via Center for Community Change by Deepak Bhargava The emerging health care reform debate shows every sign of becoming a typical Washington D.C. exercise. Everyone is saying the right things while simultaneously allowing the lobbyists to gut any hope for our lofty words and intentions to come to fruition. For all the talk of change it looks like the corporate lobbyists will win the day. The case in point is the manner in which some Washington insiders seem intent on treating the public health insurance option as a mere bargaining chip. The issue is simple: when the horse trading is over, will people have the option to purchase either a public or private plan? A Lake Research poll shows a whopping 73% of voters want everyone to have a choice of a public health insurance plan. Private insurance company lobbyists, however, have made defeating that choice their top priority. Surprising? I think not. A public health insurance option would put downward pressure on costs and upward pressure on quality; something that would be good for people and bad for profits. What should surprise us about how this debate is shaping up is how many Washington insiders seem intent on treating the public health insurance option as a mere bogeyman – that is a means to scare insurance companies into making concessions. Are people who care deeply about real reform just deluding themselves? When the chips are down and back room doors close – will insurance companies simply agree to a few cost controls and the public health insurance option will then be quietly dropped in the nearest trash can? Will profits win and people lose? For the sake of the country – the public option must not be seen as a mere scare tactic to force petulant and greedy insurance companies to show up at the table. For my group, the Center for Community Change and others like Health Care for America Now who care deeply about putting the health care system on a path toward universal coverage, sustainable costs and higher quality care – the public plan option is the benchmark by which we will measure whether health care reform has truly been achieved. Regulation alone will not solve the problems of cost controls, reliability and higher quality health care access missing from private insurers. Private insurers will always have an incentive to find ways to decline coverage and raise costs to create more profits. According to a Harris Poll, only 7% of people judge private health insurance companies to be "honest and trustworthy." Trust in private health plans ranks above tobacco (2%) and oil companies (4%) but below hospitals (31%) and banks (21%). As it turns out – this is a case where public perception mirrors reality. A report from the American Cancer Society and Kaiser Family Foundation showed that despite having private health insurance, cancer patients are running up large debts, filing for personal bankruptcy and even delaying or forgoing treatment because they can’t afford care. We all live in dread of finding ourselves amongst those thousands upon thousands of Americans every month whose health care costs force them into bankruptcy – 68% of whom have private insurance but lose everything anyway. Basically, everyone besides private insurance companies and their lobbyists recognize that we must get a handle on the skyrocketing expenses which are bankrupting Americans, damaging business competitiveness, curbing job growth and lowering the quality of health care. Reigning in costs will require us all to recognize a simple and overwhelming fact: public insurance has a better track record than private insurance when it comes to constraining expenses while preserving access. Take a look at one simple measure: between 1997 and 2006, health spending per enrollee grew at 4.6 percent a year under Medicare, compared with 7.3 percent a year under private health insurance. This occurred while Medicare has maintained high levels of provider participation and patient access to care. As lobbyists fight to remove the public plan option from the health care reform debate – every member of Congress should take notice that private insurers are once again fighting against the will and interests of most Americans. They are doing what Wall Street has done for so long and what got us into our present economic mess: putting greed before the public interest. If Americans wake up after a health care reform bill passes and have no new choices – no public option for their families – they will know that after all the promises of change – it’s still business as usual in Washington.