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Earl Ofari Hutchinson Headshot

The Public Option is Dead as a Doornail

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President Obama, House Speaker Nancy Pelosi, and a parade of House and Senate Democrats should get academy awards for their play act on the public heath care option. It's as dead as a doornail. Yet, the principal players still tease the public with their talk about it. The public option epitaph was written months ago during the more than two dozen secret meetings that Obama and his aides had with the insurance industry and pharmaceutical bigwigs.

The deal went like this. The major insurers and the pharmaceuticals would drop their seven-decade opposition to health care reform if the Obama administration did four things. It must guarantee that the estimated 45 to 50 million uninsured would buy insurance from the private health insurers with penalties for non-compliance. The mandate would guarantee the insurers a monopoly on a product that would make the old 19th Century Robber Barons green with envy. The government (taxpayers) after delivering them would then pay the cost to cover many of them with billions in subsidies. This is a treasure trove of untold riches for the insurers. Minimal (or no) checks on what private insurers charge and no real way to compel them not to dump those they deem to sick, too poor and too undesirable to insure.

The elimination of the public option, though, sealed the deal. Obama could pay lip service to the public option but not fight for it. The lip service was important solely to keep labor unions, progressives, and liberal Democrats in tow. They were the ones who turned the presidential campaign into a holy crusade to put him in the White House. With 2010 midterm elections near any hint that the White House had cut a deal to scrap the public option will stir wholesale revolt by the left side of the Democratic Party. All factions have made it clear that a health care bill without a public option is a sham. They speak for the majority of Americans. Every poll and survey including a mid October Washington Post poll has found that the public solidly backs a public option.

The double cross by America's Health Insurance Plans, the private health insurer's industry group, which commissioned a study that claimed that private insurers would have to jack up prices and families would pay through the nose for health care if the reform bill passed didn't change the deal. It actually strengthened it. A few days after the industry's blatant blackmail, White House Chief of Staff Rahm Emanuel again reiterated that a public option was not "the defining piece of health care." This was a wink and nod to the industry that the White House would keep its part of the bargain no matter the trickery, skullduggery, or lies from the industry.

The fall guy for the play acting has been Senate Finance Committee Chairman Max Baucus. He's been hectored, cat called, finger pointed, and raked over the coals for supposedly single-handedly torpedoing the public option. Baucus just took his cue from the White House. When the deal was cut, he had the green light to craft a reform bill that is firmly within the parameters of the industry guidelines the White House rubber stamped months earlier. There can be no deviation from that. As agreed, the public option was nowhere to be found in his plan. It was never a part of the round-the-clock negotiations the key players on the finance committee engaged in to nail down the fine points of the bill.

Only the most hopelessly naïve can be surprised by the White House and Capitol Hill play acting. Obama desperately needs to knock down a win on health care reform, no matter how much of an industry giveaway it is. He's heard the loud grumbles from progressives and liberal Democrats that he is way too quick to make nice with the GOP on comprehensive heath care reform. His soft shoe of the public option is their single biggest point of displeasure with him.
Some progressives will scream sell-out and flip-flopper at him when he signs the final bill sans a public option.

It won't much matter. Their criticism will be buried in the avalanche of media publicity, a blitz of laudatory industry accolades, and congressional back patting when Obama signs the gutted final bill and declares it the greatest victory for health care reform since LBJ inked Medicare into law four decades ago.

The major provisions of the reform bill won't kick in for years down the line. In that time, memories will have long since faded as millions remain uninsured, private insurers continue to rake in their grotesque profits, and the promised cost savings from reform never materialize. A true public option was the obvious answer to this. But when the insurers, pharmaceuticals and the White House agreed to play act on it it was dead as a doornail.

Earl Ofari Hutchinson is an author and political analyst. His forthcoming book, How Obama Governed: The Year of Crisis and Challenge (Middle Passage Press) will be released in January, 2010.

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