A recent op-ed piece in the New York Times describes “A Public Option That Works” for health care in San Francisco. Briefly, the city has enacted legislation that creates the Healthy San Francisco program which deploys a medical home to coordinate care at designated public clinics and hospitals within the city. Low income participants receive heavily subsidized access while others have the option of participating in the program at rates lower than they would pay for an individual private insurance policy. The NYT article itself provides further details, including the structure San Francisco has devised to pay for the program.
Whether or not the Healthy San Francisco model would work on a national scale is open to debate, but if nothing else it proves that there are different varieties of “public options” out there and that each can mean something radically different. In other words, it’s rather disingenuous for those in Washington to propose a Medicare-like public option as the only option. It’s also a bit premature for any of us to support or oppose a public option until we learn the specifics of what a particular proposal actually entails. All of this underscores the need for cooperation. Perhaps we can take elements of a number of ideas that might not work on their own and combine them into one that will. Maybe with some rational objectivity and bi-partisan input we could devise an altogether new strategy that’s better than any we’ve seen so far.
As with so many other aspects of health care reform, there are many ways to approach the public option. We owe it to ourselves to consider all of them. Or to at least recognize that they exist. Personally, I don’t believe a federally-run public option is necessary or helpful, but as the issue continues to stir emotions and prompt heated discussion, we should at least know what it is we’re debating.
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