If there are substantial premium increase throughout Obamacare, that is a reflection of the health care received by the insured population. Adding a public option as “competition” to private insurers or to serve rural populations does not change a thing. Those costs will still be there.
The small portion of premiums that represent profit is easily replaced by the costs of running an inefficient massive bureaucracy, although much of that cost is hidden from view or accountability.
And keep in mind …
to have any chance of managing costs (keeping health care “affordable”😎), a public option must employ the same cost control techniques used by private insurance companies.