Japan and the public option

I'm really tired of hearing all the alarmist nonsense in the US about the public option and the way it will kill American insurance companies and lead to a national takeover of insurance.

Japan has a public option. They also have private plans, union plans, company plans. There are even special plans for foreigners who don't like the Japanese public option but still want insurance. I'm not going to analyze the Japanese system in depth, except to point out that it is a lucrative insurance market that American companies have asked the US government to insist that the Japanese government open to them. Like a lot of other markets in Japan it's protected. This is admittedly out of date, but still significant:

The potential to make money is huge. Shukan Kinyobi once reported that the U.S. government is pressuring Japan to change public health insurance regulations. As it stands, if any part of a patient's treatment involves procedures or medication not covered by public insurance, the entire treatment cannot be covered by public insurance. The U.S. wants to isolate types of treatment so that American insurance companies can sell private insurance to cover treatments not covered by public insurance.

Admittedly, the system in Japan is complex and can be confusing for people who are just getting into it. Such a public option system can be unnerving for people who might move to it. Therefore, US insurance companies, presumably including the same companies begging the US government to get them into the Japanese system, are scaring Americans that the big bad public option is going to take over health insurance.

BULL!

The public option in Japan is what you have to put up with when you can't get insurance through your company or your union. It is the minimum plan to get insurance to people the insurance companies don't want or won't cover. As soon as I could get off it, because I had a regular job, I got off it. You would too. But it is necessary for two reasons:

1. The insurance companies can't, won't, or don't want to cover everyone. They don't now in the US. There has to be an option for people who can't otherwise get insurance. It doesn't have to be compulsory, but it has to be there. It's compulsory in Japan, but it hasn't been enforced, so people who don't want insurance (yes, there are such people) or who don't know about it (and there are too many of those in the foreign community in Japan) won't be on it. But there has to be a public option for even the possibility of universal coverage.

2. Competition with the public option will keep the private companies honest. It won't put them out of business. It just means that if they don't give good value for their money there is an option people can go to. They still make out like bandits.

Personally, I would put up with single payer, but I would prefer the public option.