In the coming days the media will be abuzz speculating what Obama might say next Wednesday during his prime-time address to a joint session of Congress. Here's what he should say: this bill will pass, and it will pass with a public insurance option. No two ways; it's time to stop beating around the bush and fight for what's right.
The Washington Post's Ezra Klein reported on Wednesday that there's a battle going on between the political and policy camps in the Obama cabinet as to how to proceed on health care. But if Obama and Democrats message this properly and let people know the truth, the public option is a winner on both grounds.
There are copious reasons why the public option is a necessity, but to break it down: a) it is crucial for holding down costs; and b) it'll provide the desperately needed competition for insurance companies -- who, as the Associated Press and the New York Times recently documented, operate as virtual monopolies across the states.
Due to the lack of competition in the present system, insurance companies can freely raise premiums without being forced to improve quality or efficiency. They can drop patients from coverage when it isn't profitable to cover them. They can from the outset exclude people who aren't good for their bottom line. They do these things regularly -- which is why tens of thousands die needlessly every year and more go bankrupt due to medical bills.
Substantively, a public option will create competition that will lower prices and improve quality across the board. It will also lead to more choice. Yes, contrary to the widespread nonsense that a public option will bring about a "government takeover" of health care, it'll simply allow people to choose between the existing private options and a new public option. Without this, the bill won't amount to much -- insurers might behave themselves for a while but they'll inevitably write loopholes now or over time and return to their ways.
Politically, it will be the victory Democrats need not only to reinvigorate their dismayed base, but to achieve the landmark legislation that'll reestablish themselves as a party that gets things done and follows through on its promises. Even the bitterest skeptics today will come to appreciate having an affordable alternative to private insurance, and it'll soon be a dead issue -- just like Social Security and Medicare are now.
This is what Republicans and insurance companies fear most, and it's why they're pulling out all the stops to try and muddy the debate with slanderous lies and propaganda. These so-called conservatives clearly don't want choice and competition, and are determined not to let principle get in the way of their political objectives.
And the Gang of Six? Chuck them. It's beyond hypocritical for Charles Grassley and Mike Enzi to actively campaign against this bill and then claim to still want to negotiate. They've also echoed some of the most heinous lies surrounding it. For Obama to continue honoring their voices after their blatant displays of bad intention would show incredible weakness on his part.
Through all the transparent dishonesty it's become clear that the GOP wants this bill to fail for its own political reasons. It's really that simple. If these reforms are to have a positive impact, Republican support is not feasible -- and more importantly, not necessary.
This is Obama's true test. His biggest flaws as president so far have all come down to his hesitation to fight the narrow, entrenched industry groups serving their bottom line at the expense of the people. (In fairness it's not easy when the GOP is primarily out to assist them.) Obama prefers to be a uniter, not a fighter; but on health care he needs to fight, because his opponents are too invested in sustaining the broken system and don't want to see it fixed.
Next Wednesday will be a huge day for health care reform. It may be President Obama's last chance to take back the mantle he's recently let slip and win this one for America.