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Reports

The Public Option Only Looks Dead

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Posted on Oct 1, 2009

By E.J. Dionne, Jr.

The strangest aspect of the debate over a public option for health coverage is that the centrists who oppose it should actually love it.

It doesn’t involve a government takeover of the health care system. The idea is that only consumers who wanted to enroll in a government-run health plan would do so. Anyone who preferred private insurance could get it.

The public option also uses government exactly as advocates of market economics say it should be deployed: not as a controlling entity but as a nudge toward greater competition. Fans of the market rightly oppose monopolies. But in many places, a small number of insurance companies—sometimes only one—dominate the market. The public option is a monopoly-buster.

Centrists tell us they want to hold down spending and fight deficits. Strong versions of the public option, as the Congressional Budget Office showed in giving a favorable assessment to Sen. Jay Rockefeller’s proposal, cut the costs of insuring everyone.

Unfortunately, the debate over the public option has rarely concentrated on the substance of the idea. Instead, it has been almost entirely ideological.

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Because opponents know from polling that the public wants the chance to choose a government plan, they move the discourse to abstract and often demagogic ground. The most revealing “argument” during the Senate Finance Committee’s public option debate on Tuesday came from Sen. Chuck Grassley.

“The government is not a fair competitor,” Grassley said. “It’s a predator.”

Grassley was then forced to explain how he felt about Medicare. Is it predatory for government to pay health bills for the elderly? Is Social Security, which lives side by side with private pension and savings plans, predatory? Is it predatory for government to regulate, well, predatory lenders or stock swindlers or bank boodlers?

Democrats have been far too timid in taking on the right wing’s arguments against government. They have been defensive at a moment when they should be going on offense by insisting that government can expand human freedom and give people options they would not otherwise have.

Consider universal K-12 education, loans and grants to help students attend college, clean water systems and unemployment compensation so people can get by while they look for the next job. A public insurance option lies squarely within this American tradition of using government to open new avenues of choice and opportunity.

The public option was voted down in the Finance Committee—15-8 on Rockefeller’s strong version and 13-10 on Sen. Charles E. Schumer’s compromise version. Sen. Max Baucus, the Finance Committee chairman, was in the odd position of saying that the public option was dandy (“There’s a lot to like about a public option,” he declared) but twice voting “no” because he believed too many other senators would vote no. I guess that’s how leadership works in the Senate.

Yet supporters of the option and the Obama administration have made unforced errors of their own that led us to Tuesday’s votes.

The public option is a means to an end, not simply the symbol it has become in some progressive circles. From the beginning, the public option should have been seen as part of a larger effort to make insurance affordable. This means that its promoters need to worry more than they have so far about subsidies for the uninsured. If this bill does not help make insurance affordable for middle-income families, it will be a failure.

As for the Obama administration, it’s been too ready to hint that it would throw the option overboard. Its highly public unfaithfulness to the view it purported to hold simultaneously enraged progressives and weakened its own bargaining position.

Schumer and Rockefeller were right to insist that this week’s votes will not end the battle for the public option. Its final form will be subject to negotiation and might involve a “trigger” to bring it into being in uncompetitive markets—as long as the trigger is not a meaningless sop. But the fight is worth waging to keep the issues of competition and affordability at the top of the congressional mind.

And one more pragmatic consideration: Americans wonder if all this noise around health care will do anything to change their lives. By offering a genuinely new insurance product of its own, the government would be acting as an innovator, a prod for change and, to borrow a phrase, an insurer we could believe in. As Max Baucus has taught us, there’s a lot to like about that.

E.J. Dionne’s e-mail address is ejdionne(at)washpost.com.

© 2009, Washington Post Writers Group


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By leftover, October 3, 2009 at 7:22 pm Link to this comment
(Unregistered commenter)

How about drilling beneath the headlines for some truth about the “public option” or whatever it is they’re calling it today?

Review of the “option” and co-op proposals

Kip Sullivan’s letter to the Congressional Budget Office.

Thanks to Kip Sullivan and the great folks at PNHP

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By CaptRon, October 3, 2009 at 11:54 am Link to this comment

No Single payer—No Public Option—then no healthcare reform-no healthcare for Congress paid for by us and no GOP/DEM party votes. Just my opinion.

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By Sallyport, October 2, 2009 at 1:57 pm Link to this comment
(Unregistered commenter)

Today’s unemployment figures give us another reason to insist on the single-
payer health care in H.R. 676.  The Dems’ disastrous cave-in, giving up single-
payer right out of the starting gate may have doomed reform for this go-round. 
If it comes down to a “public option” that involves mandated health insurance, I
hope people will rise up & simply refuse.  Granting the insurance corps more
profit & more power may doom us forever.

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By Dave Schwab, October 2, 2009 at 1:08 pm Link to this comment

Medicare For All, also known as single-payer health insurance, is favored by a sizable majority of Americans.

How can we convince our Members of Congress to enact what the people want?

Let them know that unless they support Medicare For All, you won’t support them.

Take the Medicare For All Voter Pledge today:

http://bit.ly/medicareforallpledge

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By P. T., October 1, 2009 at 10:26 pm Link to this comment

E. J. Dionne always seems to write about these topics as if industry money to politicians plays no role.

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By mackTN, October 1, 2009 at 6:06 pm Link to this comment

I don’t know who these Democrats are anymore; I think they are mutant clones who have seized the minds and bodies of what used to be the fighting Democrats.  I hope these sitting Democrats will be opposed in the next elections by real Democrats who won’t take money from corporations, will slam the door on lobbyists, and who will work their butts off for constituents.

And the Obamas need to stop galivanting for the Olympics and focus like a laser beam on health care reform with a public option.

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By Ian, October 1, 2009 at 5:22 pm Link to this comment
(Unregistered commenter)

The people know what they want. The latest NYTimes/CBS poll asks whether they support a ‘MediCare type option’ to compete with private insurers. By a 2 to 1 ratio, the people want it. Two to one.

In all my years, I have not seen the degree to which this congress so cynically ignores the clear wishes of the people.

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By LostHills, October 1, 2009 at 4:49 pm Link to this comment

Why do they continue to run EJ Dionne’s pieces here? They are nothing but pure drivel and Obama worship spin doctoring.

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By ocjim, October 1, 2009 at 2:31 pm Link to this comment

I hope everyone here is CALLING your reps and demanding a strong public option.  If they oppose it, demand to know how they’ll bring down costs & how much THEIR plan will save or cost the country OVERALL in 10 yrs.  The former head of Medicare under Bush said if we keep things as they are, it will cost the country about $34 Trillion (10 yrs) over $17 TRILLION of it will be paid by the federal govt.  That would crush our economy and we’d get absolutely NOTHING for it.
$1 or $2 Trill for reform doesn’t look all that bad by comparison.

Wonderful post, Sandy. As you say, if voters knew how much more they will pay without the public option, maybe they will flood their feckless reps with phone calls, faxes, and emails.

I feel like I am alone in burying not only my representatives in communication but also the miscreants who are trying to kill real reform.

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By freepressmyass, October 1, 2009 at 1:00 pm Link to this comment
(Unregistered commenter)

Anyone who still insists Obama wants the public option is delusional. The guy has never fought for it. When he really wants something man he sure knows how to get on it, like the Olympics in Chicago.
Tacky move IMHO.

Let’s not forget who Obama’s first pick was, Rahm The Stealth Republican Emmanuel as his Chief of Staff. If that wasn’t an immediate sign that Obama was no friend to progressives, and that he was going to throw progressives under the bus, then hold onto your socks and bend over. 
If Obama wasn’t such a back room sell out himself he would be out there pounding the podium for Congress to deliver a bill he can sign; a bill with a good public option.
Frankly, what they’re handing us now is such crap already, it’s insulting that they’re still squabbling over this piece of shit.

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By sandy, October 1, 2009 at 12:49 pm Link to this comment
(Unregistered commenter)

It’s a distortion to call opponents of the public option “centrists.”  They are more conservative than the majority of Americans on health care & most other issues. 

The AMERICAN PEOPLE should be used as the standard when characterizing political debate and in determining where a position falls in the political spectrum.  A single-payer plan would be the more liberal position. The vast majority of us, 2/3 of the people, (& a majority of our doctors) support a public option which is the most popular, moderate, CENTRIST position.  Most everything else being discussed (doing nothing, co-ops, etc) would be conservative Right-wing positions. 

Face it, the corp media & most of our leaders are out of touch & much more conservative than the majority of us in America….healthcare, gun control, abortion rights, gay rights, conservation and the wars in Iraq and Afghanistan .....  Conservataive corp media tries to marginalize and reframe what is in fact the center as “leftist.  Even less biased public media has been found guilty of this.

And while Blue Dog Dems may be out of touch w/ the majority of the people, the reactionary Right actually holds the majority of Americans in utter contempt…. seeing us as odious “socialists” for supporting a CHOICE of private and public insurance.
———————-
  I hope everyone here is CALLING your reps and demanding a strong public option.  If they oppose it, demand to know how they’ll bring down costs & how much THEIR plan will save or cost the country OVERALL in 10 yrs.  The former head of Medicare under Bush said if we keep things as they are, it will cost the country about $34 Trillion (10 yrs) over $17 TRILLION of it will be paid by the federal govt.  That would crush our economy and we’d get absolutely NOTHING for it.
$1 or $2 Trill for reform doesn’t look all that bad by comparison.

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By ocjim, October 1, 2009 at 11:40 am Link to this comment

“Unfortunately, the debate over the public option has rarely concentrated on the substance of the idea. Instead, it has been almost entirely ideological.”

So you say EJ. The ideology only justifies taking the health care industry money and mouthing its interests, making it seem as though so-called moderate Democrats aren’t on the payroll of fat cats.

Why else would the blue-dog Democrats reject the will of the people? They figure that the campaign money they get from pharma and private health care, will get them elected and that the voters are too stupid, have too short of memories, or are too inattentive to really vote them out of office. After all the alternative is the likes of a bigot called Barbour or whatever who is a red-neck neocon.

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By tropicgirl, October 1, 2009 at 11:16 am Link to this comment

(”“Its final form will be subject to negotiation and might involve a “trigger” to
bring it into being in uncompetitive markets—as long as the trigger is not a
meaningless sop.”“)

If you were listening carefully yesterday and today to Pelosi and Shumer, you
would have realized that the fix is now in. The legislation cannot morally
advance without a public option. But that option will be so watered-down and
pathetic it will be doomed. Pelosi is calling (as we blog) for “allowing” states to
have their own public option. This will fail because there will not be enough
bargaining power. If you listen carefully you will see the public option slowly
extracted until it is just an empty shell.

Even the author of this article is talking about the hated, useless trigger, that is
even rejected by Olympia Snowe, the wicked witch of the North.

Shumer is no friend of the public option. His sole intent, after taking thousands
from the health insurance company, is to water it down. He said the other day
that he doesn’t like the ads by progressives to get people to come down on the
Blue Dogs, because he is one. He is a straw man.

So, consistent with the way the Democrats have acted legislatively, since they
took the majority, a very harmful, expensive, phoney bill that will continue to
let corporations act like the mafia, shoving billions more at them, while telling
the American people they care, will be “passed”. Like a rotten kidney stone.

But this time, there is a hitch. The bill at the end of the day is not like the
porkulus or the bailouts. It depends upon cooperation from the American
people. I predict this very bad bill will spur on such incredible outrage, such
total rejection and non-cooperation from the American people, thousands of
lawsuits, and be such a debaucle that it will not only bring down Obama, but
many, many legislators. It will be a rallying point. And they brought it all on
themselves. And Reid knows that the longer the debate goes, the less chance
of this thing passing is ensured.

Again, think about the simple fact that EVERYONE could be covered for ANY
type of TREATMENT, for LIFETIME with the amount of money being shoveled at
these totally corrupt health insurance corporations, who are exempted from
laws against monopolies, for reasons no one knows.

This, in itself, shows the total dishonesty of what is going on here.

And Bill Nelson (who hides from being on tv and likes to play with war toys), my
senator, will be reminded by myself today of the message Michael Moore
delivered on the Ed show yesterday. We will, via Mr. Moore, organize candidates
to run against people like him. We don’t need the Democratic party to do this.
He is a foot-shuffling, knuckle-dragging Neanderthol who is too old and
stupid to still be in office.

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By ChaoticGood, October 1, 2009 at 11:13 am Link to this comment

If the Democrats cannot stand up and fight for us, then they deserve to be defeated.  The Republicans are fighting everything because they have nothing to lose and everything to gain. 

The Republican supporters are going to vote for them because they can put down the Democratic “Socialist” agenda, even though most of them don’t even know what socialism means.

Republicans have learned that emotion trumps reason. Democrats don’t know how to deal with people who are driven by emotion and do not respond to reality.

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By Frank Rizzo, October 1, 2009 at 10:01 am Link to this comment
(Unregistered commenter)

It’s becoming clear that we have a government of, by and for the Corporation.
Government doesn’t represent the People regardless of your party. We’ve known
that the GOP is on the take. What’s sad is to see how many Dems have been
corrupted by lobbyist graft. Max Baucus is no more a Dem than John Boehner. I
hope the good people of Montana vote this pig out of office.

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By Paul Burke, Author-Journey Home, October 1, 2009 at 7:53 am Link to this comment
(Unregistered commenter)

Big insurance by refusing care to patients and reimbursement to doctors over typos has ticked everyone off.  They have a monopoly over the whole process a hugely well financed lobby team and representatives on both sides of the isle.

A friend of mine recently laid off without children is paying $2,500.00 dollars a month for his COBRA that is outrageous. Health insurance costs more than his mortgage - unbelievable.

The economic impact of getting sick to the individual is catastrophic and that effects the whole market system because lots of people get sick.

When Bush implored people to go out and spend - well that’s kind of hard to do when you are buried in health care bills, filling and refilling out forms and in foreclosure because you made a typo.

The system is broke and well heavily stacked in the insurance industry’s favor - with no incentive except global economic melt down to fix it.

Oh wait a minuter didn’t that just happen….

Paul Burke
Author - Journey Home

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By bogi666, October 1, 2009 at 7:49 am Link to this comment

The way the Obushama administration has handled its health care initiative was doomed to fail from the start and puts into question Obushama’s sincerity about it being successful. He had several different Congressional committee’s introduce their own versions of health care legislation, a recipe for failure. Obushama should have developed a health care bill and presented it to Congress, this would be leadership. This point of view was articulated on GRIT TV by an Obushama detractor, a black woman.

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By T Groan, October 1, 2009 at 7:49 am Link to this comment
(Unregistered commenter)

My response to Inherit the Wind is that in actuality Obama and the majority of the dumbocrats, despite giving lip service to the notion of a public option, in reality don’t care about it. It makes a good sound bite but, as you can see, he has done next to nothing to promote it. He’s just another corporate whore.

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By hark, October 1, 2009 at 7:38 am Link to this comment
(Unregistered commenter)

It’s the legacy of Reagan.  Government is the root of all evil.  Not just brutal dictatorships like the old Soviet Union, but government in general, in the abstract.  And the Democrats surrendered to this new paradigm.  It will take decades to root it out of the American psyche, but there’s nobody around to do the job.  Whoever tries will get trounced on election day. 

It’s the same trap as the war machine.  We can’t spend on the people because our national security is at stake.  Whoever takes on this myth will get trounced on election day.

So we are stuck in a trap of our own making.  We can’t solve big problems because that takes the government, and the only thing we allow our government to do is to feed the voracious appetite of the military industrial complex.

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By Bud, October 1, 2009 at 6:12 am Link to this comment
(Unregistered commenter)

Maybe Congressman Alan Grayson of Florida could do us a favor and drop his trousers in front of his so called democratic constituents so that all of those inept,uncaring,political whores know what a SET OF BALLS looks like!!AS a lifelong democrat as everyone in my family has been and continues to be,I am thoroughly embarassed,disgusted,annoyed,and pissed off at these incompetent inept fools that refer to themselves as democrats.WHAT A BUNCH OF LOSERS!!!!!

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By Inherit The Wind, October 1, 2009 at 3:40 am Link to this comment

When the HELL is the Democratic leadership and Obama going to stop farting around with Re-thuglicans and DINOs (Democrat-In-Name-Only) and use the power of patronage and government programs as a club on all these @$$#oles? Let Nelson et al know they are going to lose committee seats and programs in their states, along with automatic judicial picks if they don’t stop betraying the Democratic Party and their President!

As for the Re-thugs: Any GOP member who will NOT commit to voting for a compromise bill (so far, that means Olympia Snowe), should be shut of the legislative process—not allowed to simply end it.  The Re-Thugs, like Kyl and McConnell, don’t want ANY change. They don’t care that 50 million Americans have no coverage—it’s their fault for being poor—that’s kinder, gentler conservatism!

When the GOP ran things they did it with an iron fist and the Dems whined and hoped for a bone. Now that the Dems are in charge, the GOPs are hammering with the iron fist (as they have nothing to lose) and the Dems are whining “please help us!”

What’s wrong with this picture?

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