Watching the healthcare reform debate grow increasingly rancorous, I
am reminded of the oath taken by doctors and nurses when they begin
practicing medicine: First, do no harm. As a former nurse, I know that
this oath is the cornerstone of our work. Which is why, as this debate
unfolds, I wish that the politicians were also bound by this important
oath.
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Any plan that is signed by President Obama will not add “one dime to
our deficits now or in the future. Period.” One bill House Democrats
offered would add $220 billion to the deficit over 10 years, according
to the Congressional Budget Office (CBO). Democrats and the
administration have characterized the bill as deficit-neutral because
they are not counting the estimated $245 billion cost of adjusting
Medicare physician reimbursement rates. Further, CBO Director Elmendorf
is on record as saying that none of the proposed pieces of legislation
to date would create “the sort of fundamental changes that would be
necessary to reduce the trajectory of federal health spending by a
significant amount.”
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The public option will reduce healthcare costs by creating more
competition. Unfortunately just the opposite is true. By design, a
nonprofit, government-run and subsidized plan would have an unfair
competitive advantage. Public entities generally do not have to adhere
to state pricing or regulatory guidelines. Today, nine times out of 10,
the reason certain markets are dominated by one or two large insurance
companies is that state regulations make it challenging or impossible
for smaller, private insurers to compete. A public option will only
make this situation worse. In such an anti-competitive environment,
private insurers — entities that are facilitating access and choice for
millions of Americans today — would be forced to reassess whether it is
viable to offer coverage in markets across the country.