Michael Critelli
Executive

Michael Critelli

Michael J. Critelli served as the chief executive officer at Pitney Bowes, a mailstream solutions company, for 11 years, where he innovated in employer-based health care.

A Public Plan Is a Bad Idea

The only reason to have a public health plan is to ensure that those not able to covered by private health insurance plans have some kind of coverage. If health reform legislation required private insurance plans to accept every applicant without excluding pre-existing medical conditions and if every individual were required to purchase health insurance, virtually all currently uninsured Americans would have coverage.

I cannot imagine that any public health plan operated under the same rules as a private insurance plan could be competitive. The public plan would be subject to all sorts of political interventions and would be required to delay making changes in health plan until it had solicited extensive public comments. A public plan would not be allowed to operate as flexibly with respect to labor work rules or to invest in much technology innovation as a private insurance carrier. Therefore, it would naturally be less competitive if left alone.

So what would happen? Taxpayers would be forced to subsidize the public plan, which would be subject to less onerous law and regulations, and it would operate with different accounting and tax rules to enable it to offer competitively attractive insurance coverage. Based on my experience with non-U.S. postal services allowed to compete outside their national postal monopoly spaces, national governments gave extensive and illegal state aid to post offices, subjected them to more favorable accounting rules, and imposed labor rules on private sector competitors to "level the playing field."

In a great book entitled "Competing with the Government: Anticompetitive Behavior and Public Enterprises" edited by R. Richard Geddes, a whole series of articles describe a range of anti-competitive public enterprises in a wide variety of markets. We do not need to create the material for another chapter in a future edition of this book.

By Michael Critelli  |  August 4, 2009; 12:42 AM ET  | Category:  Health Care Reform , Health costs , Insurance , Politics , Public option
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There are far to many powerful opponents to allow a public option to get a fair hearing. To-date the opponents of a government option have spent $53 billion with false information trying to sink even a fair debate. This amount of money is only spent when the threat is real and they know there monopoly is under serious competition

When a government as hold of the purse strings, insurance company’s have no choice but to get real and stop taking there clients/customers to the cleaners with unfair costs and exclusions.

There is more than enough evidence to prove beyond doubt, people get better health care and live longer when there is a Government option. Surely its about giving people a choice, and if the insurance company’s are treating there customers fairly, then they have nothing to worry about. America as 1 in 7 people without insurance, and another 2 in 7 with exclusions, due to pre existing illness.

Where is the fair choice for these people? insurers have no risk they just price people out of health care and exclude them. Call this competition? This why a public/people's plan will work

Why not have a people's plan, and see how it goes, it cant be any worse than the existing system. Why are the opponents frightened of such a system be given a try????. Of course they wont be able to fleece all there customers for much longer.

Health is more about people than profits “Well in every country other than America” Why do Canadians and Europeans live longer, they have access to health-care, that’s not based on the means to pay, but based humanity and fairness, no-matter what your current health or financial position.

Posted by: Gyp-Illinois | August 12, 2009 11:15 AM
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There are far to many powerful opponents to allow a public option to get a fair hearing. To-date the opponents of a government option have spent $53 billion with false information trying to sink even a fair debate. This amount of money is only spent when the threat is real and they know there monopoly is under serious competition

When a government as hold of the purse strings, insurance company’s have no choice but to get real and stop taking there clients/customers to the cleaners with unfair costs and exclusions.

There is more than enough evidence to prove beyond doubt, people get better health care and live longer when there is a Government option. Surely its about giving people a choice, and if the insurance company’s are treating there customers fairly, then they have nothing to worry about. America as 1 in 7 people without insurance, and another 2 in 7 with exclusions, due to pre existing illness.

Where is the fair choice for these people? insurers have no risk they just price people out of health care and exclude them. Call this competition? This why a public/people's plan will work

Why not have a people's plan, and see how it goes, it cant be any worse than the existing system. Why are the opponents frightened of such a system be given a try????. Of course they wont be able to fleece all there customers for much longer.

Health is more about people than profits “Well in every country other than America” Why do Canadians and Europeans live longer, they have access to health-care, that’s not based on the means to pay, but based humanity and fairness, no-matter what your current health or financial position.

Posted by: Gyp-Illinois | August 12, 2009 11:15 AM
Report Offensive Comment

There are far to many powerful opponents to allow a public option to get a fair hearing. To-date the opponents of a government option have spent $53 billion with false information trying to sink even a fair debate. This amount of money is only spent when the threat is real and they know there monopoly is under serious competition

When a government as hold of the purse strings, insurance company’s have no choice but to get real and stop taking there clients/customers to the cleaners with unfair costs and exclusions.

There is more than enough evidence to prove beyond doubt, people get better health care and live longer when there is a Government option. Surely its about giving people a choice, and if the insurance company’s are treating there customers fairly, then they have nothing to worry about. America as 1 in 7 people without insurance, and another 2 in 7 with exclusions, due to pre existing illness.

Where is the fair choice for these people? insurers have no risk they just price people out of health care and exclude them. Call this competition? This why a public/people's plan will work

Why not have a people's plan, and see how it goes, it cant be any worse than the existing system. Why are the opponents frightened of such a system be given a try????. Of course they wont be able to fleece all there customers for much longer.

Health is more about people than profits “Well in every country other than America” Why do Canadians and Europeans live longer, they have access to health-care, that’s not based on the means to pay, but based humanity and fairness, no-matter what your current health or financial position.

Posted by: Gyp-Illinois | August 12, 2009 11:14 AM
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Kathy-Ellen - "Although I am convinced a public option will work if you look at over 50 years of success in other countries."

Name me another country that has a public OPTION. They all require basic coverage, written and priced by the government for everyone. Like Medicae for All.

Posted by: lensch | August 7, 2009 12:30 PM
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To date there doesn't seem to have been enough incentive for private insurance companies to create plans more palatable to the American people. The threat of losing their monopoly may just get them to step back into the ball park. Although I am convinced a public option will work if you look at over 50 years of success in other countries.

Posted by: kathy-ellen | August 6, 2009 2:00 PM
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I agree that a public option would not work and for some of the same reasons you offer. But the solution is just the opposite of what you propose.

The goal of a well run corporation is to make money for shareholders. In the case of health insurance companies this is in conflict with providing good efficient health care to the country.

The for profit insurers have learned that the way to get a high stock price is to have a low Medical Loss Ratio which is the percentage of inflow (premiums) paid out in medical benefit to patients. Notice that they consider medical benefits as "losses."

They do this in two ways. They make the numerator smaller by making it difficult for doctors and patients to collect. They make the denominator larger by obscene executive compensation, high profits, billions spent processing complicated forms they require of physicians and patients, and still more billions spent on fighting with doctors and patients over coverage and payments.

What we need is HR676, Medicare for all. I am a mathematician. If you look at the figures, you will see that because of the waste of for profit insurers and the maketing costs of the drug companies, we can easily give an improved Medicare to everyone at no more than we are now paying.

Posted by: lensch | August 5, 2009 10:56 AM
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