Much ado about very little

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Health care reform quiz: The so-called "public option" will (a) drive private insurance companies out of business and eventually force every American to enroll in a single-payer, government-run health care system, or (b) force private insurers to compete for patients, thereby driving down prices across the board, and everyone will live happily and healthfully ever after.

The Congressional Budget Office, the nonpartisan agency responsible for analyzing the effects of legislation, has weighed in on the public plan contained in the House reform bill, and the answer is — ta daa — neither of the above.

The CBO says the public option would insure only those Americans not already covered by an employer or by Medicare or Medicaid (also known as government-run health care). That means about 30 million Americans would be eligible for the public plan, but the CBO says only 6 million would likely choose it. That's 2 percent of Americans under 65.

Furthermore, the plan might actually help private insurers, not hurt them. Those enrolling in the public option would have to pay most of the cost themselves, and their premiums would likely be higher because they are less healthy as a group. Healthier people would likely opt for private plans.

Can we get back to discussing real issues, please?

Unfortunately, that's not likely to happen in the poisonous political climate prevailing in Washington.

Sen. Joe Lieberman, who once was a Democrat but backed John McCain for president, says he'll filibuster any Senate bill that includes any public option whatsoever. On the House side, Rep. Virginia Foxx, R-N.C., said Americans have more to fear from the Democrats' health reform package than from terrorism.

Well.

What concerns us — far more than wild predictions of economic catastrophe or the sound of totalitarian jackboots marching in the streets to compel everyone to sign up for socialized medicine — is the fine print in the CBO projections. The 2 percent of Americans likely to choose the public option would do so by 2019, when the plan was fully implemented. That's 10 years from now.

We recognize that government is not known for blinding speed. We further recognize that altering the course of something the size of the health care industry is akin to asking a supertanker to do figure eights on Hyatt Lake.

But 10 years?

If the House plan suffers from glacial slowness, the Senate plan's public option could be worse than no public option at all: As currently drafted, it would allow states to "opt out." That would mean a public option for some, but not for all, depending on where they happen to live.

The whole idea behind covering every American under some plan, public or otherwise, is to reduce the number of people receiving emergency care they can't pay for, which drives up costs for everyone. Letting states opt out of full coverage defeats the purpose.

Then there's the issue of time. Senate Republicans are hinting they may drag out debate on health reform, possibly into next year, which puts full implementation that much farther off.

With that in mind, state efforts at fixing health care, such as the process now under way in Oregon, may have a better chance of actually improving health care than anything Congress can muster.

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