Obama (D-IL): “I don’t think we’re going to be able to eliminate employer coverage immediately. There’s going to be potentially some transition process” (3/24/07, at SEIU “Universal Health Care Forum”); “I happen to be a proponent of a single-payer universal health care system” (2003 at AFL-CIO event)

Frank (D-MA): “I think if we get a good public option, it could lead to single-payer; that’s the best way to reach single-payer” (7/27/09)

Schakowsky (D-IL): “And next to me was a guy from the insurance company, who then argued against the public health insurance option, saying ‘it wouldn’t let private insurance compete’ — that ‘a public option will put the private insurance industry out of business and lead to single-payer.’ He was right! The man was right!” (4/18/09)

They are correct, of course. The term “single payer health care” is just a fancy way of referring to a health care system in which each and every health care transaction goes through a middle man — and in which that middle man is the government (yes, the same one that runs the DMV, the Post Office, Medicaid, and myriad other offices and programs you’ve come to despise dealing with over the years).

Further, Frank and Schakowsky are correct about the “public option” being the best way to get to a single-payer system, for two reasons.

First, creating a federal health coverage entity to compete with private insurers keeps us locked in to our current expensive and inefficient “middle-man” way of doing health care business. The American health care system is the best in the world, but it is an expensive one — and a major reason for that isn’t a lack of regulation, but (a) too much regulation, and (b) a dependence on an expensive middle man to carry out health care transactions.

Dealing only with (b) here: If doctor visits and small medical expenses were paid out-of-pocket, instead of through a third party, then costs would come tumbling down, both because we’d be cutting out the middle man and because folks would actually know what things cost and, through the power of the consumer’s purse in a free market, effectively demand that those prices drop to a level they could — and were willing to — pay. Insurance shouldn’t be the payor for every expense; rather, it should be insurance against catastrophic events.

You don’t go through your homeowner’s insurance underwriter to purchase a new light bulb for the front porch, screen for your window, or doorknob for your bedroom door. Doing so would be ludicrous, because it would jack up your premiums, cause the price of those goods to rise as a result of administrative and middle-man-salary costs, and give you less control over your home repair dollars. So, you pay those minor expenses out-of-pocket and rely on insurance to back you up in case of unaffordable catastrophe.

The same should be true of health care. Unfortunately, not only do we honor (and pay for) the Unholy Trinity of Insurer-Doctor-Patient (with each leg of the triangle only being able to communicate and exchange resources with one other) in every medical transaction, but the drive toward “single-payer” health insurance which anti-private industry zealots like Obama, Frank, and Schakowsky are leading, is a one-way ticket to a permanent, bureaucratic health care middle man. The middle man needs to be cut out, not to have an impassable wall built around him by government.

Second, entering a government entity into competition with the private sector is a contest that is going to have the same outcome every time, for three simple reasons: (1) the federal government makes the rules, (2) the federal government has an unlimited supply of funds, being able to print and borrow as much money as it takes to fund its programs, and (3) the federal government is not constrained by the one Great Equalizer among private sector operations: the need to make a profit to survive. A federal entity can be “in the red” financially every year of its existence, and still be able to continue operating — something a private sector business simply cannot do, due to its absolute need to be able to make payroll, afford overhead, and pay its taxes.

When given the opportunity to include in their version of the health overhaul bill a provision specifically stipulating that the “public option” would not be able to make use of factors (1) and (2) above in its competition with private entities, Democratic members of the House Energy and Commerce Committee predictably voted to give their path to single payer a competitive advantage rather than to level the playing field.

During Friday’s markup of the House legislation, Rep. George Radanovich (R-CA) offered an amendment that would have prohibited the federal government from employing special tax breaks and favorable regulation on behalf of the “public option.” Radonovich’s amendment would have inserted language in the health overhaul bill that would have ensured the “level playing field” between the “public option” and private coverage that Obama, Congressional Democrats, and their allies claim to want.

Rep. Christopher Murphy (D-CT) argued that the government-run health coverage program would really be a nonprofit entity, and that as such it would be unfair to prevent it from receiving preferential tax treatment. Rep. Frank Pallone (D-NJ) went one further, arguing that the government-run health plan should be able to borrow cash from other federal agencies’ budgets in order to assuage any losses incurred by providing subsidized coverage to a massive swath of the American population — something that would, of course, reinforce the federal government’s natural competitive advantage by further removing any need to minimize losses in the marketplace.

What this means, in short, is that as written, the “public option” in the House health care bill is a one-way ticket to single-payer, government-run health care — period.

As a result, your options are to call your Senator and Congressman in opposition to this legislation, or to go ahead and take a number to see the next available physician at window C11 down the hall. The choice is yours — but the time to make it is now.