Is The Public Option Out, Or Just Under Another Name?
Posted by Michelle Moquin on December 12th, 2009
The Public Option died on Thursday. Or did it just resurrect under another name? I’m sure most of you feel as I do: I don’t care what they call health care reform or what title the bill falls under, as long as it covers what’s needed to improve our health care system.
As Arianna Huffington so simply states below, ‘ It’s not the label we give these that matters, it’s the end result: competition and cost reduction.’
If the fight over health care reform has proven anything, it’s just how broken our system has become — from the crippling influence of money on our politics to the way the modern misuse of the filibuster has taken away the power of the duly elected majority and handed it to a handful of bought-and-paid-for senators (yes, I’m talking about you Joe Lieberman).
This disturbing and destructive state of affairs has created a country that is, in the words of Tom Friedman, “only able to produce ‘suboptimal’ responses to its biggest problems.”
And that’s where we find ourselves on health care as we head towards the legislative end game. The big optimal solutions have all been gutted — and we are left to pick through the patchwork of suboptimal ones.
What makes this exercise harder is that the details seem to change form more frequently than the characters in Twilight. At the moment, and while we are waiting for the latest CBO score, “the whole town,” as Mike Allen puts it, “is talking about a proposal that few have seen, and none understand.”
One by one, Congressional leaders who said they would not support a bill without a public option have come to the conclusion that, on second (or third or fourth) thought, they actually will. Leaving aside what this does to the already tattered trust the public has in their representatives, is a progressively watered-down public option preferable to a Medicare expansion combined with a national non-profit insurance plan similar to the one offered to federal employees, regulated by the Office of Personnel Management?
Bernie Sanders, one of the leading advocates of the public option, is now arguing that these proposals combined “may be stronger than the very weak public options that both the House and the Senate have already passed.”
Jacob Hacker, the godfather of the original public option concept, also approves of the proposed expansion of Medicare, calling it an “enormous positive development.”
Of course, expanding Medicare by allowing those 55 to 64 to buy into the program won’t be subsidized for the first three years and therefore may end up being prohibitively expensive, especially if it ends up being an expansion of Medicare not tied to Medicare rates.
Amidst the tea leaf reading and jockeying for political position (at least among Democrats; Republicans are united in their commitment to kill reform) it’s important not to lose track of the things that absolutely have to be included in any health care bill for it to deliver reform in more than name only.
It has to expand access to include as many of the 46 million uninsured Americans as possible. Both the House version and the current incarnation of the Senate bill go a long way to meeting this goal.
It has to create competition and reduce costs. In the end, it doesn’t matter if this is accomplished by creating a government-run non-profit insurance provider (the so-called “public option”) or by adopting a national privately run system that is heavily regulated by the federal government, and allowing those 55 to 64 the “option” of buying into the Medicare program. It’s not the label we give these that matters, it’s the end result: competition and cost reduction. The current bill mandates that most Americans get insurance coverage, creating 30 million new customers for the insurance industry. These new customers have to have options — especially less expensive options — or this will be a massive windfall for insurance companies.
The best way to provide more choices for consumers is through the latest incarnation of Sen. Ron Wyden’s Free Choice Act, which he is offering as an amendment to the health care bill. The provision would give employees the ability to choose their own insurance plans within the insurance exchange — instead of having to accept the plan chosen by their employer, as is the case in the bill Harry Reid brought to the floor of the Senate.
To qualify as real reform, the bill also needs to give Congress the ability to negotiate with the drug companies over Medicare prescription drug prices. The White House cut a deal with PhRMA taking away this ability to negotiate. That agreement is still part of the Senate bill but not part of the House bill — and should not survive the conference process.
And, knowing how quickly things can get slipped into bills, or carved out of bills, in the dark of night, we have to ensure that the positive elements of the current bill don’t suddenly vanish — especially the provisions that keep insurance companies from denying people coverage on the basis of pre-existing conditions or dropping customers when they actually become sick.
If the final bill contains all these elements, it will be a suboptimal solution worth supporting.
Then we can move on to the business of fixing our broken system, so we can get back to being a country able to produce optimal responses to our biggest problems.
Arianna Huffington – Huffington Post
Readers: I know you’re out there reading, and my sense is you’re having a tough time posting. Such is life sometimes in blogsville, especially here. Miss you…
Doug: You know how I feel about your optimism. :)
Gratefully your blog host,
michelle
Aka BABE: Your Bad Ass Bitch Editor
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December 12th, 2009 at 2:42 pm
Michelle, I have had a very bad week. I am very disappointed that the Public Option did not pass after all that we tried to do to make it pass.
I saw my Diabetes Doctor, my Orthopedic Doctor, and my Neurologist and received bad news from all three. I am walking around with my head in the clouds. I was told that I would have to live this way for the rest of my life. Many of my problems are progressive, so they will get even worse as I get older.
I have spoken to Carr about my problems and he wants me to experience and deal with this suffering in order to become a more understanding Human. I will need to be compassionate and understanding of the sick and less fortunate in the future.
I have been feeling self-pitty and must learn to accept and live with my health problems. At least I am disabled and receive MediCaid to pay for my Doctors and Medicines.
My heart goes out to the many people like me that do not have Insurance and must live with all manner of illnesses or put food on the table.
America was once a great country after WWII and the ‘Baby Boom.’ Americans prospered. People from all over the World came here and experienced the American Dream. Now America is broken. The Republicans robbed the Middle Class and we became ‘Corporate America.’
We are run by Corporations who have taken their jobs to other Nations for cheaper labor and America doesn’t produce anything any more. Everything is imported from China and other ‘Third World’ Nations who are experiencing explosive growth while America just becomes a playground for the super wealthy and hell for the 95 that is left.
The Middle Class is a thing of the past. The Republicans will do anything — and I mean “Anything” — to keep their wealth and Political control. They will fight everything good that president Obama has planned for America tooth and nail until they regain their previous power and control of the American people.
They have 30 years or more of running this Country and living off the labor of the poor. They want this back. Unfortunately, They just might get it.
HOWIE
December 12th, 2009 at 2:48 pm
Hello Michelle, How are you? Looks like your readers are being blocked from commenting again. I am disappointed to see that the public option seems to have died. Just knowing why this bill has failed is the real disappointment. Your post says that health care reform has met some success, to what degree it is not immediately clear. Thanks for all you did and do.
Al
December 12th, 2009 at 6:04 pm
Horace,
I was a bit surprised to see a comment directed towards me. I was not sure how or if I wanted to respond at all. And when I finally decided, I was having difficulty posting my comment. A common issue on this blog, so I hear.
That being said, thank you for the compliments. However, the true person to thank is Anonz for the effect my comment had on you. He is my erotic Erato. I am not a poet, nor any sort of writer. It’s quite simple: Anonz’s wonderful way with words inspires the poet in me to emerge…
But Horace, you are correct. My words are one-sided. He has not chosen me here.
So in regards to you and me, I’ll have to see. I am married and have been for 14 years. My husband has had his infidelities; I have never….not yet. But I am playing around with the idea. Perhaps we could start here with a little ‘internet intercourse’….no promises that it will go any further than here, of course.
Lastly, I can tell that you aren’t too concerned with my appearance since you have shown some interest and yet you have no idea what I look like. But I will tell you that I am attractive, and I have been known to turn quite a few heads.
So…what do you think? Since you are the prose man who loves the poetic delivery, inspire me. I am up for a little fun….um…are you?
Ricky
December 12th, 2009 at 8:46 pm
Mr. Alexander Hamilton — How are your travels with Adam and your dear Female friend? I am anxious to hear more from you, or Adam about your experiences. The blog hasn’t had much activity from anyone interesting for whatever reasons. Your history of History would enlighten many and I certainly would love to hear your ‘pearls of wisdom.’
If you can reach the blog, please fill us in about what you have seen and done lately. I personally miss hearing from you. I hope we are still on speaking terms and you do not consider me unworthy of your comments.
I looked you up on the internet and found out that you died (left) at the age of 47. That makes you younger than me. I am 5 years your seniior. I always imagined you as an older gentleman in your time. Once again, I was wrong. You are still a young enough man to enjoy life. I am out of the game due to my medical disabilities.
The Tao are not commenting and I await hearing from any of them. Viv, Adam, or anyone else able to blog in — We could use some Tao commentary on this blog. It would interest all those who believe in your existence, such as myself.
Please try to comment to us. We miss your alien knowledge and points of view.
Hope to hear from any of the above mentioned.
HOWIE