No Public Option Is Still Much-Needed Reform

09/22/2009 05:12 am ET | Updated May 25, 2011

There is a lot of anger from the left about what's being seen as Obama capitulating to the Republicans on health insurance reform. During the campaign Obama favored a public option. Now, the public option appears in danger and many liberals don't think "real" reform is possible without it.

In a perfect world, I'm for the most progressive health reform possible. But, our world is far from perfect and politics is the art of the possible. There are 47 million people in America without health insurance and they don't care if it's a public or private option that provides it. They just want access to quality health care.

A few days ago Matthew Yglesias wrote where he stood on health care and I found myself agreeing with him.

-- In terms of the present-day political debate, I think mandate-regulate-subsidize plus a public option would be a major improvement over the status quo.

-- But even though mandate-regulate-subsidize without a public option wouldn't be as good, I still think it would be an improvement over the status quo.

-- I don't think reform advocates should "drop" the public option; I think they should fight for it and try to bring practical pressure to bear on members of the Senate to vote for one.

-- But if in the final standoff we get a choice between mandate-regulate-subsidize and the status quo, I would prefer to take mandate-regulate-subsidize.

In summer 2003, I moved to Burlington, Vermont to join Howard Dean's Presidential Campaign. One of Dean's main draws for me, besides his brave stance on the Iraq War, was his success at providing near-universal health insurance to Vermont's residents. He did this without a public option.

In fact, Ezra Klein recently pointed out that Dean, considered one of the most liberal candidates in the '04 primary, didn't have a public option or co-ops in his national '04 platform.

Dean's plan would have insured millions fewer people than the bills being considered in the House or the bill that we think we'll see out of the Senate.
For all that, it was a good and well-meaning plan. But it was a lot worse than what we're considering now. It was a lot worse even than the compromises we're considering now.

I admire the liberals in the House who say they won't vote for a bill that doesn't contain a public option, but I hope in the end they put a reform bill on Obama's desk to sign. As Paul Starr says in the current issue of American Prospect, "if any of them actually do vote against the final bill and prevent it from passing because it fails to offer a public option, they will help to ruin the best chance in years to put health care on a path toward reform."

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