Republican opponents of health-care reform will help it succeed

I hope historians give House Minority Leader John Boehner the credit he deserves for promoting health-care reform.

Creation of a public-health-insurance option is central to giving consumers a competitive choice, but the Ohio Republican is opposed to it, period:

"Listen, if you like going to the DMV, and you think they do a great job, or if you like going to the post office and think it's the most efficient thing you have run into, then you will love the government-run health-care system that they're proposing, because that's basically what you're going to have."

Interesting choice of examples. Washington state government was nimble enough to farm out auto registry to private agents who provide the service for a modest fee. Uniform procedures and electronic record-keeping reduce administrative expenses. Imagine.

Is the GOP party leader truly suggesting the U.S. health-insurance industry is a model of efficiency? As bitter and sardonic as the mirth may be, no one is laughing harder than health-care providers.

Doctors and hospitals spend enormous sums to slog through the paperwork and protocols of hundreds of different insurance plans. The expense — dutifully passed on to policyholders — is part of the endlessly escalating cost of health care in America.

The cruel, expensive irony is that all those legions of insurance companies do not represent any sense of competition in the slightest. Operating in a closed, lucrative loop, they have no incentive to change how they do business.

The presence of a public-health-insurance option gives consumers and employers a choice in the marketplace. If the alternative is as grim as the gazillion-dollar advertising campaign from the industry will suggest, then clients will stay loyal.

Of course, the truth is that employers are as eager for options as their baffled, anxious employees. As the expense of insurance has soared, access to coverage has eroded. President Obama cut to the chase on public perceptions:

"The American people understand that, too often, insurance companies have been spending more time thinking about how to take premiums and then avoid providing people coverage than they have been thinking about how we can make sure insurance is there."

The current economic upheaval starkly illustrates the failings of a health-care system that links insurance to employment. Parents of college graduates and 20-something adults see them entering a job market dramatically different even from the recession-racked '70s and '80s.

State lawmakers have a front-row seat to the public-policy dilemma. An open letter from 700 legislators around the country to the White House and Congress spoke to the need for a public-health-insurance option:

"The effects of these problems stress state budgets, exhaust family resources, result in lost worker productivity, stifle entrepreneurial spirit, and literally cause tens of thousands of deaths each year."

For all the hyperventilating about the anticipated costs to come, consider the expense of the inefficient system already in place. Calculate the costs to be avoided by keeping people healthy. Our current insurance system thrives on exclusion.

Pharmaceutical companies were adroit enough to barter a price-cutting deal last week with the U.S. government. Too bad the health-insurance industry is not prescient enough to be part of the solution.

America deserves better health care. Thank Republican Boehner for opposing it.

Lance Dickie's column appears regularly on editorial pages of The Times. His e-mail address is ldickie@seattletimes.com