A doctor explains why the public plan works


Posted by AzBlueMeanie:

Dr. Patricia A Gabow, M.D., CEO of Denver Health, "an integrated public safety net health care system serving Denver," wrote this opinion for the Denver Post Public/private health debate (emphasis mine):

America is immersed in an important discussion about how to reform our health care system. One proposed reform is the establishment of a public plan that would be available as one choice among many plans.

This public plan is estimated to be about 20 percent cheaper since its overhead would be lower, in part because it would have substantially lower management salaries. There would be no needed profit margin and no expensive, competitive advertising. Every American would still have a choice.

Nevertheless, we have heard objections from some components of the health care sector expressing concerns about the concept of public plans and the role of government in health care. Yet we should remember that right now we have five public government health plans in America — Medicare, Medicaid, SCHIP, the Veterans Administration health system (VA), and Tri-Care. The millions of Americans covered in these plans would not want to see them go away.

These public plans are crucial to many Americans. What senior wants to have the government-run Medicare go away? What family wants to see government-run Medicaid coverage for nursing home care disappear? What working parent wants to see government-run SCHIP coverage for their children abandoned? What soldier returning does not want to have access to the VA system? What military family doesn't want to use government-run Tri-Care insurance?

Moreover, no private or nonprofit component of the health care sector wants to see these five government programs disappear. In many cases, the availability of these programs has made those organizations profitable either directly or indirectly by taking the burden of many high cost and/or uninsured patients from them.

As someone who has been a public-sector provider for decades, I believe in the power of the public sector to provide high-quality, cost-efficient care. Denver Health is a local example of the utility of the public health care programs. The quality of care that is possible is demonstrated at Denver Health, which has one of the lowest hospital mortality rates in the country, and one of the highest childhood-immunization rates. Across the spectrum, from prevention to high-risk treatment, the public sector can succeed.

Not only is our public sector health care high quality, it is also cost efficient. The city's payment for indigent care has been essentially stable since 1991 and is substantially below many other cities'. Denver Health's Medicare charges are 50 percent lower than peer hospitals and Medicaid charges are 30 percent lower. Our charges are lower than the average in all 35 DRGs (diagnostic-related groups) as reported by the Colorado Hospital Association (2007) and the lowest in 25 of them.

Despite the fact that 46 percent of Denver Health's patients are uninsured, Denver Health has been profitable for 18 straight years. While Denver Health has the highest percentage of uninsured patients in the metro area, it has the lowest percentage of commercially insured patients, presenting little competition for the private health care market — something that has been a concern about a public plan. In many ways the coexistence of a government public program with private enterprise can be seen in the side-by-side competition of the U.S. Postal Service and FedEx — a choice that works for American consumers and for business.

Our experience has taught us that a public plan is a viable approach.

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AZ BlueMeanie
The Blue Meanie is an Arizona citizen who wishes, for professional reasons, to remain anonymous when blogging about politics. Armed with a deep knowledge of the law, politics and public policy, as well as pen filled with all the colors stolen from Pepperland, the Blue Meanie’s mission is to pursue and prosecute the hypocrites, liars, and fools of politics and the media – which, in practical terms, is nearly all of them. Don’t even try to unmask him or he’ll seal you in a music-proof bubble and rendition you to Pepperland for a good face-stomping. Read blog posts by the infamous and prolific AZ Blue Meanie here.


  1. Very informative and this may be a good example of how a public plan could work. But as far as reducing costs, officials from the Congressional Budget Office today stated that there would be no cost savings for 10 years under the current proposed plan. People want real reform right now, and there should be coverage available to everyone, and both private and public options should be available. Right now, people need to qualify for a government plan…why couldn’t they purchase one? There really needs to be more reform of the industry as far as regulation and price caps, and this is what isn’t being discussed really.