The private insurance market will be an essential part of whatever reform plan emerges from Congress, but a public plan should also be strongly considered ”“ as an alternate route to health insurance coverage.

A public plan would encourage private insurers to try and match Medicare’s low administrative costs. Perhaps more importantly, it could ensure that there is a safe harbor for those facing serious illness.

In an interview with the Associated Press this week, Sen. Olympia Snowe, R-Maine, said she was not yet willing to endorse establishment of a  public plan. Yet she succinctly expressed the problem in relying on private insurers.

“I don’t think we can entirely depend on the private insurance market to deliver. They haven’t delivered thus far, and that’s why we’re in the predicament we’re in today,” she said.

In the U.S. today, profit-making companies exercise broad control over access to health care, and pursuit of profit sometimes overrides fairness and medical necessity. A public plan could help restore balance to our skewed health care system.

House and Senate hearings have documented  the discriminatory practices of insurance companies. There is ample evidence that firms routinely deny coverage to those at risk of illness, and avoid doing business in states like Maine, where consumer protection is strong.

Health insurance companies understandably prefer not to insure those who are older or at risk for illness, so they offer benefits and pricing designed to appeal to healthy consumers. And the actual use of health insurance often jolts patients who thought they had good plans ”“ they find that reimbursement is subject to many limitations.

The industry has also become cynical about avoiding their obligations altogether when big bills come due. In testimony last month, health analysts told a congressional committee that companies carefully review the policies of patients undergoing extensive treatment, looking for discrepancies that will enable them to break a contract.

Even inadvertent omissions can be considered good cause for rescinding a policy. At a recent hearing of the House Energy and Commerce Committee, patients told how this practice, called rescission, left them facing hospital bills without any coverage. Company officials defend rescission as protection against fraud, but a Texas woman battling breast cancer said she lost her coverage for failing to disclose a visit to a dermatologist for acne.

Health insurers protest the unfairness of having to compete against a public plan. We believe such competition should be considered healthy.

It’s hard to imagine how health reform will evolve even in the next few months. Rather than rule out a public plan at the start, we’d like to see debate and discussion of how such a  plan could be offered as just one option among many commercial offerings.

— Questions? Comments? Contact Kristen Schulze Muszynski or Nick Cowenhoven at 282-1535 or kristenm@journaltribune.com or nickc@journaltribune.com.