The Public Option is Dead as a Doornail

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.

Comments

[Indon]

Aren't there other versions of the bill, with the public option?

I mean, sure, they haven't been mentioned extensively in the media, but that's not because they aren't important. It's because the media wants to hype up the people most obviously bought out by the industry, for the sake of pushing ratings (and they might have been encouraged by certain non-news organizations).

The only official power Obama has over legislation is the veto, and he's not likely to veto a healthcare bill with the public option if it lands on his desk.

I daresay that this time, the making of the law is actually in the hands of the lawmakers.

[AnnfromCA]

I don't think anyone is going to like the end result. It's just the worst of both worlds.

[bioluminescence]

The Word Health Organization says there are 37 countries who have a better health care system than the U. S. They include Chile, Costa Rica, Cyprus and Spain. But when it comes to military spending, the U. S. is number one by a country mile. It spends more than all the other countries in the world combined

Clearly, the government wants to protect Americans from every imaginable threat in the world except their own health care system.

[RRoadrunner]

I posted this on he HP on 9/2/09
I've seen many, many issues in my life time and know when to fold. We are now dealing with smoke and mirrors. There will be some kind of reform with enough loop holes for the insurance industry to drive their brinks trucks through, but the public option is DEAD. Sure the "new" democratic party will slap themselves on the back for a job well done but the change we were promised was nothing more than rhetoric. This was a once in a generation opportunity for the "new" Democratic party to restore the damage done to our country by the republicans and they failed to deliver. Not because of ideology but because of greed. It's truly a shame. The "old guard" in the democratic party had something this buch lasks.... INTERGRITY.
Regarding this article,
The inept inner circle of the president have played the Democrats like a fiddle. If congress does not push back hard and demand a robust PO, they do not deserve to be in the majority. Obama, like all other politicians has been one big disappointment from bank reform to gay rights he's let other fight his battles. His unwillingness to take a stand and fight in the end will cots him. Those he seeks to accommodate in the end will bury him.

[seawolf77]

These are moments that I absolutely live for. You really have to savor it. If Obama does not get public health care for real than he is a one term president and Hillary is virtually a shoe in for 2012 because people will realize now they can;t have their cake and eat it too. Ahhh conservatives have to choose between a woman and a black man, between a black man being triumphant, or a woman.. But we are getting it.

[Terminal1]

Hillary will NOT be any better.

[Uosdwis]

Do you think a "gutted" bill is going to slip by, unnoticed? Do you think Howard Dean is going to crow about it? Wendell Potter, the Cigna whistleblower? Keith? Rachel? Ed? Every progressive talker? Everyone on DKos? HERE?? All of us are going to scream if there is any backsliding at any point in the process. Obama is NOT going to get away with just signing ANYTHING that says reform.

[TommyMcCarthy]

Sometimes I just HATE it when Earl's absolutely right!
tm

[Edmonsky]

The healthcare bill under consideration provides for expansion of Medicaid to include uninsured poor people. How does private insurance companies benefit from insuring poor people under Medicaid?

The healthcare legislation under review prohibits insurance companies from denying coverage for pre-existing conditions or capping costs or dropping insured when they are sick. To mitigate this situation, individual mandate is proposed in order to bring into the system, the young and healthy to even things out. This is an issue of commonsense rather than conspiracy theory.

[Citizen54]

How about if we mitigate the situation by removing for-profit insurance companies from being involved in the the health and care of Americans?

Mandates are a way to make sure the insurance companies maintain their high profits. We must resist.

[Mike Hihn]

BEFORE Obama was President, the insurance industry offered to cover pre-existing conditions AT REGULAR PREMIUMS, if there was mandatory coverage. See New York Times, 11/20/2008

http://www.nytimes.com/2008/11/20/us/20health.html?_r=1&scp=1

The "robber barons" OFFERED to insure tens of millions of those sick people AT A LOSS.

Sick people are treated at a loss. The losses are covered by premiums or taxes on healthy well people. Math 101.

Who covers the losses for all those sick people AT REGULAR RATES? The tooth fairy?

According to the deal, the losses on the sick newly insured would be offset by premiums on the healthy newly insured. NO SUBSIDIES (except for income).

Then Americans rebelled at the tought of mandatory coverage, so Baucus weakened it. So NOW who covers those losses. Higher rates on the currently insured. Who else? The French?

When Democrat gots enraged by the insurance companies telling us the truth, they showed that they were too stupid to deal with healthcare at all. And they lied about who broke the deal.

The President and his party now REWARD healthy people for not buying insurance. Because they GUARANTEE healthy people will always be abe to buy health insurance AFTER they get sick!

Is that why I can't buy life insurance on my dead father? Because the robber barons are greedy? That's what Democrats said, when they promised anyone could buy health insurance AFTER they get sick. Duh.

http://PoliticallyHomeless.net

[anfractuous]

Perhaps we should add a trigger that kicks in when a family's heath care costs constitute more than 50% of a Goldman Sachs employee's salary.

[S1m0n]

Earl, are you talking about insurance, or prescription drugs? Do you know?

But I can't help noticing that evidence is conspicuous by its absense from your analyses. Do you have any to support your claim that the events you describe actually took place?

~~

In general, the observation that the Administration has opted to divorse prescription drugs from medical insurance is a solid one, I think. They've never claimed to be doing otherwise, to start with, and it's also the strategically sound option. Divide and rule works. Giving Big Pharma another decade on the gravy train is a reasonable price for keeping them on the sidelines while the insurance biz is dealt with.

To start with, drug patents are the easier problem, and they get easier once the government is more involved in funding them. Patents are a straight-up government-created monopoly, which can be amended in any way by government fiat. Absent the explicit legislation, there is no monopoly; nor is there any contractual relationship between buyer and seller to interfere. A drug patent is worth what the government says it is, period. Of the two monopolies which are abusing the public and damaging the nation, Big Pharma is the smaller problem. It's reasonable to decide to fix it later.

[Mike Hihn]

>>>Patents are a straight-up government-created monopoly, which can be amended in any way by government fiat

But you're not a communist. The house you live in is also a government -created monopoly, by your "logic"

Property rights are not a monopoly. Government can also blow your head off by fiat. That doesan't mean it should, or that it's moral.

http://PoliticallyHomeless.net "Those of us -- left, right and center -- who hold principle over partisansh­ip."

[ThePeacemakers]

Also, another thing that will let you know how far under the bus you've been thrown:

What's the start date on the provisions of the bill?

Will mandates and fines be enforced before 2012? Or do they want to wait until after 2012 election before we see the health insurance execs new private planes and billion dollar bonuses while Americans face fines.

1) Primary challengers
2) Third party

That's the new action. No more letters.

[lgillooly]

I hope you are wrong/ I admit that I was skeptical when I heard of the back room negotiations with Pharma and Insurance, but now I believe all bets are off because of what the Insurance companies did. We will have a public option with an opt out for states and will reverse the anti trust exemption. If not, Obama will not be re elected.

[FrozenNorthObserver]

The price tag for a secret deal?

Pharmaceuticals / Health Products: Top Recipients- Top recipient 08-Senator Ob*a*ma- $2.1mil
http://www.opensecrets.org/industries/recips.php?ind=H04&cycle=2008&recipdetail=A&mem=Y&sortorder=U

Pharmaceutical Manufacturing: Top Recipients-Top recipient 08-Senator Ob*a*ma $1.1mil
http://www.opensecrets.org/industries/recips.php?ind=H4300&cycle=2008&recipdetail=A&mem=Y&sortorder=U

[mummblemouth]

Rather than a call to arms this blogger appears content to do the job of the opposition and attempts to demoralize those fighting for a public option. He may be right, but to suggest that the option was dead months ago and because of that we should no longer fight for it is exactly what the republicans and, to his thinking, democratic and industry leadership wants. Well, that's the way to certain failure, if the democrats want to lose in 2010 and 2012 they'll forgo the public option and many, many progressives will vote third party, many, many more democrats will be disillusioned and not vote at all, and the republicans will be even more fired up with that blood in the water.

[highking1979]

I believe the author of this piece is sadly stuck in a negative mentality. This type of view point would prefer you do nothing because its already been done in some secret meeting. This is also the same type of thinking that would say it doesn't matter what you do because "destiny" or "fate" has already determined what you will do. And I agree with a previous poster. If the Democrats mess this up, it will most certainly end their majority and ruined their chance of ever getting back into power like they are now. Anyone else feel like our politicans have all lost their minds?

[ThePeacemakers]

They will attempt to scare you into voting dem by presenting "bat .... crazy" repubs as an option.

Worked last time, didn't it?