Today On Point is discussing the Public Option Debate. They lead off with “The White House signals health care compromise, and could back away from a government-run ‘public option.’” Yet is that what is really going on?

It contradicts what Linda Douglass, communications director for the White House Office of Health Reform is saying:

“Nothing has changed,” she said. “The President has always said that what is essential that health insurance reform lower costs, ensure that there are affordable options for all Americans and increase choice and competition in the health insurance market. He believes that the public option is the best way to achieve these goals.”

Is it that the media has gotten the story wrong? Are they stuck in black and white thinking that the choice is between either the public option or health co-ops? Is there not the possibility of both? Could there even be potential synergy between the public option and health co-ops?

Personally, I want more choices for health insurance. The public option would be a great choice, and I don’t believe we can have meaningful reform without it. Health co-ops would be another good choice.
However, too much of the debate has been about limiting our choices to the existing private insurances companies.

On a story about health co-ops on NPR last night, Sen. Kent Conrad argued for health co-ops. His argument was weak conflating health co-ops with other very different forms of co-ops and presenting part of the price of health co-ops, but not the full price. This was talked about a little bit later in the show. Sen. Conrad had suggested that we could have health co-ops across our country for $6 billion dollars. However, that is only the amount of money necessary to meet insurance reserve requirements. The larger costs come in developing the infrastructure to process and pay claims.

In fact, health co-ops would probably be much more effective and successful if they didn’t have to develop as much claim processing systems. If we had a single payer health care system, we could still have health co-ops, the public option, and private insurance all delivered much more efficiently.

All of this raises interesting aspects of how a better health system could be designed. Perhaps, as part of the plan for health care reform, the Government could develop an open source claims payment system that they would run for the public option, would offer as a service to health co-ops or even private insurance companies, and other health insurance providers could use the source to set up their own payment systems.

Likewise, some of the ideas of health co-ops could be used in a public system, such as having policy holders elect oversight boards. If co-ops, which remain fairly unproven can show themselves to be as effective as a public option, people will choose co-ops instead of the public option, or perhaps parts of the public option, and other government run health programs could be administrated by co-ops. We’ve seen something similar in the way public, private, and charter schools are run.

The most important part is to move away from fear driven black and white thinking and moving towards a better thought out cooperative effort to improve health delivery in our country.

What do you think, without resorting to black and white thinking, would do the best to improve delivery of health care in our country?