Pulling the Plug on the Public Option

By T.L. Caswell

The public option in health care reform has been slain, and the murder weapon may be a truckload of greenbacks. The Obama administration caved in recently amid slipping support for the option in Congress, where some members enjoy a very profitable relationship with big players in the health insurance industry. It appears that once again money talks, loudly.

President Barack Obama threw in the towel Saturday when he said at a Colorado town hall meeting on health care reform: “The public option, whether we have it or we don’t have it, is not the entirety of health care reform. This is just one sliver of it. One aspect of it.”

This amounted to admitting there is little chance of getting the public option through Congress, and some members who were on the fence are, after Obama’s remark and other developments, now likely to move into the camp that opposes the proposal.

On Sunday two top Obama lieutenants—Secretary of Health and Human Services Kathleen Sebelius and press secretary Robert Gibbs—reflected what the president had said the day before. 

Sebelius, appearing on CNN’s “State of the Union,” said that the public option is “not an essential element” of reforming health care.

Gibbs, on CBS’ “Face the Nation,” said Obama thinks “the option of a government plan is the best way to provide choice and competition,” but “the president will be satisfied” if Congress comes up with another way to reach that goal.

By Sunday night, the administration was pulling away from the Sebelius remark, even though the horse had left the barn when Obama spoke in Colorado. In a not-for-attribution statement that evening, an administration official said the HHS secretary “misspoke.” The Atlantic’s Web site put it this way:

… The official said that the White House did not intend to change its messaging and that Sebelius simply meant to echo the president, who has acknowledged that the public option is a tough sell in the Senate and is, at the same time, a must-pass for House Democrats, and is not, in the president’s view, the most important element of the reform package.

A second official, Linda Douglass, director of health reform communications for the administration, said that President Obama believed that a public option was the best way to reduce costs and promote competition among insurance companies, that he had not backed away from that belief, and that he still wanted to see a public option in the final bill.

“Nothing has changed,” she said. “The President has always said that what is essential [is] that health insurance reform lower costs, ensure that there are affordable options for all Americans and increase choice and competition in the health insurance market. …”

Those words surely are wafting away on the breeze. What’s likely to stick in official Washington and elsewhere is Obama’s softening on the public option.

Under Obama’s original vision, a plan backed by the federal government would make available to Americans an exchange through which they could select insurance, either from a private company or the government. According to David Axelrod, senior adviser to the president, such a plan would be self-sustaining and require no subsidies in the long run, although some government funding might be needed at the beginning. As the administration sees it, a public insurance plan would be the least expensive to consumers because of Washington’s leverage in negotiating with physicians, hospitals and other health care providers. Of course, private insurance companies see this as dirty pool—unfair competition from Uncle Sam.

Sen. Kent Conrad on Saturday declared “there are not the votes in the United States Senate for a public option. There never have been.” Conrad, a key health care negotiator on the Senate Finance Committee, probably knows what he’s talking about. He also knows where his bread is buttered. According to Open Secrets, the North Dakota Democrat has since 2005 received more than $300,000 in money connected to the insurance industry. Only lawyers and law firms have given more to Conrad.

Have any other members of Congress received money tied to the health insurance industry? I’m glad you asked. Here are some illuminating figures from Open Secrets (see the link near the bottom of the Open Secrets page). Below are other members of the present Congress who have figures above $200,000. The champ of the list, by far, is from neither the Senate nor the House, but rather the executive branch—one Barack Obama, at $1,427,180.

Sen. Chris Dodd (D-Conn.) $767,841
Rep. John Boehner (R-Ohio) $737,260
Sen. Hillary Clinton (D-N.Y.) $697,351
Sen. John McCain (R-Ariz.) $684,787
Sen. John Kerry (D-Mass.) $680,184
Sen. Max Baucus (D-Mont.) $655,899
Rep. Earl Pomeroy (D-N.D.) $611,554
Sen. Ben Nelson (D-Neb.) $522,546
Sen. Mitch McConnell (R-Ky.) $520,327
Rep. Charles B. Rangel (D-N.Y.) $490,098
Sen. John Ensign (R-Nev.) $477,620
Rep. Eric Cantor (R-Va.) $461,850
Sen. Joe Lieberman (I-Conn.) $449,066
Sen. Evan Bayh (D-Ind.) $448,938
Rep. Roy Blunt (R-Mo.) $425,378
Sen. Chuck Grassley (R-Iowa) $422,149
Sen. Orrin G. Hatch (R-Utah) $382,880
Sen. Arlen Specter (D-Pa.) $366,828
Sen. Harry Reid (D-Nev.) $361,750
Sen. Jon L. Kyl (R-Ariz.) $350,968
Rep. Dave Camp (R-Mich.) $350,873
Sen. Kent Conrad (D-N.D.) $339,330
Rep. Steny H. Hoyer (D-Md.) $320,071
Rep. Richard E. Neal (D-Mass.) $316,414
Sen. Saxby Chambliss (R-Ga.) $314,823
Rep. Paul Ryan (R-Wis.) $309,500
Rep. John B. Larson (D-Conn.) $304,900
Sen. Richard C. Shelby (R-Ala.) $285,900
Sen. Susan Collins (R-Maine) $284,830
Rep. John Tanner (D-Tenn.) $250,750
Sen. Judd Gregg (R-N.H.) $248,175
Sen. Richard Burr (R-N.C.) $247,686
Sen. Jim Bunning (R-Ky.) $247,437
Rep. Joe Barton (R-Texas) $243,595
Sen. Mike Enzi (R-Wyo.) $237,750
Sen. Robert Menendez (D-N.J.) $236,725
Rep. John D. Dingell (D-Mich.) $233,950
Sen. Tom Carper (D-Del.) $232,220
Rep. Sam Johnson (R-Texas) $227,808
Rep. Spencer Bachus (R-Ala.) $224,050
Rep. Nathan Deal (R-Ga.) $222,196
Sen. Ben Cardin (D-Md.) $219,854
Rep. Mike Rogers (R-Mich.) $216,250
Rep. Edolphus Towns (D-N.Y.) $204,200
Rep. Charles E. Schumer (D-N.Y.) $203,450
Sen. Blanche Lincoln (D-Ark.) $203,050

The total for these 46 members of Congress is more than $17 million. That’s enough to take a few trips to visit the constituents.

This partial list of those who received industry contributions is not presented to suggest that any of the congressional members have been “bought” by the health insurance industry. But what flesh-and-bone human being would not at least be influenced by such largesse?

It is possible that the public option will arise, Lazarus-like, but the United States of 2009 is likely to turn out to be a land of Mammon, not miracles.

T.L. Caswell worked for the Los Angeles Times for many years and now edits for Truthdig.

White House / Pete Souza

President Barack Obama waits to greet members of Congress before a meeting in the Oval Office.