Is The Public Option Gone? Do I Care?
by Nathan Empsall, Fri Dec 11, 2009 at 08:35:10 AM EST
"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, theres no way Congress cant 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 weve 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. Im 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 its a bad thing.