Its back: "Public Option" Scenarios Take Center Stage Again

A true "Public Option" was all but dead just a couple of weeks ago with the only potential compromise approach that appeared possible being a "trigger" option for a government plan only if cost savings targets were not reached as has been proposed by Senator Olympia Snowe (R-ME). But in the past two days we have seen support re-emerge for a more "robust public option" perhaps from both the House and Senate.

It has been reported that President Obama told Democratic leadership at the White House Thursday evening that his preference is for the "trigger option" championed by Snowe which is a sign that the President wants to maintain a sense of bipartisanship around the health reform plan. At that meeting, Obama did not sign on to a plan being floated by Senate Majority Leader Harry Reid (D-NV) to include a different variation of the public option in the Senate bill — a plan that would create a national public plan but allow states to “opt out.”

One of the biggest concerns with a public option is the concern that payment rates and incentives might be based off of the Medicare system which would be a disaster for health care providers. Given this sensitivity expect the public option debate to continue to focus on the details as the various options are considered including both the "trigger option" and the "state opt out".

The October Kaiser Health Tracking Poll finds 57 percent of the public say they favor the creation of a “government administered public health insurance option,” however the poll indicates that this support dips to one-third (32%) when initial supporters are told that such plans “could give the government plan an unfair advantage over private insurance companies.” However, support for the public plan rises to two-thirds (65%) when initial opponents are told that public plans would be “a fallback option" similar to the "trigger option".

As the health reform debate continues into November and perhaps beyond it will be critical for health care providers to focus on the specifics of a public option with the hope that the flaws in the current Medicare system will not be expanded.