Phila Inquirer, 8/25/09, p. A11

Several government health programs already do a decent job of covering nearly half of Americans.

By Barbara W. Gold and Stephen F. Gold

Why have the words public option caused so much furor and fear in the health debate? The reality is that the United States has had public options in health care for more than 40 years.

Currently, Medicare covers 44.8 million elderly and disabled Americans, while Medicaid programs cover 58.7 million low-income adults, children, elderly, and disabled people. In addition to these, the Department of Veterans Affairs, school health services, workers’ compensation, and state and local government programs further swell the ranks of those covered by various public options today.

Throughout the current health-care debate, facts and data about the public option have been in short supply. But from the latest government data, we know:

Nearly half of current health spending is public. Private health-care spending, which includes all private insurance and out-of-pocket expenditures, accounts for only 54 percent of the nation’s total health-care spending. The remaining 46 percent is public - primarily by Medicare and Medicaid, but also other public health programs, including Veterans Affairs and workers’ compensation.

This ratio has remained relatively constant since the early 1980s. The “public option,” in other words, has been a reality of our health system for some time, and it has not eliminated private insurance.

Since 1982, health-care spending has consumed more and more of our gross domestic product. But private and public spending have increased at roughly the same rate relative to gross domestic product.

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