Wednesday, November 25, 2009

Wither The Public Option

Robert Reich describes how the goalposts have been moved on a public option in health care reform. Once envisioned as "robust," it now appears to be feeble.

At first, Reich notes, it was Medicare for all; then a Medicare-like plan for all Americans; then a public option only to individuals not covered by Medicaid or their employer, in which the government would be unable to set its own rates; then a public option which the CBO estimates only six million people will enroll in and which, with little bargaining power, will enroll only the sickest of individuals.

And with Senators Lieberman of Connecticut, Nelson of Nebraska, Landrieu of Louisiana and Lincoln of Arkansas threatening to vote against a bill containing any public option, any government option in final health care legislation will be, if anything, weaker than the weak option included in the House bill.

It's easy to see why. On Monday, Senator Sheldon Whitehouse (D.-RI), who in the HELP Committee helped write the public option, told Keith Olbermann on Countdown:

I also think that there's some room around the details of the public option between opt-in and opt-out and trigger. I, for one, am not particularly concerned about the names. I would like to see the public option as available as possible. And there may be room for a compromise, for instance, with Senator Snowe about a trigger that actually does better in terms of reach for the public option.

Translation for the few viewers who, like Olbermann, did not understand Whitehouse: I'm for whatever we can get away with calling a 'public option.'

The same evening, Senator Sherrod Brown (D.-Ohio) told guest host Lawrence O'Donnell on Rachel Maddow:

My focus is on getting this bill passed. I think that I-I mean, of course, we see these kinds of things, but we need to get it passed. And that doesn't mean continuing to move to the right. I mean, that's what has happened in some ways in this bill. The public option is not the way Sheldon Whitehouse and I wrote it, or wanted to write it back in the HELP Committee in July. It's compromised. It's still solid and still strong.

He was a little more equivocal but nevertheless had said: The bill is compromised but is still "solid and strong." I just don't know why.

And for those who wonder what President Obama is thinking about this, think no more. His home-state Senator, Richard Durbin, likely was characteristically channeling Mr. Obama when he discussed (video below, thanks to Daily Kos TV) with David Gregory on Meet The Press the possibility of a trigger (for a bonus point, we get California Senator Dianne Feinstein's opinion):

There are many variations on the theme. I am committed to public option. I think we’ve put together a good bill. We are open because we want to pass this bill. At the end of the day we want insurance to be more affordable, we want to stop the insurance industry abuses, we want to give American people a choice in this decision.

MR. GREGORY: So the public option is negotiable.

SEN. DURBIN: They don’t have to...

SEN. FEINSTEIN: Yeah.

SEN. DURBIN: It has been. Putting in the opt-out was clearly a variation on the theme from the beginning.


Shorter Durbin (and Obama): Public option, trigger, opt-out, it's all the same.

How has it gotten to this, inasmuch as these three male Democrats, and the President, are (such as it inside the Beltway these days) progessives. Short answer: because President Obama knew that, no matter how a bill might be compromised, he could count on the support of all Democrats but the most conservative. The longer answer comes, inadvertently, from Senator Brown in the same interview on Maddow's show when he was speaking about the Democratic holdouts but could have been describing his fellow progressives:

And I think, in the end, these four Democrats-obviously, I don't speak for anybody else, but they don't want to be on the wrong side of history.

It worked for Senator Obama in the presidential election as undecided independents broke for him on Election Day- and it might hold for passage of a weak, but historic, health care bill.


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