Include a public option in health-insurance reform

BRASH, bullying talk by the nation's health-insurance industry exactly makes the case for keeping a public option alive in health-care reform.

Lobbyists are swarming Capitol Hill with threats of extraordinary premium increases for health-insurance coverage. Congress should take them at their word and create a government-run, competitive option for health-care consumers.

An insurance exchange has been proposed as a way to provide competitively priced coverage for millions of Americans who do not get health insurance on the job and cannot afford the scandalously priced private market.

Such a device would aggregate those individuals into their own giant pool, and let them shop for coverage at group rates. One of the insurance options could be a government plan, not unlike Medicare. Under such a plan, all the medical choices remain in the marketplace, but Uncle Sam handles the paperwork.

Variations on the theme include a version modeled after Washington's Basic Health Plan that would give states a role, a route proposed by Sen. Maria Cantwell.

President Obama is looking for ways to extend coverage and curb soaring costs. Private insurers are comfortable with their own excessive administrative costs, executive pay and stockholders to mollify, as the case may be.

In the same spirit of a competitive public option, the government ought to insist on volume discounts for pharmaceutical purchases through federal health programs and agencies. Not employing a standard business practice is an outrage and insult to taxpayers.

This recession laid bare the flaws of a health-insurance system linked to employment. The system places a heavy burden on U.S. companies that compete in a global marketplace where the competition does not carry that overhead.

Virtually all the legislation before Congress includes requirements for mandatory coverage, which not only presents the health industry with millions of new customers, but spreads the risk across a vast pool. Still the industry howls.

These latest bullying tactics are timely reminders that as legislation proceeds in Congress, all options need to be kept open. Create an exchange program that includes a public option.