As lawmakers on Capitol Hill hammer out legislation to overhaul the nation's health care system this year, Health and Human Services Secretary Kathleen Sebelius says that a single-payer option is not on the table.
"This is not a trick. This is not single-payer," Sebelius told Steve Inskeep. She added: "That's not what anyone is talking about — mostly because the president feels strongly, as I do, that dismantling private health coverage for the 180 million Americans that have it, discouraging more employers from coming into the marketplace, is really the bad, you know, is a bad direction to go."
Remaking the nation's health care system is a massive task: The industry constitutes 18 percent of the U.S. gross domestic product. But those skyrocketing health care costs — and the increasing burden they put on the U.S. economy — are exactly why the president says a health care overhaul must be a national priority.
As debate gets under way over Obama's initiative to revamp health care, Republican opposition has centered on one of the key pillars of the president's proposal: the so-called public option — a publicly funded insurance plan that would likely compete against private insurers.
A public health insurance plan, Sebelius said, will put pressure on private insurers to keep costs competitive. "And that's a good thing," she says. "I think that's a good thing for the American public. Medicare right now has lower overhead costs than private insurers."
Republicans argue that upward of 100 million Americans would opt out of private insurance in favor of a public plan if such a plan were available. That figure comes from a study by the Lewin Group, a consulting group owned by Ingenix, a subsidiary of UnitedHealth Group, but it is a selective representation of the study's findings.
Sebelius disagrees with the GOP's number. But she says that there are "potentially 50 million-plus new insurance customers, whether you're talking about a private plan or public option."
Republicans have also raised the specter that a public option could evolve into a single-payer health care system where funding comes from one source — usually the government. The GOP says that such a system would lead to health care rationing and long delays in treatment.
Asked if the administration's program will be drafted specifically to prevent it from evolving into a single-payer plan, Sebelius says: "I think that's very much the case, and again, if you want anybody to convince people of that, talk to the single-payer proponents who are furious that the single-payer idea is not part of the discussion."
Sebelius says such concerns are unfounded because a single-payer plan is not under consideration, and these "draconian" scenarios have muddled the conversation over the president's proposal for a public option.
"The whole idea of the public option has been difficult, in part, because some of the opposition has described it as a potential for a, you know, draconian scenario that was never part of the discussion in the first place," Sebelius says. "So, disabusing people of what is not going to happen is often difficult, because there's no tangible way to do that."