Exploring a state-run health care plan
Democrats and Republicans continue to search for a common ground on the health-care debate. The latest idea: a state-run public health plan. What would that entail? Tamara Keith reports.
Nurse Amy Grover checks the heart rate of a 3-year-old boy in the emergency room of the Children's Hospital in Aurora, Col. (John Moore/Getty Images)
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Kai Ryssdal: If you had to pick one part of the health-care debate that's gotten the most attention, aside from maybe death panels, the public option would be a pretty safe bet. The lines are pretty clearly drawn. Democrats on the left generally believe a government-run health insurance option is the only way to create competition and so force insurance companies to cut their prices. Republicans and some moderate Democrats think a public plan would just drive those private insurers out of business. The search for common ground continues, though. Hence the latest idea. Forget the federal government. What about state-run public health plans. From Washington, Tamara Keith helps us imagine how they might work.
TAMARA KEITH: So, you don't like the idea of a national public plan. What about 50 smaller public plans run by the states?
Senator Tom Carper, a Democrat from Delaware, is shopping that idea. Those aren't his words exactly. Here's how he put it in a video on his Web site:
TOM CARPER: Say to states if you don't have much competition, you don't have very good affordability. You can elect to establish your own option, your own state option.
What would it look like? Say you're shopping for health insurance in Maryland. You'd probably go on a Web site listing all the plans offered in your state. There would be plans from the private insurers we all know, and:
MEG MURRAY: One option would be the so-called Maryland Health Plan or the state-based public option.
Meg Murray is the CEO of the Association of Community Affiliated Plans. She says states have experience with this because they manage Medicaid -- the health program for the poor. And she likes the idea.
MURRAY: We believe all health care is local and so that the public plan should be established and organized and run on a local basis.
Washington State already has a public plan of sorts. Washington Basic Health covers 83,000 of the state's working poor. The state contracts with private insurers. Members choose a plan and pay a small premium. The state pays the rest. Dave Wasser is with the Washington State Health Care Authority.
DAVE WASSER: They pay us their monthly premium but otherwise it's more like they are a member of that health plan that they've selected.
Wasser says it's a popular program. But it's still far from clear whether this idea will make it into the health-care legislation.
In Washington, I'm Tamara Keith for Marketplace.
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From Jacksonville, FL, 10/08/2009
I agree with Joey from St. Paul. This story is not what I expected in reading the article title. It would be nice to have something substantive on these issues instead of just cursory. He actually posed a lot of very good questions. NPR might consider hiring him to do a piece, or at least help with good questions!
From St. Paul, MN, 10/08/2009
This story doesn't even begin to "explore" a state-run health care plan. It only informs us of the existence of that option, giving incidental information about its implementation along the way. What are the benefits of such an option? The drawbacks? Are there subtle complexities we fail to appreciate on first glance? We're told Washington has such a system in place. How have they fared? Could the rest of the nation expect similar results, or is Washington in a peculiar position?
One reason our conversations about healthcare devolve into polemical screaming matches is that our news sources fail to frame the debate in productive terms. What is America doing wrong that pretty much every other country on Earth is doing right? Almost no media outlets are exploring this question. Instead, we get the same tired analysis that people disagree about the issue. Why do they disagree? Are both perspectives valid? What do those perspectives say about the people who hold them? What questions can we consider when we try to decide what to do about healthcare? NPR has a responsibility to exlore these ideas. Get with the program.
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