If you go to any food store or pharmacy these days, you will find that in addition to many brand name products, there are quite a few generic options also available at a lower price.

If you want to buy Tylenol, it’s there, but if you want to get acetaminophen, the main ingredient of Tylenol, it’s also there, sold under the store brand or other non-branded companies, at a lower cost. The packaging might not be as nice or colorful, but the basic medicine is the same.

What if we offered a generic brand of health insurance, presumably a less expensive option?

We almost had one. Back in the days of the introduction of the Affordable Care Act in 2009, there was a proposal for a “public option” that would have allowed the public to purchase insurance from the government rather than a private company. Theoretically, cost controls would have kept prices down.

However, cries of the socialization of medicine were heard from Democratic and Republican leaders. In order to pass the legislation at all, that particular provision was taken out.

As a result, people were forced to go to state or federally run exchanges to purchase private insurance. Different tiers of services at different prices were developed: platinum, gold, silver and bronze medal plans — it was the Olympics of health insurance.

The Hawaii Health Connector, our local version of the exchange, spent $130 million dollars to enroll just 24,000 people. It was closed down at the end of last year because of its inability to sustain operations financially. All subscribers were directed to the federally run healthcare.gov site to enroll for coverage. The penalty for not having insurance was up to $975 for a family in 2015.

The success of the ACA can’t be denied. Insurance coverage was obtained for 20 million people and the rate of the uninsured reduced from 16 percent in 2010 to 9.1 percent in 2015, one of the biggest improvements in the last 50 years. But the challenges to the ACA are never-ending, heightened by the political climate of the presidential election. 

Democratic presidential candidate Sen. Bernie Sanders wanted everyone to have Medicare while presumptive Democratic nominee and former Secretary of State Hilary Clinton has proposed allowing anyone over 55 to “buy into” the Medicare plan. President Barack Obama recently reiterated his support to bring back the public option in the Journal of the American Medical Association.

So what is a “public option”?

Rather than having the government pay private companies subsidies for insuring people, why not have the government pay itself? Or have people pay the government for access to a “generic” insurance plan?

After all, less than 1 percent of physicians in clinical practice nationwide have “opted out” of Medicare. The rest accept this insurance plan. It’s reasonable in cost and if the current system is at risk of becoming insolvent in the next few years, infusing the system with a bunch of healthy younger people can only be a benefit. 

Many of the original health insurance companies have already left the exchanges, stating that the patients were too sick or that they couldn’t make money if they continued to provide the insurance coverage for that cost. Others raised their rates, hoping to still be able to profit in the market. Time will tell if the exchanges remain and which insurance plans are available.

If the government is running the plan and things are done like Medicare, then rates to purchase the insurance are kept low by keeping the reimbursement to doctors and hospitals non-negotiable and also low. Profits are made with volume and if the same administrative system is kept in place, there shouldn’t be a significant increase in costs for running the public option program. That will keep the overall cost of care lower. After all, taxpayers cover any shortfalls in the Medicare system. That’s all of us.

Private insurance companies would be forced to be more competitive in order to attract subscribers. Their rates, benefits, coverage and additional services would need to be packaged nicely to be entice employers and individuals to pay for their insurance coverage, especially if their rates were higher than the “generic” public option choice.

The reintroduction of the public option could be the next logical step in trying to equalize the health insurance industry. Not everyone buys brand name Tylenol, but enough people do to keep their sales high enough and the company in business. They see a value in it and spend their extra money for what they feel is worth it. There will still be plenty of subscribers to private insurance plans, but now there will be an option to go generic with health insurance.

No frills, basic coverage for all. A truly affordable care plan.