Times Picayune Front Page Article June 23, 2009
Obama health plan earns La. disdain.
WASHINGTON -- President Barack Obama insists that offering Americans the choice of a government-run alternative to private insurance is indispensable to health care reform.
That public option, Obama wrote Sens. Edward Kennedy, D-Mass., and Max Baucus, D-Mont., earlier this month, would give Americans "a better range of choices, make the health care market more competitive, and keep the insurance companies honest."
Liberal activist groups last week began bombarding Sen. Mary Landrieu, D-La., with negative ads -- online to start, with radio and TV ads to follow -- for opposing the public option.
In fact, no one in the Louisiana congressional delegation supports the public option as envisioned by Obama, and only freshman Rep. Anh "Joseph" Cao, R-New Orleans, remains undeclared on the question.
"At this point, I'm not sure where I stand on it, " Cao said.
The other Republicans in the delegation, including three medical doctors -- Charles Boustany, R-Lafayette, Bill Cassidy, R-Baton Rouge, and John Fleming, R-Minden -- all say they think a public option would ultimately destroy the private insurance market.
They agree with Mike Reitz, president of Blue Cross and Blue Shield of Louisiana, who made the rounds on Capitol Hill last week, visiting every member of the delegation except Cao and Boustany.
Reitz said that inserting a public plan in the market would rig the process. The tax-supported system, he said, would be able to artificially lower premiums and shift costs to private insurers, cutting away at any competitive advantage they might have.
"The government makes the rules, so they are always going to win the game, " he said.
Reitz predicted that employers would drop private coverage en masse, forcing employees in huge numbers into the public system.
"What employer is going to want to cover their employees if the government will do it?" Rep. Rodney Alexander, R-Quitman, asked.
Rep. Steve Scalise, R-Jefferson, said consumers who move to the public plan won't realize until it's too late how limited their health care choices will be.
Landrieu and Rep. Charlie Melancon, D-Napoleonville, the delegation's only two Democrats, said they think a government-sponsored health care option should be introduced only under certain circumstances.
Melancon said a public alternative should be "an option of last resort" if market forces fail to lower health care costs.
Landrieu spokesman Aaron Saunders said the senator supports a "predominantly private system that features a federal backup plan that serves as a safety net." While she is "open to compromise, " Saunders said, Landrieu "does not believe that health care reform starts with a public option."
Landrieu's Republican Senate colleague, David Vitter, recently congratulated her for agreeing with him.
But activists supporting Obama's effort are incensed, especially because Landrieu signed a letter on the eve of her re-election last fall pledging her support for overhaul that included the choice of a "public health insurance plan." Saunders said his boss hadn't read the letter carefully.
An advocacy group called Change Congress has launched $10,000 in online ads, focused in New Orleans, asking: "Will Mary Landrieu sell out Louisiana for $1.6 million?" The dollar figure refers to the sum Landrieu has received in political contributions from health and insurance interests over the course of her senatorial career.
By week's end, MoveOn.Org announced it would air similar 60-second radio ads this week in New Orleans, while Democracy for America, a sister organization of Change Congress founded by Howard Dean, was creating a Landrieu-focused TV spot.
Besides the political donations to Landrieu, the Change Congress campaign features a testimonial from Carrollton resident Karen Gadbois, founder of the Web site "Squandered Heritage" and a breast cancer survivor who has no health insurance coverage for herself or her teenage daughter.
Later in the week, Change Congress promoted the story of Zach Hudson, a senior at the University of New Orleans who volunteered in Landrieu's re-election campaign but is now "disillusioned."
Hudson was most recently in the public eye as the young man who launched the campaign to persuade adult film star Stormy Daniels to run for the Senate against Vitter. Hudson said he is no longer involved in that effort
To Fleming, what supporters of a public option really want is a single-payer system. "It's just the first step to what their ultimate objective is: the elimination of competition, " he said.
But Alex Lawson, a health care researcher with the Institute for America's Future, said "health insurance is a classic example of a market failure" that can only be jolted into real competition by a robust public alternative.
Lawson is an author of a recent report that found that in Louisiana, Blue Cross and Blue Shield controls 61 percent of the market.
"There is absolutely no competitive pressure to either compete by delivering better services to the customer or by driving down premiums, " he said. "They can set rates at whatever they want to -- and do."
But Reitz dismissed that notion, saying Blue Cross and Blue Shield competes hard for every dollar in Louisiana.
The fate of Obama's public option is very much up in the air. At the end of last week, House Democrats issued a plan that included a public option, but the draft of a Senate Finance Committee plan, more mindful of centrists such as Landrieu, did not.
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Jonathan Tilove can be reached at firstname.lastname@example.org or 202.383.7827.