The Sunday New York Times ran a front page story headlined "The Fading Public Option." Since the beginning of the health care debate in April, the main stream media and purveyors of Conventional Wisdom have regularly pronounced the public option dead and gone. But in fact they continue to be dead wrong.
In fact, the prospects that there will be some form of public option in the final health insurance reform measure this fall have actually increased over the last month. Here is why:
1). The odds have dropped that some sort of "bipartisan" consensus will become the final template for a bill. That has reduced the ability of Republicans to tube a public option as a condition of their support.
From day one, the Republicans were never going to support a public health insurance option for everyday Americans. The Republican party staunchly opposed Medicare forty years ago. Despite former House Speaker Newt Gingrich's hope that it would "wither on the vine," Medicare is now an unassailably popular public health insurance option for seniors. The Republicans and private insurance industry will do everything they can to prevent the American people from having access to another -- undeniably superior -- public health insurance plan.
The insurance industry desperately wants to protect its "right" to raise prices and take home huge profits -- to skim off as large a portion as they can of every dollar spent on health care.
So the insurance industry and Republicans were never going to agree to a public option. What has changed is that the Republican decision to try to block health insurance reform has completely eliminated their leverage over what will be in the final bill. In the end, Democrats are increasingly clear that they will have to pass health insurance reform with Democratic votes -- which we can -- either by using reconciliation rules or by securing 60 votes for cloture from Democrats and 50 votes for final passage.
2). The pundits ignore the legislative facts on the ground. Four of the five committees with jurisdiction in this debate have reported out bills with a strong public option. The bill that passes the House at the end of this month will include a strong public option. Whether or not the bill that passes out of the Senate has such a provision, the House-Senate conference committee will likely send a final bill with some form of public option to both chambers for final passage. That's because a bill without a public option will have a hard time passing the House and a bill with a public option can, in fact, get more than 50 votes in the Senate.
3). The president has made it very clear that he not only supports a public option, but he will demand some mechanism to assure a competitive market place and drive down costs.
The Republicans played right into his hands with their new talking points on this week's Sunday news shows. Virtually every Republican argued that the Massachusetts plan -- that requires everyone to purchase health insurance -- has the highest health care costs in the country. Precisely. You can't force everyone to purchase insurance from private health insurers unless you create competitive pressure to control costs by giving consumers the right to choose a public health insurance plan.
The private insurers would love the government to require every citizen and most businesses to buy their product -- who wouldn't? What they don't want is regulation, or worse yet, competition, that prevents them from doing whatever they can to make as much as they can. And remember that the insurance companies are exempt from the anti-trust laws that seek to assure competition in other markets. They can collude, divide up territories and drive up prices until they're blue in the face.
An AMA survey, released in late January, gives a score gauging the concentration of the commercial market for 314 metropolitan statistical areas. The report showed 94% had commercial markets that were "highly concentrated" by standards set by the Federal Trade Commission and Justice Department.
In Maine, for instance, one company -- Wellpoint -- had 71% of the market. The second competitor was Aetna with only 12%.
There is another way to control the behavior of the private insurance companies when we mandate coverage -- serious rate regulation -- treat them like regulated public utilities.
Rate regulation is an even more serious political lift than a public option -- which is also a much more efficient means of assuring competitive prices than rate regulation.
The pundits, insurance companies and Republicans need to get used to one idea. Many Democrats -- including the president -- will ensure that the final bill have some robust means of ensuring competition and controlling prices, and a robust public health insurance plan is the best option on the table.
4). Giving Americans a choice of a public health insurance option remains incredibly popular. A poll conducted for Americans United for Change by the respected firm of Anzelone and Liszt -- completed last Friday -- shows that, by a 62% to 28% margin, likely 2010 voters would be more inclined to support President Obama's healthcare reform plan if it included a public option that gave people a choice between private insurance plans and a public health insurance plan.
Voters like the idea of making a choice themselves -- and not having the choice made for them by Republicans who are trying to defend the profits of private health insurers. The voters have been unaffected by the insurance industry-generated talk that giving them that choice would prove the demise of the private health insurance industry.
There are three major forces that keep pushing the notion that "public option is dead." First are the Republicans and insurance industry that want to weave a "public option is impossible" narrative in order to create a self-fulfilling prophecy. They hope that if public option proponents think it is impossible, they will give up. That motivation is completely understandable, but Progressives shouldn't fall for it -- or contribute to it.
The second is a desire in the media to create a story that President Obama has "mishandled" the health care debate. That is simply wrong. President Obama has moved us closer to giving America universal health care than any other president in 60 years, and the odds are very good he will succeed where all others have failed.
But the third is the most insidious. It is the cynicism in the media -- and Washington Conventional Wisdom -- that anything fundamental cannot pass out of Congress. That there isn't any hope that everyday Americans can defeat the special interests. It is the same cynicism that convinced most of the "sophisticated" in-the-know Capitol Hill insiders that Barack Obama could never be elected president. And to that cynicism I give the same answer that we gave then, and that thousands gave at the president's Minneapolis health care rally on Saturday: "yes, we can."
Robert Creamer is a longtime political organizer and strategist, and author of the recent book: Stand Up Straight: How Progressives Can Win, available on Amazon.com.
Tom H. Hastings: We Can't Afford Health Care? You lie!
Does it not seem that when the US can afford and not question nearly 1,000 military bases on other people's sovereign soil -- 287 of them in Germany alone -- that we can afford to create jobs?
While I know from broad reading of readers' comments on many different sites, since I read all over the web for many hours daily, that *in the blogosphere* there are many, many comments from people opposed to any "government take-over of health care," so-called "death panels," etc., from my numerous private conversations and e-mails from people right across the political spectrum in all parts of the country that there is considerable support for a public option of some sort, including amongst my conservative relatives and friends, though yes, they're support is less enthusiastic. Aqs for my friends on the far left, well, they're not going to be satisfied with anything short of punitive treatment of the entire medical establishment.
House Bill 3200 says in Sections 242 and 246 that to be eligible for treatment, a person must be "lawfully present" in the U.S. Straightforward
Some pointed out illegal aliens can get treatment in an emergency room. That's true in many ER's in many countries, not just the U.S. And yes, it's costly and subject to manipulation by illegal aliens.
Just how are we to decide whom to ID and whom to let slide, anyway, anyway?
What a nightmare.
The temperature is way too high in this discussion, or, screaming match is more like it way too often (for which I, um, "credit" the Looney Left and Rabid Right in equal measure).
We need a knock down, drag out fight to remove private donations to campaign funds. Removing lobbyists will refocus many in Congress on - their constituents, for it will be those constituents, happy with their improved health care, roads, bridges, schools, banking. etc., who will enthusiastically vote for them again.
the tractor pull is coming, lets hope he can drive this rig in the mud and the rain
Stop the ownership of treatment facilities by doctors. Let them earn their income from good treatment of their patients.
I am an Independent and once visited HuffPost often for updates. Lately, the vitriol from the far-left re: the public option makes me want to visit less and less.
It'll get done -- and it'll get done shrewdly.
If you think the public option contained in HR3200 is a fine thing indeed, I wish you would explain why.
The nonpartisan experts of the Congressional Budget Office (CBO) have judged that HR3200 will do nothing to control systemwide costs and will expand coverage only by 10 million--that's only 20 percent of the people who are now without coverage.
The CBO verdict on the Senate HELP bill is even more discouraging: NO expansion of coverage, along, of course, with no cost control.
Now expanding coverage and controlling costs are the two key imperatives of reform, and the main Democratic bills--the best we can hope for, since they'll be pared down in House/Senate conference--accomplish neither.
Now that's not the vitriolic "far left" talking, that's the CBO.
So I'd be interested in hearing your counterpoints.
For a thorough history and analysis of the fate of the public option, I urge you to read the following analysis by Kip Sullivan of Physicians for a National Health Plan (a solidly progressive but hardly "far left" group):
"Bait and Switch: How the Public Option Was Sold"
"Bait and Switch: How the Public Option Was Sold"
http://pnhp.org/blog/2009/07/20/bait-and-switch-how-the-%E2%80%9Cpublic-option%E2%80%9D-was-sold/
you attack this Independent, and twist her words....and use a vitriolic tone to do so?
If you're on the left, as I am, you need to behave like it. You can get your point across, and disagree, without sounding like bill o'reilly. Be respectful of people who are respectful, and don't act like a right winger, please. You have good points to make.
http://www.huffingtonpost.com/david-sirota/unitedhealth-lobbyist-ann_b_284442.html
"Many Democrats -- including the president -- will ensure that the final bill have some robust means of ensuring competition and controlling prices, and a robust public health insurance plan is the best option on the table."
The fact is that the public option is the ONLY option on the table to robustly control prices and ensure competition. For weeks now, writers have been referring to these mysterious "other measures" to control price and create competition and they wind up being nothing more than etherial references. No substance. THEY DON'T EXIST. Triggers? Give me a break. By the time a trigger could be pulled there will be a lot more damage done both to the economy and people's lives.
This notion that the public option is not the only way to control prices and create competition needs to be articulated, not just obliquely referred to as if it's a given.
Put your ideas on the table or stop referring to them.
Have you really studied the details of the watered-down farce that the Dems are presenting under the name "public option"?
Please read the following brilliant, thorough analysis by Kip Sullivan of Physicians for a National Health Plan:
"Bait and Switch: How the Public Option Was Sold"
http://pnhp.org/blog/2009/07/20/bait-and-switch-how-the-%E2%80%9Cpublic-option%E2%80%9D-was-sold/
I too, like almost every progressive I know, favor single-payer, but as Obama campaigned and people focused on Healthcare Reform, the Public Option became the compromise position on which he was elected. I think most progressives see it as a step toward what will probably evolve into single payer.
However after reading your link, I'm now not sure that the "mouse" version suggested in the House and Senate will have enough of an impact to warrant the further funding and expansion necessary to make it viable.
I'm realizing that all of these measures, in addition to being diluted, are being lined up in a kind of faux pecking order rather than combined to work in concert. That's where this whole idea of a "trigger" comes from. It's crazy.
Anyway, thanks again for the link.
If we can't manage a "strong" public option (at the least, I am in favor of single payer) then I want the bill to go down in flames with nothing done. It might not be good for Obama, but it will eventually be worse for the Republican party. No one will forget who opposed reform if the bill is defeated. Republicans made sure of that with their shameless antics and dirty tricks so openly displayed and loudly proclaimed. Most Americans will want to throw up a little if Republicans make the mistake of celebrating any win they achieve.
In less than four years the status quo will blow up in Republican's faces. At that time the only fix will be emergency actions that may well put our budget over the line where we can not recover from the economic collapse. This would spell the end of the Republican party as we know it and relegate it to the status now enjoyed by Libertarians and Constitutionalists which may end up being better for America than a watered down health care reform.
So how are there 50 votes in the senate?
You need 60.
Because we have a for-profit model - the U.S. health care system is rated 37th (just above Costa Rica). We have more deaths per 100,000 from treatable diseases, spend $3-6000 more per person, 5-12% more per GDP and we still don't have universal coverage.
The top 10 rated countries have universal coverage, require non-profit health care whether it's public or private sector, and have sustainable % of GDP. They all have higher rates of survival from treatable disease.
Without a publicf option there will be no viable competitor. Costs will not be lowered. We will have nationalized "Romney Care." There is plenty of competition between private insurance in Massechucetts, yet "Bay State health insurance premiums highest in country" - that is unacceptable!
Pitting Profits against Patients" is economically unsound, unethical and a conflict of interest. When you think about this, it is outright ghastly.
Universal coverage and the end of health insurance is the only true solution. No one is even trying to solve the problem.
I no longer care about this so called reform. Let it fail. If it passes we're still up the creek without a paddle anyway...
The original public option would have had access to 100 million people, and this one is confined to merely 10 million, if that. You simply cannot negotiate if you are limited to that many people. So the whole point is worthless.
We may as well call for this bill to fail, and inject single payer as soon as possible, and call for millions to march and demand it. Its the only way single payer will ever be accomplished.
Either that, or we allow this to pass, let the inevitable occur, waste tons of taxpayer dollars, and in another 10 years, (when we are but a shell of the country we once were) introduce reforms that eliminate private insurance and rally for it then.
One guy wore a 'Tyranny Response Force' shirt. NewsChannel 8 showed a sign with a hammer and sickle as the 'O' in 'OBAMA.' In the absence of an official count, most newsies (including AP, NYT, WP) went with 'tens of thousands.' ABCNews.com quoted D.C. fire officials as estimating the crowd at 60,000 to 70,000 protesters.
DNC's Brad Woodhouse: 'That the protests in Washington fell several hundred thousand short of what organizers projected is evidence of what we began to see at the end of August and what we saw in the public polls after the President's speech: there is strong support for the President's agenda for change and there is a small, vocal far right wing minority that opposes everything the President does - including speaking to schools children and encouraging them to get good grades.'
About Co-ops. I know we want to believe the best. But Co-ops, very simply put, are not viable competition. These were tried from 1930's -1940's and failed; funding was cut off. They do not affect Insurance Industry pricing (GAO study done March 2000). Co-ops that become actual competition (e.g. blue cross/blue shield) are bought up and run by the Insurance Industry to keep prices steady. They remain non-profit but do not affect % of GDP or price to the consumer.
If not now, when? If not us, who?
Kennedy was one of our greatest champions of health care reform. He carried the torch for a long time...and now it is up to us to continue to carry it!
Our elected officials in Congress receive health care mostly paid for by us tax payers, yet many are trying to make it impossible for us to purchase an affordable plan of our own :
While many of us are struggling to afford medical insurance/medical bills.
While Congress people try to stop healthcare reform.
While Congress people accept large contributions from lobbyists to prevent health care reform.
Please sign these petitions - and by all means, spread the word! Thank you!
http://www.petitiononline.com/PubOp676/petition.html
http://www.democrats.com/honor-ted-kennedy?cid=ZGVtczQ0MTA5OGRlbXM=
http://salsa.wiredforchange.com/o/5649/t/4922/content.jsp?content_KEY=2763&tag=hk1_typ-e1
I've also read that profit health insurance is holding a payoff money bash on her behalf.