The fight for inclusion of a public option is a waste of time. It’s a struggle to obtain what we’ve already got.
And I should have been pointing that out, but it slipped my mind what Amy Smoucha of Jobs with Justice wrote in a letter last December. I printed that letter, which included this paragraph:
Both the House and Senate bills bill create a national, non-profit, publicly accountable option for health insurance coverage. The House bill contains a national public insurance option. However, even in the Senate bill, people purchasing insurance in the Exchange will be able to choose from national plans, including at least one non-profit plan, supervised by the same department of the federal government that selects health insurance plans for federal employees. Before the recent invention of a “public plan” demand, progressive health care activists were asking Congress to either open up Medicare for all or allow people to buy into the plans administered by the Office of Professional Management-the same plans that Congress and Federal employees have. We just won a long-standing demand.
Because of my faulty memory, I have, like most of you, been calling McCaskill, urging her to sign the Bennet letter. I’ve even criticized Rep. Russ Carnahan for not signing the Polis/Pingree letter to the Senate urging the passage of the public option through reconciliation. My apologies to Rep. Carnahan.
The fact that I’m no longer working to get the public option included, though, doesn’t necessarily mean that I think the provision in the Senate bill solves the problem of rising costs. It might not help much. Public health experts disagree about whether the Senate bill will do much to contain costs, just as they disagree about whether the public option would do so. Most Americans like their private insurers and don’t want to be shoved into a public plan. Thus the number of participants might not be enough to give either one of them great bargaining power so that they could drive down costs.
That preference among Americans for keeping their insurance has driven the direction health care reform has taken under the Democrats. The Herndon Alliance polls Americans on health issues and reports to Democratic leaders on what messaging will succeed with the public. So:
When President Barack Obama says Americans can maintain their “choice” of doctors and insurance plans, he is using a Herndon strategy for wringing fear out of a system overhaul.
But if Americans get what “choice of doctors” means, they don’t have much of a clue what “public option” means. Trying to sell that idea confuses them and, thanks to the Republicans, divides them.
Besides, when we say “public option”, which public option are we even talking about? The term has always been a place holder for a variety of ideas, none of them very specific. At first, it was sort of a synonym for single payer; then the “robust public option” was an expansion of Medicare for those who wanted it; but rural areas, which get the short end of the financial stick when it comes to Medicare, protested. And rightly so. Finally the public option meant a government run program for those who cared to buy into it. But that provision was and is the weakest part of the reforms the bill offers.
What we need to understand is that the bill itself is hugely important to pass, and we dare not be complacent about getting it passed. If we have to give up the public option to get that done, so be it. The very last behavior we ought to indulge in is risking the passage of this bill with a stubborn insistence on a provision that is marginal; and besides, it’s already in there.
with or without a publicly run insurance option. And certainly the relatively weak exchange non-profit plan could, possibly, provide a starting point for improvement although as it stands it could backfire badly as well
I, however, disagree, that we refrain from calling our representatives and asking them to support a publicly run insurance option in place of the weak-non-profit. I still agree with Bernie Sanders on the importance of a real public option and now that the White House and Senate are seemingly becoming more open to reconciliation, they have an opportunity to pass it and should take it.
You are also, however, right that getting any health care is very iffy right now – but one of the reasons is that the Liebermann/Conrad/Nelson/Baucus Democrats (whom McCaskill seems to want to emulate and hang with) helped blow it, and I do really think that they need to be held accuntable for that fact. It is a mistake not to press them to do more and to act like progressives.
In all honesty, I would just be so interested in knowing what it is about this bill that you find so compelling. Not even a weak public option, discriminatory toward women, no implementation until 2013 or 14, totally costly and still leaving 30 million uncovered. What am I missing?
Sorry I misquoted. I should have rechecked my source. The latest figures from the PNHP February 24 press release estimate that 23 million will remain uninsured.
As for the “insurance” that you speak of, well, there is “insurance” and then there is “insurance”. Far from facilitating any sort of equitable and/or adequate health care, consumers will simply get what they pay for. Many will be placed in means tested Medicaid programs which are dependent on state revenues for full funding at a time when states are cutting services right and left almost across the board. It was recently discussed on these pages in the comments about Florida cutting out Dialysis services for Medicaid patients. It looks as if Medicaid patients “insurance” isn’t going to get these people the care necessary to sustain their lives. Add those deaths to the 23,000 mentioned above.
As I stated earlier, I am unsure of just what is so compelling about the current reform that we just can’t afford not to pass it, but at the same time we can wait four years to implement it. Just what is it that we would be ‘fighting tooth and nail” for if individually introduced. And now I am now doubly confused by the argument that we have to pass something in order to “fix” it before we can have anything better. What would it mean and what would we lose if this bill failed. Not a lot of much, I suspect. Plus waiting four years to implement the primary provisions of this bill risks it all anyway b/c who knows how the political landscape will look in four years.
I don’t think my position can be described as idealistic. By weighing the consequences, (23,000 deaths per annum for at least four years) I am simply unable to find enough compensation in the current bill to validate pursuing such an elusive adventure in the art of doing almost nothing. No, I am not idealistic nor am I looking for a miracle, I just refuse to be sent on foolish errands.
It will continue to be 45,000 deaths per year for the next four years until this health bill is enacted and AFTER the bill is implemented, the death rate per annum will fall to 23,000. (This according to the estimates of the Physicians for a National Health Program)
You can do the math. It is too much for me to contemplate.
Maybe I can square it because I have been in real-life situations where I had to choose which victim to work on, and that decision has proven to be life or death. It is really fucking simple for me: 23,000 is less than half of 48,000. That’s some simple damned math.
Pass it now and perfect it later. That’s how meaningful social legislation has always been done in this country that still isn’t Sweden. (I’m starting to think it never will be!)
to apply for citizenship in Sweden or France or Canada or Austrialia or Germany or any of the many other civilized countries that actually care more about their citizens than about playing wars of choice for entertainment.