The News of Its Death Is Greatly Exaggerated

Kent Conrad has repeatedly said there are not enough votes in the Senate for a public option, and now says he won't vote for one. HHS Secretary Sebelius says the public insurance option is not essential. These statements add to a steadily growing conventional wisdom that the public option is now dead.

Not so fast. This fight hasn't even come close to being played out yet.

Conrad is accurate that there are not currently 60 votes in the Senate for a public option. But what conventional wisdom ignores is that there are 64 House members who are unequivocally on record as saying they will not vote for a health reform bill that has no public option, way more than enough to take that possibility off the table. So there are two possibilities right now:

• If both sides of this equation hold tight, no bill passes at all
• Something happens to change the dynamics

The conventional wisdom says that while it is entirely possible that the first scenario happens, that if the second scenario happens it will be because House progressives fold. There seem to be no other possibilities to all the expert prognosticators.

Now, I will admit that progressives have been known to fold before, as Chris Bowers wrote today. But let me suggest that there are other possibilities here, scenarios that are actually within the realm of the possible. If progressives in the House hold their ground, if they hang tough on the public option, what happens next will go something like this:

1. The House will find the votes to pass a comprehensive bill with a public option soon after they get back from August recess. That will be reasonably easy, because Pelosi will be able to peel off a reasonable number of Blue Dogs, many of whom have said they would support a public option, to vote for the bill.

2. The Senate will find the votes to pass a convoluted, tortured, unworkable bill, not only with no public option but so messed up and compromised to be unworkable anyway. This is less certain than number one, but Democrats will probably find a way to pass something.

3. The conference committee will sit for several weeks as Senators like Conrad say we will never pass a public option, House progressives says we will never pass something without a public option, and the White House, Pelosi, Reid, and conference committee members work out details to try to get something passed.

At that point, there are a few possibilities. One is that Democratic leaders just give up and declare health care reform dead. That seems unlikely to me, given the high stakes. Another possibility is that House progressives just fold up. That is more likely given recent history, but given their clear promises and the strong pressure on them not to, they might just hold this time. So let's assume for the moment that they do hold strong. Here are a couple of possibilities for getting a bill passed:

A. The first is that conservative Senators are given a fig leaf compromise on the public option, so that they can say to people they forced a compromise, and then are brought over with all kinds of other incentives that make them more comfortable with the bigger bill.

B. The second is that the conference committee simply breaks the bill in half, one half being the less controversial part that everyone agrees upon, the other being the public option and the financing, both of which can go through the reconciliation process. Then Obama and Reid muscle the 50 votes they need for support.

None of this is easy, and none of it is pretty, but having been through a ton of these kinds of issue fights, both from inside the Clinton White House and from the outside, I can tell you that all of this is doable. These kinds of rhetorical logjams happen all the time, where it looks like the House and the Senate are both unalterably dug in, and then magically deals get done. On important bills, effective Presidents and Congressional leaders find some tough-to-thread-the-needle sweet spot, or they use some uncomfortable or inelegant legislative tool, and things that matter can get done. The media and establishment conventional wisdom, which always tends toward the dire and toward the conservative scenarios, is sometimes proven wrong. So ye of little faith, do not give up hope. The worst thing sometimes happens, but not always. Politicians sometimes sell people out, but not always. Keep fighting for the public option.

If you're looking for inspiration, take a page out of Gov. Dean's book. I co-moderated this part wonky, part political, part fiery panel (along with the wonderful Texas AFT union organizer Tanya Tarr) with Gov. Dean, and I'm sharing it with you because like me, he still believes hope for a public option is still alive and worth fighting for.

Comments

[creolechild]

If you are concerned about receiving "real" health care reform in this country, please take the time to watch a video on our current system. The video was created by Oregon physicians who are advocating for the single-payer option. The video is very informative and helped me to gain a better understanding of various aspect of health care, as we know now it.

https://www.madashelldoctorstour.com/Mad_as_Hell_Video.html

These Oregon physicians are in the process of organizing a caravan designed to inform the public about the benefits of the single-payer option. At last count they will be stopping in approximately 23 states, on their way to demonstrate in Washington. They need volunteers and our support. Please spread the word.

[wookierage]

Just asked to review a company's health care plan. This years increase? 42.5% medical; 13.3% vision/dental! How'd they resolve increase?...

[OneLiberalLady]

The description you give of possible scenarios reminds us how very complicated this process is, and it is far from over, including hopes for a public option. The idea of passing the parts that are agreed on in a fairly bi-partisan way (requiring 60 votes in the Senate) and then doing the rest by reconciliation is very intriguing. Politics is, after all, the art of the possible.. And it's certainly not a science.

[expired]

People, we have to tell the Obama administration that it is time to stop playing the patsy to the cons and stand up and lead this country into a new healthcare reform. President Obama, you have done more than enough to reach across the isle. Enough with the partisanship crap. It is not working. No matter what you do or say, the cons will yell louder. Grow a pair already. We need a strong public health care option sans the concessions for the corporate welfare hounds. Bring it home, President Obama. Bring it home.

http://www.whitehouse.gov/

[wookierage]

Guys, guys, guys (and gals) -- remember how you felt just before our President was elected? The 2-3 weeks leading up the election? How bleak and far away our victory seemed? How we despaired of having four more years of republican rule? It's always like this right before we smash them. Now let's stop the whining and bed-wetting, let's go kick their asses. They're one step away from extinction. Let's give them a good shove out the door.

[Roses]

Dr. Howard Dean has always been speaking sense throughout this. He once again does on this tape. I don't watch 'Morning Joe', but this is good. Please watch it

http://www.msnbc.msn.com/id/3036789/vp/32445707#32445707

[rblaquinta]

I totally agree. I listen to Dr. Dean 3x yesterday and I am very confident it will pass with a public option come hell or high water.

[Sundialsvc4]

What I care about is this: that the legislation, when it finally comes to the President's desk, is DAMN GOOD. No, it is truly Excellent. That it actually represents the best possible compromise between all of the competing interests and that it thereby creates permanent and lasting change in all of our lives for generations to come.

Is that too much to ask? Dammit, I don't think so. "Maybe I'm a dreamer, but I'm not the only one." We HAVE had some very good laws down through the years (Medicare was one; the Securities and Exchange Act; and so on). It was unholy-hell to get them written and purgatory to get them passed, but once they DID pass they changed the country and brought about prosperity.

The legislation that is now being crafted SHOULD have been passed twenty years ago, but that is water under the bridge now. We're faced with several fundamenta­lly-broken systems in our nation right now ... banking, finance, insurance ... and we must now, not only fix them, but fix them Excellently.

[Roses]

You make a good point.
Watch this and I'm sure you'll feel alot better.
I don't usually watch 'Morning Joe', but this is great.

http://www.msnbc.msn.com/id/3036789/vp/32445707#32445707

[bacaja]

The health care system and insurance industry is a gigantic money machine. Many senators
and congressman support the money machine because it finances them personally. The
cost of insurance and/or healthcare is destroying families and individuals, this is not a concern
of those mentioned representatives. We elected these people to represent us, the general
population, not special interests. If they do not represent us then they are charlatans and frauds.
We, the electorate know who these frauds are. Who these frauds are needs to be made known
in future primaries and elections, there is no ther message, only this message, it must be
repeated endlessly and tirelessly until "peoples" representatives have replaced them.

[Sundialsvc4]

These things take TIME, Mike.

They're still working out what to pass! And it's not like the solution of what to do, given a country like this, is obvious and vested in just a single choice. It isn't.

We are still weeks away, I think, from anything remotely resembling a consensus.

Whether we agree with these Congressmen or despise them (or both), their job is extremely complex if it is to be done well. And, it must be done well.

[Margo Arrowsmith]

The Methodists are all meeting in their smaller conventions and voting for the Public Option. Don't mess with the Methodists!

Its time to take to the streets. Do it in front of the offices of those who are wavering. Just do it right, not like the screamers.

http://www.squidoo.com/eugenehrobinson

[mom of three]

Great piece. It was refreshing to see Dr. Dean say something similar on Keith Olbermann last night. Thanks for sharing your thoughts.

[ladycubsfan]

After underestimating Obama in the past, I've decided to have faith this time. As a Democrat, I feel I have been "up for cheerleader" too many times, only to be let down. My gut tells me this time is different. I can't explain it. Things are changing...I feel it. The noise we are hearing is the death screams of the Republicans. They always WERE blowhards.
If it turns out I'm wrong, I will just work harder to get better Democrats in office, because clearly there is a problem when a majority isn't good enough.

[Kalamama]

Well said.
Also like that your a cub's fan. Me too.

[wookierage]

well said!

[Ameriki]

President Obama has already caved to Senator McCain and his buddies. Sorry to have offended you, sir.

[dynwit]

The fact that you depict this as an Obama v. McCain fight speaks volumes. Everyone here knows that McCain is a washed-up has-been whose only contribution to this nation since the election has been to whine and complain about earmarks without actually doing anything about them, even though it's his OWN PARTY that is most guilty of stuffing the budget with those earmarks. This is not an Obama v. McCain fight. The election is over and Obama won. You can't accept that, can you?

0 fans, eh? Go figure.

[zedmanna]

Lame duck... Quack, quack, quack...

[Clovie]

Chr.ist, you don't even know what that means.

[carlosgriffin]

Mike, Mike, Mike..... The public option is dead!

The people have finally figured out what the public option means, and they don't like it. Whether you like it or not the average American sees the public option as Socialism on steroids.

[Dustee]

You *real Americans* will believe anything they pay you to believe. Isn't your shift over tonight? Go home and keep a look out for Russians.

http://www.politicsandtechnology.com/2007/07/make-no-mistake.html

[mtnyogini]

The public option means a curbing of insurance company profits amassed on the corpeses of Americans denied coverage. I have no problem with that. Are you an insurance executive?

[BCLance]

No, the (few) vocal opponents don't have a clue what a public option is.

[gschear]

Thank you for re-energizing me. This is frustrating and exhausting but you and those like you must be defeated.

[robbep]

What we need to address is the public's false assumption that their private and employee based plans are not supported by the government. The government exempts 250 billion a year in taxes for employer based hlth plans. This is a huge subsidy and we shld eliminate it or place caps on it. Lets see how much the public likes their hlthcare if they have to pay its true cost. For those of you who dont want the government interfering with your hlthcare you might have to pay a little more but at least you wldnt be benefitting frm socialism.

[OneLiberalLady]

People are certainly getting a free ride with the subsidies, but it is almost impossible to touch this. And it's not fair to those who have to go out and buy their own insurance.