Much is being made of Bill Frist's admission he would support a healthcare reform package with a public option in it. Frist becomes the first prominent Republican to admit such, in itself newsworthy. Frist is a surgeon by trade, so his opinion has more credence. We're used to Republicans as pathological liars, so when one as promominent as Frist "breaks ranks", we pause.
There is something else Frist knows, as well as cardiac surgery and the Senate. Frist understands the finances of the healthcare business, and as such Frist knows the meaningful parts of the healthcare business, namely the providers and the patients, will benefit from an expanded pool of insured lives. Frist's true business has been his family's Hospital Corporation of America, at one time the largest hospital owner in the country. As such, Bill Frist knows an extremely important fact.
Bill Frist knows that Medicare's reimbursement rates are fair, and hospitals can be profitable when they are reimbursed at Medicare rates. Frist knows hospitals are today emptying out, as fewer Americans can afford to seek more aggressive interventions and therapeutics, including surgery. HCA would prefer to be 100% full of Medicare patients as opposed to being 40% full of private patients, because HCA faces enormous fixed costs that must be covered, including plant and equipment costs. The "death spiral" of higher medical insurance premiums has now run its course and all but destroyed the marketplace, and so we give Frist credit for being honest about the current situation.