Leader Blues

Tuesday, June 23, 2009

EDITORIAL >> Blanche puts people first?

Arkansasí senior senator, Blanche Lincoln, is an important and perhaps even critical player in the drive to repair the nationís clumsy and extravagant health-care system and to guarantee care for everyone. We tend to think that it is a good thing for us and the country that she has such a role, but sometimes we have had misgivings.

At times in the past few months, her remarks about health reform have conveyed a trifle too much deference to the health industry, including the insurance companies.

Like all the other senators on the Finance Committee, she receives huge contributions from the medical and insurance industries, more than $500,000 in the current election cycle (she is up for re-election next year if you hadnít heard).

You worried that she might put their interests ahead of the consuming public that is served so poorly by the current system.

She had abiding concerns about setting up a public insurance option that would compete with Aetna, Blue Cross, United and the few other insurers. The government plan, she feared, might drive costs down so much that the companies couldnít compete and make a profit.

But then the good senator Lincoln resurfaces. Yesterday, the senatorís Web site carried a statement of the principles that guide her in the Finance Committeeís work on a comprehensive health-care plan. She said she would accept nothing less than a plan that gives every Arkansan, every person in the United States, access to affordable and high-quality health care.

She said she was evaluating the options that will achieve that, including a public insurance plan and nonprofit cooperatives, the government-sponsored nonprofits that she and a few others, principally Sen. Kent Conrad of North Dakota, were touting last week as a way to avoid more direct government involvement in health care.

No one knows what these cooperatives would look like, how much capital they would need from Washington and how they would differ from Blue Cross and Blue Shield, which already has three-fourths of the private market in Arkansas, or from the self-insurance plans that Arkansas and a number of other states operate. (Blue Cross no longer calls its state companies cooperatives but not-for-profit mutual insurance corporations.)

We take Senator Lincoln at her word. She will demand that everyone be covered at a price they can afford, that medical costs will be reined in, that people with pre-existing conditions will not be denied coverage as all the private plans do now for those seeking individual coverage and that people will be assured coverage when they are between jobs.

We do not grasp how that can be achieved without a public plan that carries the might to demand discounts and lower prices from providers and force the oligopoly of private carriers to compete. We are satisfied that if Lincoln does not find the competition compelling she will support the public plan, too.

People are her first priority in this historic effort, she said Monday. We take that to mean that despite its bundles of campaign money the insurance industry isnít. That is good enough for us.