Monday, August 17, 2009

The death of the "public option": What's really going on?

By Michael J.W. Stickings

So. Is the "public option" dead or not? One of the Democrats on the Senate Finance Committee, Kent Conrad, says it is. (And I responded yesterday.) Health and Human Services Secretary Kathleen Sebelius says is it as well... or not. Therein lies some confusion, and she may very well herself be confused. She seemed to back it on This Week (ABC) yesterday, only to pull back on State of the Union (CNN). As she explains on the latter, the "public option" is "not the essential element" of reform.

Don't worry, it gets more confusing.

Sebelius was essentially just echoing the president himself, who on Saturday said this:

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, and by the way it's both the right and the left that had become so fixated on this, that they forget everything else.

Please. This is Obama, once more, playing to his beloved middle, and, in the process, vilifying both sides. This is hardly fair, though, to those on the left who voted for Obama, who continue to support Obama, and who support the "public option" because they believe, as I do, that only a government-run health-care coverage option will do what reform is supposed to do, which is not just keep costs down but provide access to coverage, and therewith to care itself, to all Americans, notably to the millions and millions who either lack coverage altogether or have no choice with respect to the coverage they have, squeezed by the profit-based insurers who are more likely to deny coverage than to extend it. To call this a fixation, as Obama does, is insulting.

Otherwise, of course the "public option" is not the entirety of reform. Of course there are other elements to it. It is simply a fact that reform is a comprehensive package. But to describe the "public option" as merely a sliver. Is that also not insulting? And is that not grossly misleading? To those who lack or have inadequate coverage, this is not a mere sliver but rather the essence of the thing. The same goes for those of us who support govermment-run health care -- and I, for one (as a Canadian who likes the Canadian system -- I am also British and feel the same way about the British system), support a single-payer government-run system that is far more extensive that what is currently being proposed in the U.S.

Sorry, Mr. President, but in playing to the middle, where conservative Democrats and a handful of Republicans, the latter clearly taking their marching orders from the right (and being as partisan as always), are trying to water the bill down so much as to render it inadequate, if not to defeat reform altogether, you risk losing the base, and bulk, of your support not just on "the left," as if only ideological extremists are supporting the "public option," but among the various liberals and progressives and moderates who want this to be meaningful reform and who think that now is the time, at long last, for just the sort of government involvement in health care that you here dismiss.

On CNN, Sebelius was pushing "consumer choice," "choice and competition," not the "public option" specifically or any specific version of reform. An administration official told Marc Ambinder that Sebelius "misspoke," on the "essential part" bit, while anther official, Linda Douglass (a key White House player on reform), said that Obama still supports a "public option." A third official refuted the first: Sebelius did not misspeak.

So what is it? As the Times is reporting:

The White House, facing increasing skepticism over President Obama's call for a public insurance plan to compete with the private sector, signaled Sunday that it was willing to compromise and would consider a proposal for a nonprofit health cooperative being developed in the Senate.

That seems to be the point White House Press Secretary was making on Face the Nation (CBS) yesterday. As Ambinder summarizes, "Gibbs said that fostering competition and choice were non-negotiable, but the specific mechanism designed to do so was up for discussion."

So Obama is waffling, Sebelius is waffling, Democrats in the Senate are waffling, and, meanwhile, Republicans are getting what they want, which is Democratic divisiveness and, ideally for them, inaction on reform altogether, all while they continue to score political points by lying about the Democratic plan.

But is Obama really pulling back from the "public option"? Perhaps not. He surely knows that he needs to reach out beyond his liberal-progressive base if reform is ever to be passed. While he may see non-profit co-ops as a suitable replacement for a government-run component, could it not be that his waffling, his apparent pull back, is actually part of his larger campaign to pass a comprehensive reform package that includes a "public option"? He has done this before, after all -- in a way, it is his modus operandi. He reaches out in search of compromise and bipartisanship, knowing that, ultimately, the other side won't agree to an acceptable compromise. But then he can at least say that he tried, that his motives were genuine, while ensuring that blame is directed at the other side. He seems to be doing with with Iran, so why not with the Republicans and the obstructionists in his own party?

But then there is the other possibility, that Obama knows that "Obamacare" is a tough sell that is unlikely to pass the Senate. Maybe he thinks that some reform is better than no reform, that a bill with non-profit co-ops is better than no bill at all, that, ultimately, the best that can be achieved is not the best (the "public option") but something that at least comes close to it.

Either way, Obama is being his usual realist self -- and it is realism that forms his core, so much not the idealistic rhetoric that we came to know during the campaign. I do not excuse him for calling the "public option" a sliver or for blatantly dismissing the concerns of "the left" as somehow akin to the fearmongering of the right, but, still, it is possible that he is doing everything he can to ensure that the best possible bill is passed.

Which is not to say that I won't be disappointed if reform does not include a "public option." I will be -- just as I am angry and frustrated now. To me, there is simply no excuse for failing to go all the way.

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  • Our President is getting his first taste of going against the insurance industry, which is, make no mistake about it, a CARTEL, no longer the intended business model originally created to protect in an event of a loss, with their hands in all elections, all the time and process as much money as our government and in fact controls many public policies. Currently, what the insurance industry wants, the industry gets. They feel that no one is too big for them. With profits paramount, currently running health care as well as auto collision repair in there unsuccessfully dysfunctional way with no one to challenge them, as well as crushing free enterprise with their referral systems. When US States successfully created affordable government run workman’s comp insurance for business, the system currently works extremely well, with government achieving a much higher level of service at half the cost, but not surprisingly the insurance industry attempts to abolish the program every legislation cycle. They complain about being in competition with the government, but have no regard to health care patients well being, care facilities or the collision repair stores they our putting out of business daily by pushing all the patients or damaged autos through locations they own or have interest in, aggressively via referral systems. Insures are in competition with all businesses they pay claims to. From health care to auto repair. The insurance industry is currently a competitor to businesses and crushes whom they feel like, with no Federal Trade Commissions stopping them. The insurance industry controls the largest majority of claims service rendered. Free competition is long gone but seriously needs to be restored. I believe government should not just challenge the insurance industry, but to do its job and control them. I wish a leader to challenge the cartel, not give in to greed, and win. Mr. Obama, please don’t give up. The insurance industry can and should be restored back into its intended purpose. The insurance industry currently has more money than local governments and is right behind the federal government with regards to cash flow. They have hand placed policy makers in all levels of our government, federally and local. This presents serious threats to our government and should be investigated by the Federal Trades Commission, FBI and the CIA to ensure the stability of our government.

    By Blogger Michael, at 2:46 AM  

  • Boo hoo! You mean couln't organize angry mobs on the left this time? I know SEVERAL Obama voters, a couple of them doctors, opposed to the public option. I guess democracy only works for you if it comes out your way.

    By Blogger QueersOnTheRise, at 7:18 AM  

  • Several -- you know several. Well she-it, I guess we should just wrap the whole thing up and opt for the plan your doctor friend is threatened the least by. I guess democracy should just shut up and listen to you and your moronic mockery.

    Or maybe you could ask your slimy cohorts at for an actual, factual and logical argument against a public option instead of saying "boo hoo."

    Borrowed sarcasm isn't enough to make the grownups listen to a pathetic little lickspittle like you, sorry.

    By Blogger Capt. Fogg, at 9:58 AM  

  • Yes, I know SEVERAL. Want me to name them so you can send their names to the White House? You won't know them anyway.

    Democracy IS listening and doesn't like the public option in sufficient numbers apparently. But of course you like to call these people an angry mob egged on by right-wing extremists. That would be like me calling all the anti-war people an angry mob egged on by George Soros.

    McCain was a shitty candidate and Bush was very unpopular, so Obama won. But now he has to deal with reality. The reality is that the country is just not as liberal as he is. Sorry!

    By Blogger QueersOnTheRise, at 10:59 AM  

  • By Anonymous Anonymous, at 10:33 AM  

  • Aren't we all sick to death of people who try to side step discussion and reality itself by calling things and people "liberal?" It's a meaningless word the only use of which it to dichotomize everything for purposes of distortion - as you are attempting to do. Classic dicto simpliciter.

    The Public option is preferred by a majority in poll after poll and what you dismiss as "liberal" is sometimes just reality.

    I laughed at the word "several" because I could come up with the names of several people with two heads. Is that supposed to prove something?

    Bush failed at everything and ruined the economy, McCain ruined his chances by selecting Palin, but the fact is that the GOP supported both ruthlessly and at the expense of most American values. Disgust with that party is more than some ephemeral phenomenon and yet it's hardly aware of how it's marginalized and radicalized itself instead of rethinking all those unfounded precepts it's tried to sell as laws of nature and economics.

    By Blogger Capt. Fogg, at 3:42 PM  

  • Public option is a best idea for achieving the goals for reform.

    By Anonymous sweets, at 2:50 AM  

  • I've attended these town hall meetings about socialized medicine. There's quite a few low producers who want the free ride government involvement forces.

    Liberalism isn't about politics. It's about people who never grew up to take responsibility for the outcome of their own actions. They have this kindergarten concept of property rights that if you have something someone else wants, you should share.

    YOU should decide whether you live or die. When you take a job with insurance, when you buy your own medical insurance, or when you spend your savings if required. If you don’t value your life enough to pay for your own medical needs, why would anyone else?

    The reason why costs are high is government interference puts a lot of non-payers in the system.

    1) Medicare and Medicaid tax you, making it hard to buy your own health insurance. The freeloaders then bid up the cost of medicine against you with your own tax dollars.

    2) Government tax relief to employer insurance plans encourages gold plated policies with low deductibles and low co-pays. No one tries to economize since treatment costs are uncoupled from the user.

    3) Emergency rooms are required by law to treat non-payers. That cost is shifted to legitimate paying customers.

    There you have it. If government would stop their centralization of power empire building, medicine would have reasonably costs.
    Ironic that the best solution is less government involvement. But that wouldn’t involve politicians or liberal free riders.

    What about the person who elects not to buy insurance then encounters a medical condition? He should be responsible for his own problems.
    If your house burns down and you didn’t buy insurance, no one buys you a new house.

    By Anonymous Anonymous, at 12:28 PM  

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