Gordon Gecko (Michael Douglas’ role in “Wall Street”) was not right. “Greed, for lack of another word is (not) good.” However, the pursuit for an economic gain is good. That is what our economic system is all about. If you create the better mousetrap, you can and should benefit from that.

As it relates to the healthcare delivery industry, skilled physicians and surgeons who heal better than their counterparts are compensated accordingly. Pharma and other medical device manufacturers who find ways to treat and cure illnesses and injuries also benefit accordingly. One might make a case and I believe successfully, that the economic incentives in place have largely contributed to the the medical advances which our country and the world enjoy.

Competition is inherently good. It causes all of us to be better at what we do. If we do not perform in our jobs, we are replaced. If we do not serve our clients or constituency effectively, we are replaced. Competition keeps us at the top of our game.

So, does the inclusion of a Public Option increase or decrease competition? The Public Option is the government run health plan the folks in DC are discussing to include in the healthcare reform debate. On the surface it would appear to increase competition by adding one more option to the mix. Peel back the layers just a bit to see what it really means.

Medicare and Medicaid (Medi-Cal in California) are the 2 current public plans in place, and are the models being looked at to decide on a Public Option for the rest of the population. Both entities reimburse healthcare providers below their actual cost. The providers then have to charge private payers (those of us covered under private insurance plans, or cash paying customers) more to offset those losses. This is referred to as cost shifting. So everytime the feds squeeze reimbursement levels down to providers, we all pay more for the same services we were receiving before. So, follow the logic and the dollars: if a Public Option exists for mainstream America, and that model follows Medicare and Medicaid, the cost shift will be even greater. Private plans will not be able to compete with the public plan; people will not pay the higher prices that they are forced to pay because of the subsidy effect created. Then all we will have left will be the Public Plan, and competition will no longer exist.

“The Slippery Slope” and “The Camel’s Nose Under the Tent” are sometimes used as scare tactics for government involvement in programs, and often that is all they are. In this case, the fear is well founded. This is not a matter of fairness. Who, afterall really cares if anyone is treating insurance companies fairly,…other than the insurance companies, their employees and their shareholders? It is a matter of economics and choice. We need more competition and not less.

Private enterprise will never have a problem in effectively competing against a government run entity. Remember Fred Smith and that little company he started up a few decades back? Federal Express? And in California, we have a little experience with a public option. The HIPC (Health Insurance Purchasing Cooperative) was founded in 1993 to compete against the private payers. Years later, it privatized, and in 2006, it folded.

The playing field needs to be level,…again, not necessarily out of fairness,…but for our economic advantage and for choice.