As teachers and principals shake the cobwebs off of our national education system in the weeks to come, there will be a new concern to accompany the normal anxieties about students, lesson plans and classrooms. After a summer in which many overnight children's camps were plagued by H1N1 flu infections, schools across the country are preparing contingency plans in case the highly contagious virus hits their campuses. While 700 schools closed across the nation when the virus first hit this spring, schools now are planning to stay open by quarantining the sick as soon as they are afflicted since the virus can be highly treatable, especially when it is caught early.
However, the challenge to quarantine the sick will not be easy since so many families in this country lack health insurance that they will refrain from getting an early diagnosis for their children. As a result, there is a grave danger that the death toll of 522 from the disease in the United States alone may rise. A recent White House report concluded that 50% of Americans may be infected by the virus this fall and winter and result in the death of up to 90,000 Americans. As the national debate about health insurance reform has been reduced to a narrow focus on the question of whether a public option should be included in a reform plan, it is important to recognize that the primary goal of health insurance reform should be universal coverage. Those Democrats in Congress who oppose any health insurance reform that does not include the public option are making a mistake that could greatly cost our nation and our party.
We need health insurance reform now to provide for the nearly 46 million Americans who currently lack coverage. This has been a goal of reform efforts since President Theodore Roosevelt included universal coverage in his 1912 Presidential campaign platform. Having nearly 18% of Americans too young for Medicare uninsured not only goes against the moral principles at the foundation of this country, it also has deleterious effects on our economy. And as a highly contagious virus spreads across the country, it is important to keep in mind how important it is that all of our citizens have coverage.
Many Americans support inclusion of a public option in a health insurance reform plan, and so do I. The concept of a "public option" refers to a government run health insurance program, similar to medicare, that would be created as part of reform to compete with private insurers. A public health insurance option, free of the burdens of the profit motive and marketing, likely would be a useful tool to keep private insurers honest. There is strong evidence that, without competition from a source unconcerned about maximizing profit, when it comes to a commodity as essential as health care, the insurance market will work to maximize profits without sufficient concern that escalating costs will be affordable for many Americans.
However, as much as the public option may be good public policy, it appears as if the votes are not there in our own party to pass a bill that includes this measure. North Dakota Democratic Senator Kent Conrad recently told the Washington Post, "[t]he hard reality is...that a public option does not have enough support in the Senate to pass." Nate Silver of fivethirtyeight.com recently wrote about the lack of support for a public option and concluded there are only 43-45 votes for the public option in the Senate, well short of the 50 votes necessary for passage.
The H1N1 epidemic reminds us all how much we need universal health coverage now. So members of Congress who refuse to support any health care reform unless it includes the public option are missing the larger picture. As someone who worked in the Clinton White House Office of Legislative Affairs in 1994 when the Administration pushed hard to pass a health reform bill, and who has watched our country suffer in innumerable ways in the intervening 15 years from the lack of care for all of our people, I believe it is critical to pass health care reform this year. Refusing to vote for a health care reform bill just because it does not include a public option would be a classic case of making the perfect the enemy of the good.
If Democrats in Congress fail to pass a health care bill this year, they will tempt the same fate that the Democratic Congress suffered in 1994. The American people may conclude that the Democrats are unable to seriously address the problems facing the country and take away our majority in 2010. Would that truly be a better fate than substantial health care reform that provides coverage to millions of Americans but fails to include a public option? Surely the late Senator Ted Kennedy, whose dream of universal coverage went unfulfilled in his lifetime, would say no.
When Congress returns from its summer vacation in a few weeks, let us all hope that 218 House Democrats and 51 Democratic Senators (or 60 if a cloture vote is required) will choose half a loaf over no loaf at all.
