Patt Morrison for September 13, 2011

The public option is not dead, but will Californians vote for it?

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Joe Raedle/Getty Images

Yolanda Escollies (C) and others hold signs in support of a public option for health care reform.

Jamie Court, executive director of Consumer Watchdog, a Santa Monica-based consumer advocacy group, plans to put an initiative to add a state-run health care public option on California’s 2012 ballot. Opponents say the initiative doesn't improve the way health care is delivered and paid for.

Despite critics, Court says he'll push forward on his plans to circulate a petition to the public in January. “We believe the premium regulation is definitely something that Californians overwhelmingly favor, and we think the public option is something that they still favor,” Court said.

Court has written that health insurance requirements are a motivating force for the initiative: “By 2014, all of us will be required to buy health insurance or face tax penalties. The problem is that health insurance companies can charge whatever they like and raise premiums at will in California.”

He says this same scenario is what drivers faced in 1988 when they were forced to carry auto insurance. Court writes that the auto companies have given politicians millions so they can make billions over-charging Americans for auto insurance—a reality, he says, that isn't too far off from the modern health insurance system. He's also written that in 1988 the California Supreme Court “issued several rulings taking away the right of policyholders to hold insurance companies accountable.”

The advocacy group plans to spend roughly $6 million on its largely direct-mail campaign to get the 700,000 signatures needed to get the initiative on the ballot. This move, Court says, comes despite the fact his effort could be up against the $100 million insurance companies could spend in order to halt the initiative.

In opposition, Micah Weinberg of the Bay Area Council, along with others, say rising rates reflect rising health care costs and extended life spans, and the government should let competition keep rates down. Weinberg calls himself an “enthusiastic supporter of healthcare reform,” and argued on KPCC's Patt Morrison Tuesday that the system is already making reforms — reforms he feels the public option doesn't address.

“We're expanding insurance coverage by giving people insurance subsidies to purchase insurance through the exchanges, so that's exactly what we're doing. A public option doesn't get us any closer to that goal and it's not a helpful addition to what we're trying to accomplish,” says Weinberg.

Weinberg argues that the real answer lies in a sea change of the incentives for medical providers. What needs to happen, he says, “is changing the incentives of the people who provide the healthcare such that they actually make money for keeping you healthy.”

“Unfortunately, for much of the health care system, they make money only when they provide more volume of services, so, whether or not you need an MRI, you get one because there's compensation associated with that.”

Court is unsatisfied with Weinberg's argument and said he will continue to push for an initiative that he believes will be cheaper if backed by public support.

Weigh in:

At a time when California is strapped for cash, will voters decide that short-term health care public option costs will reap long-term savings? Or do Californians think government-run health care is a bad idea in general? If the initiative makes the ballot, how will you vote?

Guests:

Jamie Court, president and chairman, Consumer Watchdog, Santa Monica-based consumer advocacy group responsible for Proposition 103, which established regulatory and cost oversight of state auto insurance rates; author of The Progressive’s Guide to Raising Hell

Micah Weinberg, senior policy advisor, Bay Area Council, a business-sponsored, public policy advocacy organization in the Bay Area


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