Reform is nothing to fear

Larry Summers, President Obama's chief economic advisor, recently described an "excess of fear" sweeping over the country. He was echoing Franklin D. Roosevelt's famous declaration "The only thing we have to fear is fear itself - nameless, unreasoning, unjustified terror which paralyzes needed efforts to convert retreat into advance."

Summers and Roosevelt were, of course, talking about the fear gripping the nation amid economic distress. But a similar fear has surrounded the country's efforts to reform health care.

In 1993, the health-insurance industry used fear to turn the American people against health-care reform. It helped scare people about losing the coverage they had, and political leaders lost the courage to reform the system.

Sixteen years later, the Obama administration officially kicked off its health-care reform effort in a summit at the White House. At the summit, the health insurance industry's main trade association, America's Health Insurance Plans, declared to President Obama that "you have our commitment ... to contribute and to pass health-care reform this year."

Those may sound like surprising words from the insurance companies. Why did they say that, and what is at stake?

The industry is probably counting on a mandate that all Americans carry insurance, as well as generous taxpayer subsidies to help people purchase their products. So far, so good. Health insurance is important to American well-being. It is a critical part of national security, in the true sense of the term, and is worthy of social investment.

But early on in this effort, the insurance industry has already made it known that it opposes another key element under consideration: a public health-insurance option.

During his campaign last year, Obama proposed a public insurance option, similar to Medicare, which would compete with private insurance plans in a more regulated market. As with the competition between FedEx and the U.S. Postal Service, all Americans would have the option of purchasing public or private health insurance.

It's your choice whether you send your mail through FedEx or the postal service. Sometimes I use the postal service, and sometimes I use FedEx. I like having the choice.

Why would anyone be against choice and competition? FedEx makes the post office better, and the post office makes FedEx better, and the competition benefits everyone.

But this is not what the health-insurance industry wants. Let's think about why not.

The industry might provide all sorts of arguments against a public plan. But in the end, what besides their own selfish interests could motivate their attempts to block an optional public plan? Why would you be against letting people make a choice unless you thought they wouldn't choose you?

The insurance companies are probably against an optional public plan because they have some fear of their own - fear that the public plan might be cheaper, more effective, less wasteful, and less of a hassle.

Maybe it will be. Maybe it won't be. But we shouldn't let the insurance companies' fears get in the way of health reform.

The insurance industry's strategy is hypocritical. For years, the industry has created the fear that a government role in health care would undermine choice. But how does an optional public plan do anything but expand choice? If the insurance companies are such fans of the market, then let the market decide.

When you hear charges that the administration's approach will lead to "socialized medicine" or put the government "between the doctor and the patient," call it what it is: self-interested fear-mongering.

My fellow doctors know that American health care is broken. Frankly, everyone knows it's broken. And competition and choice, including an affordable public insurance option, will go a long way toward fixing it. We can't let "nameless, unreasoning, unjustified terror" get in our way.

We should not fear fixing health care. We should fear what lies ahead if we don't.