Time for Liberals to Give Up on the Public Option
It's time for liberals like me, who favor the public option or its functional equivalent, to give up on the idea and move forward to enact an historic, landmark national health insurance legislation. And to do so now -- not next week or next month.
Without the public option, the votes are there, with at least some Republican support, to do what Democrats have been trying to do since Harry Truman all the way through President and Hillary Clinton's heroic but unsuccessful efforts in 1994. We can pass national health care legislation that would accomplish the two goals that have always been the Democratic Party's priority for more than 60 years: First, virtually universal health insurance, including those who are too wealthy to qualify for Medicaid but too poor to afford health insurance; and second, mandatory coverage for all -- meaning insurance companies must insure everyone and are barred from declining due to the status, age, or pre-conditions of anyone. (Both go hand-and-hand, since insurance would not be affordable unless there is a broad mix of healthy younger people with less healthy older people in the customer mix).
In short, the dream of progressive Democrats for a national health insurance system that guarantees that matters of life or death should not be a function of wealth can finally come true; but only, in my view -- to be realistic -- if liberal Democratic members of Congress supporting the public option put it aside now. I have four reasons.
First, it is a pragmatic judgment: It is only a matter of time before they will reach the conclusion there are not 60 votes in the Senate to allow a vote on any health care bill that includes the public option.
Second, I fear if pro-public option Senators and House members wait too long, the polarization between the parties as well as within the Democratic Party will get geometrically worse -- thus threatening the enactment of any bill this year, or perhaps for a very long time. Already we have seen liberal organizations, bloggers and strident hosts and guests on the liberal cable network evening shows making vicious attacks on those in Congress whose consciences and/or constituents will not allow them to support a public option.
This has already happened. Senator Joseph Lieberman was recently accused of "whoring for the insurance companies" by one of the liberal cable network's leading hosts because Senator Lieberman has suggested he might vote to stop the filibuster of a bill containing the public option. I strongly disagree with Senator Lieberman's position, since I not only support the public option but believe there should be an up-or-down vote in the Senate. But I also, as always, greatly respect Senator Lieberman's integrity and his sincerity. It is too bad, but not surprising, that critics cannot disagree and debate Senator Lieberman's position on the merits without attacking his motives or using scurrilous personal epithets.
Third, the public option is not as important as the other two reforms that are long overdue -- universal insurance and universal coverage.
I have heard certain liberals claim they would rather have no bill at all than a bill without a public option. I would bet that everyone of them already have health care insurance. Or to put it another way, I'll bet that there isn't a single uninsured person who can't afford health insurance, or who faces bankruptcy because of a health care emergency, or who is forced to rely on hospital emergency rooms for basic health care for their families, who would agree that if there is no public option, then there should be no bill at all that would have provided them with basic health insurance, perhaps for the first time in their lives.
And fourth, the public option as it is presently provided for in the Democratic House bill and the Senate Health Committee bill actually only allows a small percentage of people to purchase it. It seems this is a well-kept secret. It is a fact, rarely mentioned by liberals supporting the public option that the pro-public option Democratic bills would prevent over 150 million people -- i.e., all employees who currently are provided health insurance by their employers -- from purchasing the public option. This is apparently because both business and labor don't want their employer or union-controlled (or both) plans disturbed.
That leaves about 25 million or less that would have access to a public option -- i.e., the uninsured, small businesses not mandated under the bills, and self-employed individuals. That's still a big number, but it is still a small fraction of the population.
Second, if the public option is intended to create competition to "keep the private insurance companies honest," there is a private-market alternative. It was, in part at least, proposed by progressive Democratic Senator Ron Wyden of Oregon and conservative Republican Robert Bennett of Utah and many other liberal Democrats and conservative Republicans.
In the Wyden-Bennett approach (included in their "Healthy Americans Act," which, for reasons I have never understood, the Senate and the House [in a counter-part version] never seriously considered or debated), all state insurance exchanges would be required to include as one option the Blue Cross health insurance plans that all members of Congress and federal employees currently have -- or its actuarial equivalent.
Since the Blue Cross plan is heavily regulated by the states and even receives tax subsidies from the federal government, it walks, talks and looks like the public option -- but is still a private sector-run program. And with such a requirement, private insurance companies would have an incentive to sharpen their pencils and chase our business -- or else we can buy the same lower cost insurance policy that members of Congress now can buy on the public insurance exchanges.
Whatever the final outcome, clearly there are more than 60 votes in the Senate, and substantial majorities in the House, ready to vote on a national health insurance plan that has universal coverage, individual mandates and mandatory coverage -- but with no public option. We can always come back in several years to re-look at the need for a public option if private insurance companies haven't felt the pressures of competition on the public exchanges -- the so-called "trigger" proposal that Maine Republican Senator Olympia Snowe said she could support.
The perfect is the enemy of the good.
Fellow Democrats, fellow liberals: Let's reach out to Republicans and independents in the country, show them we are willing to compromise and give up the public option, and let's get a national health insurance bill passed that provides virtual universal and guaranteed health insurance coverage ... at long last.
Yes we can.
~~~~~~~~
Lanny J. Davis, a Washington lawyer and former special counsel to President Clinton, served as a member of President George W. Bush's Privacy and Civil Liberties Oversight Board. He is the author of "Scandal: How 'Gotcha' Politics is Destroying America."
This piece appeared in Mr. Davis's weekly column, "Purple Nation," in the Washington Times, today Monday, November 2nd. It also is published at http://pundits.thehill.com/author/lanny-davis.
Mr. Davis regularly appears on Sirius/XM's POTUS/Press Pool with Joe Mathieu on Monday usually some time between 1-2 pm to discuss his column for that week.
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Lanny Davis is right -- liberals and progressives should give up on the "public option" because it's been defined into a fig leaf windfall for the drug pushers of Big Pharma and the health insurers at the cost of quality, affordable health care to those who have a variation of it. Liberals and progressives should vote against any health care bill that does not provide universal, single-payer, quality health care for all paid for by ending Bush's tax cuts and ending the two useless, anti-US interests, depression
Universal, single-payer, quality health care for all that is near free. As Lanny Davis says, liberals and progressives should give up on the public option.
Anyone who writes, with no irony, "I also, as always, greatly respect Senator Lieberman's integrity and his sincerity," has summarily disqualified himself from any serious political discussion.
Davis who encouraged Clinton to act as a GOP and enact NAFTA, welfare reform and of course the financial modernization act that paved the way for the crash of 2008.
We have already compromised on the best solution..
Haven't we had enough talk of "reaching out" and "compromise"? What Lanny proposes is not compromise, but total surrender. The bill he proposes would do nothing but force people to buy insurance from an industry that has no competition, no price regulation, and no possibility of antitrust enforcement.
The public option is to the right of center on the spectrum of possibilities for health care. To the left of center are a single payer plan, a regulated monopoly system, and a complete government-run health care system. Anything to the right of the public option is virtually indistinguishable from the current system.
you're insane.
as an attorney, i would not expect you to understand what the common American citizen is fighting for.
Mandated universal health care is necessary to offset the cost of insuring everyone. the system definitely needs more people paying in, than claims being paid out. that's how insurance works.
BUT NO AMERICAN WANTS TO PAY INSURANCE COMPANIES' PROFIT MARGINS ANYMORE. they raped us for the last 10 years, and let thousands of people die by denying the coverage they needed.
NO ONE WANTS INSURANCE COMPANIES ANYMORE. they were first implemented to help people get coverage at a decent price. but now they are too predatory. you cannot ask a wolf to be the guard of your chicken coop, no matter how many more chickens you add.
the purpose of a PUBLIC system is to put the profit back into the system. to stop paying CEOs millions.
as an attorney, someone who makes their money by taking a huge chunk from those you represent, to shuffle some papers and make some back room deals, you can NEVER understand what we're talking about.
so save your "i'm with you, i support the public option, but it's time to give up" rhetoric.
lawyers, bankers, politicians, insurance people...l
Health insurance companies run smaller profit margins than most fast food restaurants. I believe the margin is about 3-5%
# 1: without a reference, your comment is useless.
#2: when the executive pay of millions of dollars in salary and bonuses is included in "operating expenses", of course they don't show much in profit for the company itself. if they were paid reasonable salaries, like only 15x as much as their lowest paid employee, there would be a lot more on the profit line.
#3: they're paying dividends. they're definitely making money.
#4: the govt isn't on the verge of mandating we eat at mc donald's.
i don't understand why you'd even bother to counterpoint my comment with such a vague and unrelated statement
Your profits can be made to look quite small AFTER you pay massive amounts to CEO's and upper management, AFTER you use clients premiums to lobby congress against said clients and AFTER you expend huge amounts of money trying to avoid paying for benefits you actually owe. If you are looking for sympathy for these poor insurance companies you are barking up the wrong tree.
Unlike restaurants, insurance companies have enormous amounts of cash flow. 5 percent of a billion dollars is a lot of money - especially when you consider the huge salaries paid to the management class in insurance companies.
I have a friend who is a middle manager for a major insurance company. She attends all-expense-paid trips to exotic locations four times a year. Athens. Paris. Florence. Honolulu. All paid by our medical payments.
"NO ONE WANTS INSURANCE COMPANIES ANYMORE. they were first implemented to help people get coverage at a decent price."
CORRECTION: Health insurance was not developed to help patients, it was developed to provide sustained funding for hospitals. Blue Cross grew out of the plan that Baylor Hospital created to help it weather the depression. Insurance had nothing to do with making care affordable to patients; the idea was that by collecting a modest amount from healthy people every month, the hospital could be assured of a revenue stream.
Those origins are reflected in most insurance negotiations today where the hospitals believe that they are entitled to however much revenue they say they need to operate...
" I'll bet that there isn't a single uninsured person who can't afford health insurance, or who faces bankruptcy because of a health care emergency, or who is forced to rely on hospital emergency rooms who would agree that if there is no public option, then there should be no bill at all "
Mr Davis, as an uninsured person who fits your profile (above) , I would not agree that being forced by law to buy insurance from the very entities that now fail to provide me with any real option for insurance,is a better end , than no reform at all.
What they offer self employed, sole proprietors like me is a $12k annual premium with a $10k deductable or in other words, $22k a year out of pocket, then they will grudgingly pay 80-20 after that.
(if they don't find a reason to deny coverage.) Let me put this blunlty: I you gross $40k a year, then
a $22k insurance policy bankrupts you,before you get sick. The promise of a reundable subsidy would come to late to save me from financial ruin, in the event of an illness. And FYI, you can't go to an emergency room for free. I'm REALLY sick of that canard. (Average $8-13K out of pocket for an uninsured to visit an emergency room).
Defending Lieberman's "integrity"? Gutting consumer protection laws? No reinstatement of Glass-Steagall ?
I'm beginning to think it's time for liberals to give up on Obama.
Bob
I am self employed and pay less than $300/year for insurance with a $1000 deductable. I am a middle aged, overweight, male smoker. I am not exactly the picture of health.
I would recommend you do a little more shopping for insurance.
What is available varies by state.
For your sake I hope you never get sick. $300.00 doesn't provide health coverage my friend. What is being described by you as health insurance is simply a piece of paper with multiple "out" clauses so that the insurance company doesn't have to provide meaningful coverage. Real insurance such as my wife, a teacher, receives costs over $10,000.00 per insurable. Since these group policies are cheaper than what an individual can get you can imagine what quality the "insurance" you have. Sorry to burst your bubble.
If you are paying less than $300/yr for insurance, I would strongly recommend that you review last week's hearings "Insured but not insured" then get together with an expert and find out what coverage you really have.
Remember, 78% of bankrupts last year had health insurance and yet 62% listed medical debt as a factor in their insolvency.
http://ene
Who on Earth would listen to anything Lanny Davis has to say about anything? This is the guy who openly opposed Obama's policy towards the coup in Honduras and directly worked against US interests there. There's a certain level of betrayal against the country there.
And aside from that, he's been dead wrong on every important issue of the past 10 years, at least.
This guy is a joke. He should be stocking shelves at an Ace Hardware somewhere, not trying to give anyone political advice.
See Joe The Nerd Ferraro's Profile
(cont)
you can attempt to maginalize those in who write vicious pieces about those who's knees buckle. but, we are on to something.
sometimes when you need something that badly, you need to fight for it.
the powers that "be" just aren't going to say, "oh Lanny, you are such a nice guy. Here, have a public option with that healthcare reform, want some pie too".
it is well beyond time for you to look in the mirror, take stock of what is at stake here, get your talented butt in line, and dig your heels in with the rest of us.
if they fracture us, they win. If they do, I will look at you as an instrument of their victory.
See Joe The Nerd Ferraro's Profile
mr davis, why do you ride under the white flag of surrender?
we have the support of the people. no current poll out there have support for this at less than 50%.
we have the votes in congress. (do give me the off the wall garbage about 60 votes. we own the majority.)
if we have 50 votes in the senate - RAM IT THROUGH.
if we have Majority plus 1 in the - RAM IT THROUGH.
the knock on the democrats and the democratic party is that we don't fight.
the country is looking to us to fight for them, they damn well should be angry at us if we don't deliver.
tell me mr. davis, who will work the polls next year for the loop-job congressman democrat that doesn't get in line with the public option. are the insurance companies going to fill out their nominating petitions for them? are the insurance agents, in addtion to selling policies, going to go door to door for these "Judas" congresspeople who have taken their 30 peices of silver.
(cont)
"Senator Joseph Lieberman was recently accused of "whoring for the insurance companies" by one of the liberal cable network's leading hosts because Senator Lieberman has suggested he might vote to stop the filibuster of a bill containing the public option."
No, he was called that because he took $5 million in contributions from the insurance industry and then declared that he would only vote for a bill that ensured the insurance industry would continue to manage health care.
Right on!
Lanny, No Health Reform Bill is better than one that includes individual mandates and no means to keep costs down through competition. It would be a failure of the Democratic Party to enrich the Health Care Industry at the cost of the sick and the poor. I will agree with you that the Public Option is weak tea in its current form, and if we really want to have the best form of Health Care it would be Comprehensive Universal Single Payer Health Care, but, at any rate. we can't allow laws to be passed that mandate the American people buy an expensive, inferior product that drives them into bankruptcy ... and god knows the majority of moderate and right wing American politicians don't give a damn what kind of health care their constituients suffer with as long as they get their campaign contributions from the Health Care Industry.
So, in essence, Progressives are being the defenders of the American People in this process, so why on Earth would we abandon the sliver of hope we have in this corrupted Health Care Reform debate?
I'm afraid we have to agree to disagree on abandoning the Public Option, Lanny.
I know progressives want a robust public option but they should also remember what Senator Kennedy said about when Nixon offered him health insurance reform and he turned it down.He said he should never have done that because we would have been that much further ahead if he had accepted it back them.Put a Cap on how much insurance companies can make and a cap on how much they can raise premiums along with not letting them use pre existing as a way to not pay for needed health care.A Lot of states already have good options out their to help cover those who cannot afford the premiums.L
It's time for all American to call for a vote on this, the peoples vote. Put it on the ballot in 2010. Do you want a public option yes or no? Just ask the qeustion. Let our voices be heard. It's obvious we can't trust our elected officials who are so torn over what THEY think we want. Just ask US what WE
want. No campaign for or against, no TV ads, no nothing, just a question. Do you want a public option? I would prefer: Do you want Medicare for all?...... but I can live with an option.
Giving up is not an option; public option or no reform. We libs need to grow a spine and not back down on this one...too important for the American people.
We libs have a spine. It is our reresentatives who need a spinal rod implanted.
I am so sick of so-called Progressives telling Progressives to give in and give up. We understand- you are all on the take. We get it. We just ain't buying what you are trying to sell us.
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