column, I believe there is no room for profits in health care if it’s ever to be affordable.

It’s not only health insurers who are profiting from people’s health — it includes drug companies, hospitals, medical billers, collection agents, lawyers, and yes, even doctors.

I’ve always thought that being in the medical profession was much like being a journalist: It’s a career you go into because you believe passionately in social service, in helping people and making this world a better place.

But I think the health care industry has lost its way, putting dollars before people.

This is not to say that there aren’t doctors and other medical professionals who care. There are. But our system is so overrun by profiteers, the good ones are often lost in the mix.

The problem is, and I think even health insurers will agree with me on this, is that the focus has been shifted from health care reform to health insurance reform. Yes, the insurance structure does need to be reformed, but so does actual health care in this country. We have to figure out how to lower costs across the spectrum if we ever want an equitable system.

Titus, who voted for the House bill, contends that everyone will sign up for health insurance coverage if they can afford it.

I disagree. For instance, the young invincibles not on a parent’s plan may decide they would rather save their money and elect instead to pay a penalty to the Internal Revenue Service come tax time.

In a video posted on Senate Majority Leader Harry Reid’s Senate Web site, he said he is seeking a moderate reform plan to create “a new structure of health care.”

The Congressional Budget Office hasn’t released its cost findings on Reid’s bill yet.

“The reason we’re talking about a public option is because we want a level playing field with the insurance company,” he said in the video posted Nov. 10. “We want something to make sure that that insurance company is honest. I think it’s the right thing to do. We’ve got to rein in the insurance companies, rein in the pharmaceuticals companies and make sure that we take care of Medicare, and do good things to allow people who don’t have insurance to have insurance.”

Doesn’t offering the states the option to opt out defeat the purpose?

Think about it: The Wall Street Journal reported the day after Reid proposed the opt out, health insurers’ stocks rose.

Nicole Lucht covers health care, workplace, energy and banking issues for In Business Las Vegas and its sister publication, the Las Vegas Sun. She can be reached at 259-8832 or at

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