Is The Public Option Gone? Do I Care?

From Salon's Alex Koppelman:
"Well, what I said -- it is a two-part statement that quotes what the President has said. We believe, we in the House believe that the public option is the best way to hold insurance companies honest -- to keep them honest and also to increase competition. If there is a better way, put it on the table," Pelosi said at her weekly press conference, in response to a question about her August comments."As soon as we see something in writing from the Senate, we will be able to make a judgment about that. But our standards are that we have affordability for the middle class, security for our seniors, closing the donut hole and sustaining the solvency of Medicare. Responsibility to our children, so not one dime is added to the deficit. And accountability of insurance companies. We will take a measure of that bill in those regards." These comments are being portrayed as Pelosi outright abandoning the public option. Clearly, she wasn't quite that definitive. But she's certainly leaving the door open to the Senate deal, and -- especially given these remarks -- it wouldn't be at all surprising to see her come out in support of it fairly soon. If the agreement is the only way any bill passes the Senate, it's not like she has much choice in the matter.
I like the public option. It would decrease health care costs in this country which are on track to gobble up more than 30% of the GDP. That said, I also agree with Nate Silver:
The energy by progressive activists on behalf of the public option has done more good than harm, and by a wide margin... In terms of the present compromise on the table, it seems to be quite clearly better than a bill without the Medicaid/Medicare expansion, the Franken Amendment, etc., but with a weak public option… Liberals have tended to underestimate what a significant political achievement it would be for Democrats to pass such a major bill that has become rather unpopular with the public. It would be going too far to characterize the Democrats as courageous for passing health care reform (if they do), because at the end of the day, the political case for passing health care reform is probably stronger than the case for failing to do so.
We need activists in this country to make the facts clear and present the best bills possible. We also need realists and pragmatists who will pass the best bills possible - and the best possible writing and the best possible passing are not always the same thing. The point of the activists is not to write the laws, but to make the pragmatic picture that Congress deals with as progressive as possible. Our goal is to change lives and to help people. Supporting only perfect bills that don't have the votes, and thus leaving the status quo in place, helps no one. Chris Bowers has said that activists, by demanding a public option, improved the bill, and that it's now time to pass the compromise rather than the public option. Meaning, the public option's place was not to be passed, but to improve the compromise that will be passed: "Covering 16-17 million more people on public health insurance than current law, among an overall decline in the uninsured population by 30-35 million, with a cut in health insurance industry waste and profits from 30% to 10%, is, in my estimation, much better than the status quo. Public insurance rolls will be increased, lives will be saved, and industry profit margins will take a real hit." I don't see anything wrong with any of that (although I don't know how true that last point about industry profits is).

We didn't obsess over the public option during the campaign and I'm not going to obsess over it now. Yes, a bill without it won't bring costs down as much, but that's okay - with costs climbing as high and as fast as they are, there’s no way Congress can’t not return to the subject later. It would be much easier, however, to ignore the second problem, the uninsured, for many more years just as we’ve been doing since the days of ClintonTruman Teddy Roosevelt. This is our moment to address the uninsured. This is only one of many moments to address cost. I’m not going to die in the trenches over the latter if that means sacrificing our own opportunity to accomplish the former. A bill without a public option is not a great thing, but you try telling the tens of millions of uninsured it would cover that it’s a bad thing.

Tags: health care reform, Nancy Pelosi, Public Option (all tags)

Comments

28 Comments

Re: Is The Public Option Gone? Do I Care?

You arriving at the ball when others have gone home. The conservative dems are now trying to strip out the medicare buy in provisions. Let me know when you can discuss what line you have because so far the real point of this seems to be that you don't have any principles at all.

by bruh3 2009-12-11 08:48AM | 0 recs
Re: Is The Public Option Gone? Do I Care?

Covering thirty million more now is a principle. Helping myself and my own family by getting pre-existing conditions covered is a principle.

by Nathan Empsall 2009-12-11 08:58AM | 0 recs
Re: Is The Public Option Gone? Do I Care?

except you are not even going to get that. This is rationalization not backed up by the history thus far. Each time your capitulate they ask for a little more and al ittle  more and little more.

by bruh3 2009-12-11 10:32AM | 0 recs
Re: Is The Public Option Gone? Do I Care?

Oh- and remember all those other "virtues" of the bills, well, apparenlty not so much as is being reported regarding coverage limits.

http://www.dailykos.com/story/2009/12/11 813203-Senate-Bill-has-Loophole-Allowi ng-Coverage-Limits

by bruh3 2009-12-11 08:50AM | 0 recs
Re: Is The Public Option Gone? Do I Care?

Does the diarist on KOS not understand that lifetime limits and annual limits are not the same thing, or are you overlooking that fact, in classic bruhian fashion?

by lojasmo 2009-12-11 09:33AM | 0 recs
Re: Is The Public Option Gone? Do I Care?

And now the abortion issue is back on the table.

by bruh3 2009-12-11 11:26AM | 0 recs
Re: Is The Public Option Gone? Do I Care?

Dunno. A mandate to but the same shitty products that got us into this mess in the first place seems pretty bad to me... and bad politics for the Dems.

They really need to ditch the 60 vote rule.  It's hideous that my health care is dependent on the narcissism and corruption of Lieberman and friends.

by mikeinsf 2009-12-11 08:53AM | 0 recs
To early to come to these conslusions -

Lets get real - we have no idea what is in this bill/mess! I just read that the life time cap is gone - what else has been "disappeared"?  We should have every reason to believe that other goodies listed in this post will suffer the same fate.  

My guess is that by this time next week most of enthusiasm for this beast will have disappeared. The Insurance Industry and Big Pharma along with the Democratic and Republican Senators they own haven't finished hacking on it yet.

by mwfolsom 2009-12-11 08:57AM | 0 recs
Re: To early to come to these conslusions -

If the "goodies listed in this post" disappear, than the bill truly would do nothing, and when that happens it's no longer a bill worth supporting. You might be right and if so we shall see in a few days. But as it stands right now at this moment, the moment in which Pelosi is beginning to grow more pragmatic, it's worth passing.

by Nathan Empsall 2009-12-11 09:00AM | 0 recs
A country

that leaves its weakest citizens further and further behind is not a country that I want to live in.

by Charles Lemos 2009-12-11 09:01AM | 0 recs
Re: Is The Public Option Gone? Do I Care?

The main argument is that those in Congress wanting to ditch the PO are not making a coherent argument against it.

The one argument was that the PO at Medicare+5 was too low a reimbursement rate. OK that's stupid if your complaining about costs, but OK, that was fixed.

The rest of the arguments are simply incoherent. The depressing part is that we are loosing to incoherence.

by vecky 2009-12-11 09:22AM | 0 recs
Re: Is The Public Option Gone? Do I Care?

Once it comes time to try and end debate and bring the bill to a vote, it won't matter how coherent they are. It will only matter how many of them there are. Would that bills were passed based on correctness and coherence rather than numbers, but that's the way it goes.

by Nathan Empsall 2009-12-11 09:49AM | 0 recs
Re: Is The Public Option Gone? Do I Care?

I agree. I'm just saying why it's depressing.

If Lieberman/Linclon/Snowe/Collins/Nelson had a better idea than the PO to foster competition and keep companies honest I'm all for it... but they don't.

by vecky 2009-12-11 11:12AM | 0 recs
Re: Is The Public Option Gone? Do I Care?

Nathan, you somehow think that progressives not playing hardball & backing down is a winning formula. I assure you that progressives joining the fight for the Medicare+ option will not mean anything, & that the same conservative Democrats will also whittle down the Medicare buy-in for 55+ & Medicaid expansion to nothing (Those Democrats are not going away). Also, the central problems with healthcare will remain: the private insurance companies are sleazy & insurance rates remain at prohibitively high levels (they really should be a third to 50% lower); the public costs of covering the new millions of insured will be so expensive that it'll be junked some time in the future; insurance companies will find some way to deny coverage to those with pre-existing conditions (as someone who works in the healthcare field, trust me on this).

Progressives can't keep jumping like scared rabbits into a new hole every time the conservative Democrats say boo. The best strategy, at this point in time, is to let them filibuster & wear them down during the filibuster. Meanwhile, progressives  keep running ads against them & organizing to defeat them in their next election. Liberman needs to be told, if you filibuster, no Democratic committee chairmanships for you.

P.S. I like the new proposal better than a weak PO but its so obvious this is going to go the same way as the PO proposal.

by carter1 2009-12-11 10:01AM | 0 recs
Re: Is The Public Option Gone? Do I Care?

"Liberman needs to be told, if you filibuster, no Democratic committee chairmanships for you."

Here here.

by Nathan Empsall 2009-12-11 10:15AM | 0 recs
Re: Is The Public Option Gone? Do I Care?

Something that is not going to happen because they continue to pursue the strategy of appeasement that lead to the lose of hte public option, and now medicare for people who are 55 or above.

by bruh3 2009-12-11 10:34AM | 0 recs
Re: Is The Public Option Gone? Do I Care?

Who are the 16-17 million who will get public healthcare?  I have not seen those numbers in anything I've read.  

by orestes 2009-12-11 10:07AM | 0 recs
Um, Americans age 55-64

by ND22 2009-12-11 10:46AM | 0 recs
Re: Um, Americans age 55-64

There are about 30 million Americans in that age bracket. About 20 million have private insurance via employeers. Another 4 million are on medicaid. That leaves about 6 million eligible for the help under the senate bill. A few more will go on medicaid when it expands. But the amount expected to buy-in to medicare is thought to be in the 3 million range.

More figures when the CBO score comes in...

by vecky 2009-12-11 11:15AM | 0 recs
Re: Um, Americans age 55-64

Thanks.

by orestes 2009-12-11 11:22AM | 0 recs
Assuming all 20 million on private insurance

don't retire early because now they can. That's probably good for another 3-4 million at least

by ND22 2009-12-11 04:08PM | 0 recs
Re: Um, Americans age 55-64

I was a bit unclear in my question.  By public, I would not include Medicaire +55 at market rates (which is what I believe we have at best at this time).  With regard to that group, it is my understanding from what I've read that it will only affect 2-3 million people.  I'm trying to figure out where all of the other people are coming from.  Numbers are being bandied about without being tied to anything.  

I would have hoped that Nathan would respond to the query since he put the figures out there.

by orestes 2009-12-11 11:22AM | 0 recs
Re: Um, Americans age 55-64

The Chris Bowers quote includes the totality of people who will sign up for medicare and medicaid under the new proposals.

I think the medicaid expansion nets another 9 million, but I've heard estimated range from 5-15. Add to this the 3-6 million (medicare or PO) and I guess that's where he got the 16 million figure from.

I believe currently 60 million people have medicare + medicaid coverage and about 3-5 million more VA. Just for perspective...

by vecky 2009-12-11 12:29PM | 0 recs
Re: Um, Americans age 55-64

Sorry, I was wrong on the last set of figures... medicaid enrollment alone is 40+ million, medicare is another 40+ million. So thats 85 million or so who are already on public plans.

by vecky 2009-12-11 01:10PM | 0 recs
Re: Is The Public Option Gone? Do I Care?

Democrats are going to get destroyed in 2010 if they fail to create meaningful health care reform legislation.  The fact that the public option has been dropped and single payer was never on the table means that I will not be giving a cent to the DNC, DSCC, or DCCC if they are going to distribute ANY money to Lieberman, et al.,

Democrats who did not tow the party line on the most important of issues need to be stripped of their chairmanships.  Also, if they have primary challenges, the Democrats need to fund those challenges.  These supposed Democrats are close to ruining the Democratic party for a few years.

This is our best opportunity to pass REAL healthcare legislation in the past 30 years and 4 or 5 holdouts have fucked it up.  There must be consequences for the Liebermans and Nelsons because they are going to cost Democrats a shitload of seats.  If Democrats can't get it done when they have 60 votes, than I am done giving them money.

by agpc 2009-12-11 10:15AM | 0 recs
There wont be any reform

Its dead.  

by Kent 2009-12-11 12:55PM | 0 recs
Shocked!

Shocked, I am, I say, that you would say that.

Sanders, Weiner, Dean have all chimed in that the Medicare expansion would be a step-up from a watered down p.o., but I'm gonna go with this definitive statement from the most negative nabob on mydd.

by thurst 2009-12-12 03:31AM | 0 recs
Re: Is The Public Option Gone? Do I Care?

As arguments for capitulation goes, this sure is weak sauce.

by tarheel74 2009-12-12 11:46AM | 0 recs

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