Public Sector is for the Public Good, But Democrat Health Plan Is Not

The U.S. health care debate, with the public option used as a bargaining giveaway, reflects the perilous state of the public sector in America. It seems likely that Democrats will soon pass a health care “reform” bill that locks in the current privatized system, even going so far as to create what amounts to a mandatory “private tax” that helps insurance companies make even greater profits at the expense of people's health security.

This means that billions in mandated premiums and other fees, and billions more in public subsidies, will be directed to privatized health care, instead of to efficient, fair and democratic public health care. This amounts to far more than creating a free-market solution, since there's no choice for people to participate in this new mandated private system. What Americans are getting is a mandated private monopoly system – the opposite of both a free market or public sector solution, and a major affront to democracy. What's at stake is people's health security.  Respecting the power of ordinary people to solve problems by having a voice in how things get done is the best way to ensure the health security of everyone in America.

While both kinds of taxes (public and private) are mandatory, private taxes paid to corporations are different than public taxes paid to government. That's because taxes to government are raised fairly and equitably, and then are pooled by the whole community to spend on public programs for the public good. With public taxes, all of this is done with the oversight of elected officials and democratic institutions. In contrast, private corporations are not democracies, and exist to make a profit – not to serve the public good.

The idea of providing universal coverage by mandating that everyone buy insurance is like solving hunger by making it illegal to not eat. Even worse, the bill that is likely to pass in the Senate would be like mandating that you buy food from private companies only, without any public option or real oversight. The solution is worse than the free market, since there is not universal health security or equity in health care, but there is also no choice to be part of the private system or not.

While there will be some subsidies these will only further line the pockets of insurers, and will leave out millions of people. There also will be requirements that insurers actually sell you insurance. But they can charge up to three times more to the sick and the old - to those who need insurance the most. So when you're young or healthy you have no choice but to pay for insurance you might not need, and then when you are in the greatest need your premiums might go to $20,000 – and mandate or no mandate, you can't afford that. In a public system you'd pay taxes, and when you needed care you'd get it. Your taxes are based on your earnings, not your health. And when you are oldest, and least likely to be earning an income and most likely to need care, you'd get care regardless of your ability to pay. That's the fairness inherent in public sector solutions.

The private sector cannot provide health security to everyone living in America because it's not designed to do that. Unlike private corporations, government is designed to ensure public participation, provides a fair and equitable means of public pooling of resources, and has the mission of advancing the public good - since there is no profit to be made by the government. The aim of government should be to maximize the public good.

The very worst part of the Democratic party's health care reform measures is that these measures won't provide health security to everyone living in America. The scheme being proposed and considered now will fail to provide health security to millions of people. This means that many people will continue to go bankrupt in order to live, many more will die for lack of coverage, preventable illnesses will continue do harm to millions, and Americans will continue to live in fear of the private health insurers who care only about the bottom line.

The health care developments reflect a full out assault on the public sector, or on democracy itself. The public sector provides people with services and programs too valuable for private sector control. But the attacks against the public sector are clearly working. As a result, public education, public infrastructure, public transportation, public regulation and the public good are all under threat. This is alarming because the public sector alone has the mandate and means to ensure equity and fairness for all, and to use public resources to solve problems and improve the quality of life for our communities as a whole.

In contrast to the private sector, the public sector is efficient, fair and democratic. That's why health care should be provided by the public sector, driven by values of fairness and equity, and governed by elected bodies. Private corporations exist to serve narrow private interests, but governments exist to serve the common good. Private corporations are accountable only to their owners, but the public sector is accountable to everyone. Private corporations compete against each other, seeking to maximize private gains by any possible means. Governments seek to unite people, and work to maximize the public benefit. The attack on the public sector is an attack on democracy, and is an effort to move power away from government assemblies and into corporate board rooms. It is an attack on the power of ordinary people to improve the quality of life together, to have a voice in how things are done, and to ensure that our needs are met.

Tom Kertes