The Public Option’s Last Stand, and the Public’s

I would have preferred a single payer system like Medicare, but became convinced earlier this year that a public, Medicare-like optional plan was just about as much as was politically possible. Now the White House is stepping back even from the public option, with the President saying it’s “not the entirety of health care reform,” the White House spokesman saying the President could be “satisfied” without it, and Health and Human Services Secretary Kathleen Sebelius saying that a public insurance plan is “not the essential element.”

Without a public, Medicare-like option, health care reform is a bandaid for a system in critical condition. There’s no way to push private insurers to become more efficient and provide better value to Americans without being forced to compete with a public option. And there’s no way to get overall health-care costs down without a public option that has the authority and scale to negotiate lower costs with pharmaceutical companies, doctors, hospitals, and other providers — thereby opening the way for private insurers to do the same.

It’s been clear from the start that the private insurers and other parts of the medical-industrial complex have hated the idea of the public option, for precisely these reasons. A public option would cut deeply into their current profits. That’s why they’ve been willing to spend a fortune on lobbyists, threaten and intimidate legislators and ordinary Americans, and even rattle Obama’s cage to the point where the Administration is about to give up on it.

The White House wonders why there hasn’t been more support for universal health care coming from progressives, grass-roots Democrats, and Independents. I’ll tell you why. It’s because the White House has never made an explicit commitment to a public option.

Senator Kent Conrad’s ersatz public option — his regional “cooperatives” — won’t have the scale or authority to do what a public option would do. That’s why some Republicans say they could buy it. What’s Conrad’s response? “The fact of the matter is there are not the votes in the United States Senate for a public option. There never have been,” he tells “FOX News Sunday.” Conrad is wrong. If Obama tells Senate Democrats he will not sign a healthcare reform bill without a public option, there will be enough votes in the United States Senate for a public option.

I urge you to make it absolutely clear to everyone you know, everyone who cares about universal health care and what it will mean to our country, that the bill must contain a real public option. Tell that to your representatives in Congress. Tell that to the White House. If you are receiving piles of emails from the Obama email system asking you to click in favor of health care, do not do so unless or until you know it has a clear public option. Do not send money unless or until the White House makes clear its support for a public option.

This isn’t just Obama’s test. It’s our test.


Originally published at Robert Reich’s Blog and reproduced here with the author’s permission.

2 Responses to "The Public Option’s Last Stand, and the Public’s"

  1. Guest   August 17, 2009 at 12:14 pm

    1.) As Craig Karpel points out there is nothing wrong per se spending a larger share of GDP on healthcare. These are jobs that are part of an important part of the economy just as the financial and other sectors. The administration’s health-care plan is biased toward bean-counting rather than designed to maximize American physical and mental well-being.2.) There is nothing new or innovative in the Pelosi Bill. As Robert Samuelson points out, it is ‘status-quo’ thinking: Expand benefits and talk about controlling costs. Instead of reforming an unsustainable system, the Obama Administration is increasing government health care entitlements, claiming hypocritically to ‘save’ money. (See JEFFREY S. FLIER – Health care reform: a free market perspective – http://ecommons.med.harvard.edu/ec_res/nt/A29698DD-A40C-4FD2-9926-718E04778B37/HealthCareReform_Paper_Fall1994.pdf on existing distortions.)3.) Keith Hennessey has done a careful study on the matter than demonstrates the fallacies above. The Pelosi legislation falls short of nearly all the Administration’s purported objectives.In short, the Obama administration has shown poor leadership, short-term thinking and left Congress unleashed. Instead of listening to critics, threatening to veto the bill unless it conforms to the CBO and there are other changes, he is trying to sell the public snake oil.It seems that he seems to suffers from ideologue rigidity in his thinking and is unable to understand conceptually the issues that he is trying to deal with.He cannot run a Presidency as it is an endless political campaign!

  2. Guest   August 18, 2009 at 7:41 pm

    Robert, Robert, Robert, as usual with your posts you miss the forests for the trees. When will hard core liberals face the music that the backlash against public health care is not due to Fox news, evil lobbyists, or the like but the fact the public has actually had time to read and discuss the proposed bill (no thanks to the current administations efforts to quickly cram it down our throats) and reflect on the actual inconvenient facts….government has proven pretty much inept at managing anything from the current bankrupt fiasco known as Medicare to Cash for Clunkers, and moderates, independents, conservatives and many blue dogs are waking up to the fact that the slope of increased government control over our lives is not just very slippery but very dangerous to our freedom and way of life!