- The cost of health insurance is crushing the self-employed and microbusinesses that form the bulk of the rural economy.
- The availability of affordable and quality health insurance is the primary barrier to entrepreneurship—the most effective rural development strategy—reaching its potential for rural people and rural communities.
- Individual and business mandates with the current system as the only health insurance option are unlikely to address unique rural challenges.
- Workplace characteristics more common in rural areas are risk factors for higher rates of uninsurance, underinsurance and greater dependence on the individual insurance market, conditions all subject to issues of cost, choice and level of coverage that a public health insurance plan could address.
- Public health insurance plan available as an option helps address the rural risk factors leading to rural insurance instability and would act as a backup for all of the rural factors leading to greater insurance instability.
- A public health insurance plan could lead to significantly lower costs for businesses and households. Models show public health insurance plan premiums would be 16 to 30 percent lower than private plans, and premium savings would be up to 41 percent greater with a public health insurance plan [emphasis mine; Jon M. Bailey, director, Rural Research and Analysis Program, Center for Rural Affairs, "Why Rural America Needs a Public Health Insurance Plan Option," July 2009].
Bailey's colleague at CRA Elisha Greeley Smith has more on how the public option would boost the rural economy by alleviating the problem of "job lock," the phenomenon in which people stick with jobs in which they are less satisfied and less productive (economic impacts! invisible hand shackled!) just to keep employer-based health insurance policy.
Senator Thune is already bailing on his rural constituents by opposing the public option. Senator Johnson knows quite personally how good a public option is. Let's hope Rep. Herseth Sandlin's Blue Dog proclivities won't keep her from seeing how the public option is good for everyone in South Dakota.