Lobbying is all about the wrong issue

Today's News & Observer story about Blue Cross/Blue Shield's lobbying against a public option in health care reform legislation should not surprise anyone. I received an automated telephone call asking me to look for an item in the mail that would include a post card to send to Sen. Kay Hagan (D-NC) urging her to support health care reform that strengthens Americans' right to traditional health care, or something slyly misleading to that effect. I threw the mailing in the trash.

Health insurers have been sending a lot of mailings this year urging support for Hagan's decision to let Americans keep their health insurance, yada, yada, yada. None of the mailings clearly stated that the true purpose was to oppose a publicly run health insurance option. I can't imagine how many millions of dollars have gone into this lobbying campaign. As angry insurance clients in today's N&O story have angrily realized, these are your health insurance premiums at work.

As the health care debate drags on in Congress, I am increasingly concerned that the debate is not about health care but only about health insurance. Reforming health insurance gives us an improved health insurance program, but it will be a system still plagued by the unintended incentives and consequences of the current system. In an earlier post, I recommended a David Goldhill article from The Atlantic, which advocated more radical reform of the health care system. If only health insurance is reformed, people with health insurance can still be bankrupted if the cost of treating a chronic illness exceeds their insurance company's lifetime cap.

While Blue Cross/Blue Shield and 100 members of the Senate nibble around the edges of a problem, they are ignoring the big picture. We need a national consensus that health care might not be a "right" (it's not mentioned in the Constitution), but it is a "public good," the same as education or parks. Health insurance is a huge industry, but it is standing in the way of essential reform that will make health care accessible for all.