"The Founding Documents" Of The Public Option

In this week's edition of The Week In Blog at Bloggingheads.tv, The Heritage Foundation's Conn Carroll pushed an argument voiced by another conservative blogger Patrick Ruffini: that the initial intention of the public health insurance option was to create a Trojan Horse that would bring about single-payer health care and the demise of private insurance. The proof? Prof. Jacob Hacker's original policy papers.

As Ruffini blogged: "It was first raised in 2007 by Berkeley economist Jacob Hacker, and popularized as a device that would "someday magically turn into single payer." ... reading through the founding documents of the public option is about as damning as if one got ahold of a secret dossier of Milton Friedman's proclaiming school vouchers a necessary 'compromise' that would eventually usher in the death of public education in America."

One problem with that story: the "founding documents" from Hacker say the exact opposite.

The very first Hacker paper laying out his "Health Care For America" plan for a public option (which, it must be stressed, envisions a stronger public plan that found in any of the pending bills in Congress) says it plainly: "Equally important is what Health Care for America would not do. It would not eliminate private employment-based insurance."

A follow-up paper from Hacker published by the Institute for America's Future titled "Healthy Competition" further stressed the importance of maintaining a successful private insurance industry (emphasis added):

One of the key reasons for public plan choice is that public plans can offer a set of valued features that private plans are generally either unable or unwilling to provide. Stability, wide pooling of risks, transparency, affordability of premiums, broad provider access, the capacity to collect and use patient information on a large scale to improve care—these are all hallmarks of public health insurance that private plans have inherent difficulties providing. On the other hand, private plans are generally more flexible, and they have, at times, moved into new areas of care management in advance of the public sector. The bottom line, then, is that both public and private plans have unique strengths and weaknesses, and all Americans, not just the elderly or the poor, should have access to the distinctive strengths of a public health insurance plan, as well as the strengths of private plans.

So it doesn't appear that conservatives have actually read the founding documents, but have simply read Mark Schmitt's telling of the history of the public option at Tapped, which includes the line: "Ideally, it would someday magically turn into single-payer." True, for some liberals that would be the ideal. But it would only happen if the vast majority of Americans chose the public plan on the merits, not because they were forced into it.

But that never was Hacker's ideal, as proved by his own words. More importantly, as far as the legislative debate is concerned, it is far from the ideal of congressional policy makers. All the pending bills restrict access to the public plan to some degree in part to prevent any prospect of an exodus out of private insurance.

This is partly the reason why the Congressional Budget Office estimates the public option would cover only 10 million people, not the 100 million people conservatives keep claiming.

I encourage all conservatives to actually read the founding documents. They might learn something.

Views expressed on this page are those of the authors and not necessarily those of Campaign for America's Future or Institute for America's Future