We've moved!

Social Icons

twitterfacebooklinkedinrss feed

Monday, August 17, 2009

Reich: Public Option Is "Last Stand" for Real Reform

I've argued hard here (and here, here, and here) for a public option health insurance plan (and 77% of my readers and a similar percentage of Madison residents and the American public back me). I've been willing to accept that as a compromise down from the ideal single-payer system. Now the Obama Administration is signaling it's willing to bail from even that reasonable compromise.

Howard Dean says a public option is a sine qua non of health coverage reform. I'll let Robert Reich carry the argument further:

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 [Robert Reich, "The Public Option's Last Stand, and the Public's," Robert Reich's Blog, 2009.08.17].

And what of the non-profit health cooperatives being suggested as a sufficiently tolerable alternative that could pass the Senate?

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 [Reich 2009.08.17].

President Obama should not have to compromise to appease opponents who are willing to use any means necessary, including manufactured rage and outright deceit, to protect a broken status quo. It's time to stand for what's right, not what polls well with lobbyists. Let's push that House vote on single-payer. Let's show just how much support there is for real health coverage reform. And let's make clear that the public option is the rock-bottom compromise position.

Mr. Obama, we did not elect you to give in to willful deceit and ignorance. Spend that political capital, fight for the public option.

(Besides, how will the Republican cries of "Socialism!" and "Tyranny!" stick if you don't create the one big government program that scares them the most? ;-) )

Update 13:20 CDT: But I agree with Ned Hodgman of Understanding Government that President Obama at least deserves credit for making a case that puts facts and sensible policy above emotion and identity politics.

Update 17:00 CDT: As I suspected, compromise on public option is pointless, since it won't win over Republicans anyway.


  1. I'm not sure I agree Cory. I think substantial changes would occur by eliminating pre-x, mandating portability, allowing competition across state lines and group coverage to form outside the employer relationship (farmer groups for example). Very good things could happen, but all would be dependent on mandating enrollment.

  2. John, you're right that those items would represent an improvement. However, if the government mandates enrollment, the government should offer coverage.

  3. I vote that we just let other not for profit health care providers begin operating in the USA. There are some great German companies that are not for profit and operate with a less than 5% total overhead rate. Now that would be competition!


  4. Tony, that is an excellent idea!

  5. Amend Tony's link: http://content.healthaffairs.org/cgi/reprint/13/4/22.pdf.

    I second Stan's agreement. Let's do some NAFTA/WTO health care!

  6. Tony may have hit the nail on the head. Increased competition,
    negotiated contracts with providers and drug companies will drive down consumer costs, both for the insurance product and for the care itself.

    Blue Cross Blue Shield has now come out with a Basics Plan that is much more affordable for those who want basic coverage and protection for major health issues.

    The question still remains...What do we do about unemployed who lost their protection, those who can't afford protection and those with pre-existing conditions or need expensive prescription drugs?

    The cooperative (coop) healthcare plan may serve as a huge group plan in which those issues could be diminished. And if the feds provide a portion of funding, as is being discussed, it could be allocated for low or no-income participants.

  7. So instead we should let low/no-income participants go without care and die? Who's running the death panel here?

    Coops: can 51 state-level coops all assemble enough participants to cover their costs, spread the risk, and negotiate for lower prices? Wouldn't coops still leave smaller rural states at a terrible disadvantage? If little coops are good, why not increase the advantage with one national coop?

  8. "Blue Cross Blue Shield has now come out with a Basics Plan that is much more affordable for those who want basic coverage and protection for major health issues."

    Rod, just curious. What kind of premium and deductible does this plan carry and does it cover maternity/birth?

  9. Just clarifying--I'm not asking for myself. But I'm curious to know if plans like this are good for young families in South Dakota who will be starting/growing families and really do need maternity coverage.

  10. Looked it up myself, and for my family, it would cost us $4,236 per year for a $4,500 family deductible--no maternity coverage (complications only are covered). It would cost $3,408 a year for a $9,000 family deductible.

  11. Only semi-related, but I have the biggest crush on Robert Reich. He's one of the smartest people alive.

  12. Oh, Kelsey, take a number on that crush. ;-)


Comments are closed, as this portion of the Madville Times is in archive mode. You can join the discussion of current issues at MadvilleTimes.com.

Note: Only a member of this blog may post a comment.