So says Speaker Nancy Pelosi about private insurance companies. What is immoral is their desire not to be forced out of business by a monopsonistic competitor who will - by taxpayer subsidy, market power or legal mandate - force prices to a level that drives them out of business.
That's what makes it a gaffe. An unintended statement of what she truly believes.
Low prices are, of course, generally a good thing, but not when achieved in this way. In the long run, they have to go back up or quality and innovation must suffer. This is why monopsony is considered a market imperfection.
It might be possible to design a public option in which this is not possible - or at least less likely - but I haven't seen any serious proposal to do that.
Which leads us to a more foundational question. Why must there be a public option? It is not required for a system of universal health care. The Netherlands and Switzerland don't have one (although private insurers are heavily - really overly - regulated).
There are three arguments. The first is that insurers make more money, the more they decline claims. One of the aspects of private insurance that has gotten little attention is that most people covered by their employers are not, for the most part, obtaining insurance from what they think of as the insurance company. The plan is self insured (possibly with stop loss coverage in case the whole company gets typhoid). In other words, the employer pays the claims and the "insurer" is compensated with a fee. While there could be incentives to hold down costs, the basic job of the "insurer" is to satisfy the employer. Keeping costs down is part of that, but so is keeping employees reasonably happy. The incentive structure for a public plan will be the same.
This brings us to the second argument. This one says that "profit" is a cost. It drives up the price and less profit is good. Certainly a consumer is uninterested in her seller's profit. She wants the best care at the lowest price. But we generally regard the profit motive as a spur to folks to figure out how to do that. If human beings didn't respond to incentives, communism would not have been a false God.
So we come to the third argument, candidly stated by Tammy Baldwin earlier this week. The public option is a way station to single payer. It is "how we get there."
The Speaker did not say that opposition to that would be almost immoral, although I wonder if she thinks so? Single payer systems tend to elevate at least the idea of equality of care over all other considerations (even though, as far as I know, almost no single payer system has achieved it - even in Canada, there is always Buffalo). One is willing to give up a certain amount of quality and innovation for an apparent (if not an actual) equality. That is very much a moral crusade, even if it is a misdirected one.