An Open Letter On The Public Option To David Axelrod

Dear David,

You sent me an email on healthcare from the White House last month, one that went out to millions of people. Now I'm replying by sending one to you. You told me it was time for a reality check. Now I'm telling you the same thing. My message is very simple. As a lifelong FDR Democrat, I won't support any health care bill that doesn't have a robust public option. I'd much rather see a bill without one go down to defeat, than have a bill pass without one.

Apparently, by accounts in Politico and elsewhere, you've been deputized to let it be known that the public option is dead, and to try to appease the majority of us Americans who support it (by 55 to 41 percent, according to a very recent CNN poll) by assuring us that its "spirit" lives on. Sorry, David, that's not good enough. Neither is the "trigger" the White House is discussing with Sen. Snowe. You can be sure that's one trigger that will never be pulled.

I've read that if no bill becomes law, that would be a crushing blow to Obama's presidency. Maybe so. That would be too bad. But we liberals might not knock ourselves out to keep it from happening. Trouble is, you people don't get it. You may have to learn the hard way. Stop worrying about Grassley and Enzi and Rush and Sean and Baucus and Conrad, and Billy Tauzin and Karen Ignagni and their hundreds of lobbyists; and start worrying about the people who worked, paid and voted to put you in the White House. We can live without you if we have to. After all, we survived eight years of George W. Bush. But you folks can't continue to live in that big house on Pennsylvania Avenue without us!

Liberals have been waiting since FDR for universal health care. Heck, we can wait a few years longer -- especially those of us on a public program called Medicare, courtesy of one of your predecessors. It's wonderful. We ought to have its equivalent for everybody. I know that, unfortunately, that's not politically possible right now (partly because, god forbid, the next head of United Healthcare might not then be able to retire with $1.7 billion in his pension). But at least there's got to be a public option: a chance for some people to have the price advantages of a cheaper government plan soon, and a camel's nose under the tent so we can move toward Medicare for everybody someday.

A recent report said that in more than 90 percent of markets around the country, a single private health insurance firm had a near-monopoly -- not enough competition to significantly keep prices down. Here's how reporter Ezra Klein described the situation in his Washington Post article:

The Justice Department judges an industry "highly concentrated" if a single company controls more than 42 percent of the market. By that definition, 94 percent of statewide insurance markets are highly concentrated. A recent study by the advocacy organization Health Care for America Now showed that in Indiana, WellPoint controls 60 percent of the insurance market; in Iowa, Wellmark accounts for 71 percent; and in Alabama, Blue Cross/Blue Shield holds 83 percent. In the past 13 years, there have been more than 400 corporate mergers involving health insurers.

Then too, individual insurance costs far more than many families can afford. Besides which, a lot of small businesses have problems providing employees with affordable insurance.

That's not good enough. The public option, if it's robust enough, might just make insurance affordable to people who don't have jobs or can't get decent (if any) coverage through employers. If not, let's forget the whole thing for now. Until the day enough Americans get so fed up with the current system that's needlessly hurting and killing their families, that they decide to catch up with the rest of the civilized world and demand something better.

Six months ago, I'd never heard of a public option. Neither had anyone else. But you folks convinced me -- including Obama in his July 18 weekly address -- that one was absolutely necessary. Do you recall what the president said? Let me refresh your memory:

...any plan I sign must include...a public option to increase competition and keep insurance companies honest...And that's why we'll put an end to the worst practices of the insurance industry.

Too bad that just when you got me absolutely convinced, you guys began backing away from it.

You'd better reverse course again. I read that Obama has scheduled a health care speech to Congress next week and a talk before the AFL-CIO. He'd better come out in support of a robust public option.

If not, a lot of us liberal Democrats might just conclude that we can't really trust your guy. Some of us might just stop caring if the Republicans gain seats or take over Congress next year, and stop bothering to work hard to see that they don't. We'd be unhappy with such results, but we'd have to acknowledge that the Dems got what they deserved. And if some GOP lunatic beats Obama in 2012, we'll just have to grin and bear it, saying that's just the American Way.

Those of us who say this will, of course, be insured, from Medicare and elsewhere, so we won't personally suffer (except, of course, when we get cheated or our health put at risk by health care companies -- can you really trust Big Pharma's $80 billion deal with you when the biggest pharma of them all, Pfizer, just paid a record $2.3 billion in fines for cheating? And didn't you make a deal with hospitals? And didn't the largest hospital chain in America, HCA, pay $1.7 billion in fines for Medicare fraud a few years ago? Sorry to bring up stuff like that.) Continuing the current system will just insure that millions more Americans -- including kids -- will continue to be cheated, and to suffer and die needlessly.

One thing more. Obama's seven months in office have resulted in growing disillusionment among the liberals who worked hardest to get him elected. There's no move to close Guantanamo. The Iraq war, which Obama promised to "end in 2009," shows no sign of ending. There's no light at the end of the Afghan tunnel, despite increasing anti-war sentiment at home.

The economy continues to edge downward, although a lot less than before. Growing unemployment is not expected to turn around for months. Foreclosures still mount. Banks still don't deal with toxic assets, and credit remains tight. Deficits continue to grow. Republicans have made much of all these problems. Independents aren't happy about them either. Now, especially if Obama folds like a paper napkin on the public option, that could be the last straw that causes many liberals to throw up their hands and stop fighting.

Liberals' strong support of Obama is a political love affair. So he should beware of a strong, angry, jilted lover. As columnist Eugene Robinson wrote:

Giving up on the public option might be expedient. But we didn't elect Obama to be an expedient president. We elected him to be a great one.

And if he turns out to be just another pol, then we can do without him.

Sincerely,

Sandy Goodman
Rockville MD

Comments

[dyspeptic]

Sandy, Excellent and right on! I completely agree.

"Stop worrying about Grassley and Enzi and Rush and Sean and Baucus and Conrad, and Billy Tauzin and Karen Ignagni and their hundreds of lobbyists; and start worrying about the people who worked, paid and voted to put you in the White House. "

I will not vote again for any politician that betrays the real public option, available to all who want it. No triggers. No coops. Real public option, available to all who want it.

I gave the $2300 max, for the first time in my life, housed an out-of-state volunteer, and more, for Obama. I would not have done those things if I believed I was helping to elect an appeasing triangulater. In fact, I preferred Obama over Hillary because I thought Hillary would be an appeasing triangulater.

So, give us health care with a real public option, available to all who want it. Close Guantanamo. End the un-Constitutional Bush repeal of habeas, etc. Do what you promised!

[PlaceboStudman]

Dear Mr Axelrod, Mr Emmanuel, President Obama, and members of congress,

I must ask, why did you choose to tackle Insurance-­but-you-ca­ll-it-heal­th-care reform, before tackling energy reform? What is the point of giving people affordable, accessible insurance, if you do not tackle the issues that are causing people to become ill and need insurance to begin with? Why have you not discussed reforming the FDA and the USDA, to give us better food and better products, many of which end up being the cause of so many of our health issues? If you had reformed these aspects of society before reforming insurance, then the costs would drop dramatically, as fewer people would need insurance to begin with, leaving it for those who really need it, the truly chronically and critiically ill.

Placebostudman
HuffingtonPost contributor

[msgirlintn]

Great Letter! I hope you mailed it or faxed it. My daughter pointed out something to me tonight. She says he hasn't really followed through on anything he promised during the campain. She also says that if there isn't a public option, she will not vote for him in 2012. The young people are one of the reasons that he made it to the white house, and I'm sure she isn't the only young person that is getting disgusted with him. You mention HCA in your letter, Are you aware that Rick Scott that is running the Conservatives for Public Rights ads was with HCA when those fines were paid? And, that Bill Frist's family owns HCA, the nations largest for profit health care system.

[SameSo]

Neither you nor your daughter is paying attention, obviously, if she believes and you agree, that "he hasnt really followed through on anything he promised during the campaign." That is such a sad commentary on the mentality of the average american. We foreigners looking on at you can only shake our heads in disbelief. Do you people think democracy is an easy form of government? Its more difficult than dictatorship. Perhaps youd prefer to live in a dictatorship where the dear leader can wake up on any given morning and decide he wants a particular policy enacted by lunch time and he bloody well gets what he wants. And on time too. Bunch of wusses!

[RyanCSmith]

There is a difference between the democratic process and repeatedly failing to follow through on his promises. If people can't trust their elected officials then democracy is a moot point and Obama unfortunately is not helping himself. If he won't fight for the public option he won't see me fight or vote for him in 2012.

[JDM73]

Great stuff, Sandy! Thanks.

[Heartlight3]

This is a very good letter. Did you actually send it to him? I would like to think that the White House really reads the Huffington Post, but I'm not sure they do. They seem to respond to the lies and deception of FOX News more than they respond to the voice of their base which often speaks through HuffPo. The Repubs are moving father and farther out into the ozone following their rabidly insane fringe, while the progressives are crying out to be heard by the ones they worked so hard to elect. I'm not sure they are listening. If you didn't actually send this to David, and are expecting him to read it on his own, please send it to him directly. They need to know that there are many, many of us out her that feel this way.

[Awake-and-Sing]

Thank you!!!

This article is wonderful.

I think that not enough is being made of the "mandate" issue.

If Obama cowers and refuses to stand up for the public option, the alternative is not the status quo.

The alternative to the public option is massive corporate welfare in the form of a mandate for everyone to buy crappy, overpriced, unreliable private insurance at extortion rates under penalty of taxation if we don't.

The insurance companies are salivating over this mandate. They want a mandate with no public option.

There will be no increased health care, but their profits will skyrocket and their overpaid CEOs will get even bigger bonuses.

I hope the House votes a non-public option bill down on the grounds of morality. It is immoral to make people who cannot even afford current insurance premiums to buy these crappy overpriced products at extortion rates.

The welfare of actual people are far more important than re-elected a wimpy President who threw away his political capital on the false god of "bipartisanship" and DLC triangulation.

If Obama doesn't speak up for the public option on Wednesday then the draft Dean (or some other genuine progressive) movement for 2012 should start on Thursday.

[LarksTongue]

I fought the smears during the campaign. I exposed the myths (lies) after the election. I shared my health care story on the OFA Health Care Action Center. I contacted my Congressman, Senators and wrote letters to the editor. And after all this, I find that true health care reform is threatened by who?

Blue Dog 'Democrats' that's who.

The President knows where his base stands. The question is: do the Blue Dogs? Blue Dogs will be replaced in 2010 by the Tea Baggers no matter what we do. They are expendable. If we fail to USE our majority now, we may not get another chance.

The entire Party apparatus, including the President, was AWOL during August. Reid never should have allowed the Senate to leave for recess. We should have been knee-deep in a month long filibuster by now. A filibuster that would have exposed the Republicans and Blue Dogs for the anti-American corporate whores that they really are.

[onegandolf1]

Bottom line , Obama Administration, Blue Dog. Reps and Erring Senators:

You show us a bill without a Public Option (at the very least).

We show you the door.

[YewNeekId]

I'm behind that 100%. I am sick of being lied to by Obama and pals

[Centient]

Well said Mr. Goodman.

[mcmchugh99]

I agree 100%. If the DLC people and the Blue Dogs want to pass a "reform" bill that just requires everyone to buy private heath insurance, then they can do it without the progressive wing of the party. This is where we get off the train.

[michiganfan]

Brilliant!

[thnk4selfagain]

Medicare was part of LBJ's Great Society compliment to FDR's New Deal. However flawed LBJ's presidency was because of the Viet Nam conflict, he had the cojones to facilitate legislation that reflected his progressive social values. The world was supposed to end in dire deficits when Medicare became a reality in the late 60s. Now, one would be hard pressed to have a GOP member suggest that this entitlement be taken away from the one (and perhaps only) voting demographic for the GOP.

[WASanford]

It's a pleasure to read someone who has a sense of history.

[Matt7]

"I won't support any health care bill that doesn't have a robust public option. I'd much rather see a bill without one go down to defeat, than have a bill pass without one."

I know that's not what you mean.

[Harlem-bred]

Well said!!! Sir Goodman, you have hit the nail squarely on the head. I hope our President is aware of the backlash from his most ardent supporters..myself included.. that he is very near to creating.

[rain33]

i agree with you too!

[kewe]

FDR did great things, but he too compromised the perfect to get the good. im not defending Obama because these are different times with a far different political climate, requiring a different response. but things like social security started out sweeping and were whittled back. it took several rounds of congressional changes to get it where it is today.

what is different is that when it got down to the vote, republicans voted for it. the difference is that no matter what is in the bill, no republican is going to vote for it. they know now what they didn't know in 1935 - that it IS possible to get away with ignoring the people because corporations will always keep them in office.

[EasyZee]

You are 100% correct. President Obama is a very smart and pragmatic man. He tried, for the long term good, to get republicans on board. But it is clear now that they will not vote with him on anything because their only goal is to see him fail. That is a shame; when you lose an election you should work with the winner for the good of the people until the next election, not try to sabotage him on every single issue. He tried to work with them, he tried to include them, now it's time to ignore them.
I think President Obama is also a patient man, and he will try over and over again to work with the republicans. And I don't think that is such a bad thing, to try to bring the country together. But if the republicans continue with their racist, unprofessional behavior, eventually even President Obama will give up working with them.

[JamesinDentonTX]

Yes, I doubt that any of the people who are so mad now about the public option being sidelined will sit idly by while Sarah Palin and Joe Scarborough try to retake the white house. I iope people can compartmentalize their feelings about Obama abd continue fighting for what they believe in, no matter how discouraging it gets.