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A recent New York Times highlighted Maine’s attempts at comprehensive healthcare reform. Their experiences serve as a cautionary tale for Congress.   The state established a public health insurance plan, expanded Medicare and Medicaid eligibility, and banned insurers from refusing to cover people with pre-existing conditions, but those actions have done  little to insure more of its residents.  Contrary to the promises of public option supporters, health care costs have only continued to rise in the state.

Reasons for the high health care costs range from the state-specific to the general. Unlike the bill that recently passed the House of Representatives, Maine’s healthcare reform legislation didn’t include a mandate to buy health insurance plans. It’s a vicious cycle: forcing health insurance companies to offer policies to unhealthy people with pre-existing conditions raises the rates for younger people; young adults will be even less likely to buy health insurance if their premiums go up, which results in the insurer’s risk being spread among less people. In the end, the older, unhealthier population remains in the pool and must contend with less affordable health insurance. Therefore, there is a larger uninsured population.

Granted, Maine is a market dominated by just one private health insurance company (which, with its effective monopoly, can increase premiums to their liking); and its population is older, sicker, and poorer than the U.S. in general. Senator Olympia Snowe points to her state as a cautionary tale of what may happen if drastic changes are made too fast. Snowe is a Republican that supports healthcare reform but is against the public option. Budgeting problems have caused Maine to cap enrollment of its own public option health insurance plan at under 9,000. The federal government, unlike most states, is allowed to run a deficit. However, it isn’t exactly rolling in the money right now either.

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I look at healthcare reform as a football field. It’s separated by a virtual, high-res 50-yard line controlled by the commentators at ESPN.

On one side of the yard line, there are politicians shouting at their quarterback about a health plan run by the U.S. government; one that would force private health insurance companies to compete with a presumably cheaper public plan (“GO PUBLIC PLAN!”). On the other side of the 50-yard line, there are politicians shouting at their quarterback about a health plan run by the U.S. government; one that would choke  private insurance company CEOs until they raised their premiums or be forced out of business (“GO PRIVATE ENTERPRISE!”).

Outside the stadium, insurance companies are having an awesome tailgate party in the parking lot.

The smell of hot dogs and hamburgers are filling the air, beer is flowing as fast as the crude jokes about the game going on behind them. If you look at recent public statements from some of these companies, it’s clear they couldn’t care less who wins this one. Because they know they’re going to be the ultimate winners, no matter who makes the last field goal.

After President Obama established healthcare reform as a top priority almost immediately after saying “I Will” on January 20, most major insurance carriers went into the locker room. Their public silence  was about as deafening as the Super Bowl at half-time.

But insurance industry analysts knew it was only a matter of time before the position papers, talking points and customer Q&A scripts started to trickle down, ready for public consumption. Company leaders just needed to huddle up and come up with a contingency plan. After the House won their own marathon Pro-Public Option showdown in overtime on Saturday night, it’s as if the coach for the insurance plans threw a cooler of Gatorade on themselves in victory.

Here’s a look at some of the not-so-partisan statements that have come across the newswires about the vote:

“…(we are) deeply disappointed with the legislation progressing in Congress. Both the bill proposed by the House of Representatives and the bill passed by the Senate HELP Committee miss the opportunity to address the underlying cost drivers in our health care system.” – WellPoint, nation’s largest health benefit company, with approximately 35 million policy holders.

“A government-run program would threaten employer-based coverage…An independent analysis by the Lewin Group found that millions of employees would lose their private coverage and be forced to join a new government-run health plan. People will reject proposals that could put at risk their employer-sponsored coverage.” – CIGNA Corporation, one of the largest investor-owned health care providers in the U.S., the bulk of which is employer-based.

“We support reforms that make the market work for everyone, by bringing more people in rather than creating a new government-run health plan that would cause millions of Americans to lose their private coverage.” – BlueCross and BlueShield Association, covers 1-in-3 Americans, approximately 100 million policy holders.

It’s no shock that none of the commercial insurers are behind the public option. But what’s a little surprising to me is  they’re not hanging out in the parking lot waiting for the post-game traffic to die down.

By making these dire threats about how people will lose their coverage; pay more for what they’ve got; or even lose access to insurance altogether (as in the odd assessments of CIGNA and BlueCross), it’s insulting to the American public.

If Uncle Sam were to open up shop down the street, private insurers only make their industry look like a bunch of spoiled sports  in a game where the ones who are crying foul are the ones the Fed will be counting on to administer their plan. It’s not like the U.S. Government has some kind of top-secret, underground insurance company waiting to jump out after the Senate vote and take over like King Kong in Times Square.

Bottom line: The insurance companies are going to be just fine no matter what happens in D.C. Public option or not. You know it, I know it and they most certainly know it. For the sake of public perception at least, insurance companies need to throw their full support behind health insurance reform (or at least pretend to, in an intelligent way) because the game’s  in overtime and nobody is injured on the field.

Reform is going to happen. They may not have wanted to be in the game, but  it’s now time to be gentlemen at the end and shake the winning coach’s hand on the way off the field.

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Marilyn Wann never bought into professional modeling marketing-speak proclaiming that “Thin is In.” It’s not because her physique doesn’t fit the phrase. For her, it’s a widely-held bullying tactic for the current authors of health insurance reform. Marilyn tells New York Times reporter Susan Saulny that an increasing number of slender Americans blame fat people — not Medicare, nor pharmaceutical company profits — for the most historic overhaul of our healthcare delivery system since the U.S. Government started Medicare itself.

“We’re kind of a popular punching bag,” says Wann, author of the book, “Fat! So?”

Physicians, dieticians and the scientific community have proven that there is a common link between obesity and a slew of chronic and terminal illnesses, from diabetes to heart disease. Healthcare bean counters claim that fat people increase the entire cost of healthcare for everyone, since they are more often diagnosed with long-term disease.

We’re all aware of the doomsday, sky-is-falling stats that apparently prove we’re all eating funnel cakes, Twinkies and potato chips all while sitting in front of the couch watching The Biggest Loser every night. It’s the stuff that sensational television and reality series’ feed off of. To be sure, the Robert Wood Foundation (a think-tank on healthcare issues) just published a study showing that two-thirds of us are fat. In four states alone, Tennessee, Alabama, Mississippi and West Virginia, more than 30 percent of its residents are statistically obese.

But Wann thinks it is somewhat discriminatory that corporate America is suddenly offering sums of money, free stays at fat camps and other incentives to overweight Americans in a thinly-disguised campaign to cut group insurance coverage costs while marketing the move as a gesture toward caring about the wellness of their employees.

On the flip-side, Wann and other obesity fairness champions say the efforts for reform are energizing opportunities to cultivate what she calls, Fat Pride. “Basically, we want to be treated with respect the same as everyone else.”

Who knows. Wann and her followers might start a movement toward true health insurance portability and help prove that individual health insurance is still affordable.

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