Thursday, September 10, 2009

A Public Option, Unless There Isn't

OpenLeft is an excellent blog and I'm sure Mike Lux is a sincere and well-meaning individual. But I have a beachfront property in Arizona I'd like to sell him- and at a special price, just for him.

Last night, following President Obama's speech to a captive audience of Congress, Lux wrote in part:

I was pleased that he made clear not only that he was for a public option, but gave a full-throated multi-paragraph defense of it. He did what public option advocates needed him to do, which was to make clear that he supported it.

Mr. Lux apparently didn't watch the same speech I, or Jane Hamsher, did. Admittedly, the President did refer

to a provision in our plan that allows the uninsured and small businesses to choose a publicly-sponsored insurance option, administered by the government, just like Medicaid or Medicare.

(Sarcasm alert) Big news! President Obama likes the idea of a public option (or, rather, a "publicly-sponsored insurance option." But he vigorously qualified that support several times:

- It would only be an option for those who don't have insurance.... (and) based on Congressional Budget Office estimates, we believe that less than 5% of Americans would sign up."

Here, the President is endorsing an option so enthusiastically that he feels it necessary to point out that it would apply to very few individuals.

- I've insisted that, like any private insurance company, the public insurance option would have to be self-sufficient and rely on the premiums it collects.

The option would "rely on the premiums it collects." Those eligible to choose the option are disproportionately poor- and are going to find it extremely difficult to pay the premiums. The people (such as young, healthy persons) who are able to pay the premiums had decided to forego buying insurance. They will not be amused at having to buy it now, though this requirement might be necessary.

- It's- it's worth noting that a strong majority of Americans still favor a public insurance option of the sort I've proposed tonight.

Absolutely true- when asked by objective pollsters about a public option- without a reference to "triggers"- most respondents have been supportive. The President, however, clearly did not foreclose the possibility of the trigger mechanism, which would fundamentally change the nature of the health care plan.

- To my progressive friends, I would remind you that for decades, the driving idea behind reform has been to end insurance company abuses and make coverage available for those without it.

Everyone is (or thinks he/she is) opposed to "abuses" of anything by anyone. And making coverage available for those without coverage is a very commendable goal- but availablity without affordability is of little value. Still, there is that pesky little matter of cost.

- The public option- the public option is only a means to that end, and we should remain open to other ideas that accomplish our ultimate goal.

Not only is Obama making it clear he is not committed to a public option, but suggesting that if a plan makes "coverage available for those without it" while the cost of health care continues to rise and quality does not improve, well, we've "accomplish(ed) our ultimate goal."

- For example- for example, some have suggested that the public option go into effect only in those markets where insurance companies are not providing affordable policies. Others have proposed a co-op or another non-profit entity to administer the plan.

These are all constructive ideas worth exploring.


Evidently, to this President practically all "ideas (are) worth exploring." All except single-payer- and, to be fair, one in which we would "end employer-based systems and leave individuals to buy health insurance on their own." To Mr. Obama, these are equally radical ideas- a)some form of single-payer (such as Medicare for all) systems not uncommon in the rest of the developed world and b)barring government or the private sector from providing any assistance at all. Seriously.

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