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Public Option Rejected As Key Dems Vote 'No'
The healthcare reform debate – such as it is – has already provided more than enough disappointment for Americans who recognize the need for a thorough reordering of the way in which this nation meets the medical needs of its populace.
But the hits just keep on coming.
Indeed, there is good reason to believe the Congress is edging away from a healthcare reform debate and toward a far more limited discussion of insurance reform.
Tuesday's day-long gathering of the powerful Senate Finance Committee, where chairman Max Baucus has spent months lowering expectations, offered a sense of just how dim prospects for meaningful systemic change have become.
Baucus, the insurance-industry representative who doubles as a Democratic senator from Montana, long ago rejected the notion that a robust public option might be a part of any healthcare reform measure that would pass the Senate.
His committee, on Tuesday, agreed – blocking moves by two Democratic senators, West Virginia's Jay Rockefeller and New York's Chuck Schumer, to amend the finance committee's plan to include a government-backed alternative to private insurance.
What was especially unsettling about the Finance Committee votes was the failure on the part of most -- though not all -- senators that the public option is itself a compromise.
The reform that is needed -- a single-payer "Medicare for All" system that offers every American the care they need, flexibility in choices of doctors and hospitals and responsible controls on costs -- has been taken "off the table" by the Obama administration and Democratic leaders in the House and Senate.
What the president and his allies initially offered serious reformers was a hamstrung variation on single-payer, in the form of a "public option" that could serve as an alternative to the offerings of the for-profit insurance companies.
The public option has always been the last line in the sand for serious reformers. Indeed, as a frustrated Wisconsin Senator Russ Feingold said Thursday: "A public health insurance option is key to ensuring every American is able to afford health insurance and without it, I don't see how we will bring real reform to the system."
Says Senator Bernie Sanders, I-Vermont: "Clearly, if we are serious about cost containment, private insurance companies must have competition from a public plan."
Now, however, as Democrats compromise away their compromise, members of the House and Senate find themselves debating variations on the public option that are so cautious and constrained that they cannot really be seen as credible "alternatives" to the private sector.
And even these, they are rejecting.
Rockefeller's muscular amendment was defeated on a vote of 15 against to 8 in favor. No Republicans backed it and five Democrats were against: Baucus, North Dakota's Kent Conrad, Arkansas' Blanche Lincoln, Florida's Bill Nelson and Delaware's Tom Carper.
Schumer's more modest proposal was defeated on a vote of 13 against and 10 in favor. Again, all Republicans were opposed, as were Democrats Baucus, Conrad, and Lincoln.
The Finance Committee session did not end the debate about the character or content of the measure that the House and Senate will consider. Rockefeller still says: "The public option is on the march."
But little about the deliberations of the finance committee suggested that the public option will ever gain Republican support. Indeed, the language of committee Republicans was vitriolic. Iowa Senator Charles Grassley, a supposed moderate within the GOP caucus, dismissed the notion that a government-backed scheme would help to level the playing field by providing an affordable and humane alternative to. "It's not a competitor, it's a predator," Grassley said of the proposals for a public option.
Utah Senator Orrin Hatch, another supposedly reasonable player inside a Republican camp that it not going out of its way to be reasonable, accused Rockefeller of proposing his amendment as "a Trojan horse" for a single-payer system. If only!
Some Democrats tried to fight back. An unusually-impassioned Rockefeller told the committee that a counterbalance to the insurance industry was needed because "they're getting away with banditry and they revel in it." Massachusetts Senator John Kerry argued, correctly, that the insurance corporations and their amen corner in the GOP caucus were blocking even a modest public option because they were frightened "that Americans might like a competitive plan that is paying for itself?"
But those arguments were not sufficient to unite the Democratic caucus. The "no" voters were generally embarrassed enough to make excuses – North Dakota's Conrad highlighted flaws in the reimbursement scheme proposed by Rockefeller.
Embarrassed or not, the Democrats whose votes mattered most still voted "no."
And that's the bottom line.
Without essentially unified Democratic support for a public option – especially on key committees in the Senate – healthcare reform will not advance.
What we will get, at best, is insurance reform.
That's a little bit of change.
But it is not "change we can believe in" – let alone change that reformers will get excited about.
Speaking of the public option-free measure that he hopes to advance, Baucus told the committee: This bill is by no means a complete rewriting of the American healthcare system.
Unfortunately, he was right.
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15 Comments so far
Show AllWe can expect "single prayer" not single payer.
We'll have single payer all right, privatized single payer in the form of mandatory private health insurance. Massachusetts already has it, and they pay higher than the national average. I LOVE CORPORATE WELFARE!!!!!
It makes one wonder if they original push for health care reform was for mandatory private all along...HRM.
"Clearly, if we are serious about cost containment, private insurance companies must have competition from a public plan."
What we have now in the USA is illegal collusion among private health insurance companies to fix prices at artificially high levels.
USans tolerate it because this illegal collusion helps support the US economy which US elites damaged severely over the past several decades by allowing industries to migrate overseas so that US elites may join in the orgy to exploit cheap labor to feed the US consumption monster.
USans now have to reject the global capital racket, including the cheap labor warez, and demand instead local production. Thus truly meaningful economic opportunities will open up at the local level and USans will be less dependent on the elites' collusion rackets, such as health insurance, for employment.
Now if we want to be responsible citizens, we have to demand best value in each market sector and look to see if producers are competing to meet our demand. If not, they are likely colluding to fix prices artificially high.
It's much easier for large national-scale producers to collude and get away with it because they have access to and an ability to corrupt federal-level politicians who are supposed to enforce the anti-collusion laws and the many other anti-corruption laws. Today, the top level of the US federal government is almost fully corrupted. Few if any laws are being enforced today against the US elite establishment. So today the USan people achieve very poor value in most sectors. USans work much longer than people in other countries, and get less in return.
10000 ice cream flavors to choose from is not meaningful compensation for degraded healthcare and education.
Actions required for USans to take include writing to the politicians at all levels and informing them of the citizen's demand in the market and where the citizen draws the line. Obviously when US industry now extracts twice the price for healthcare in other countries and has a goal to raise that to three times the price within a decade, USans should draw the line now and cancel their health insurance with the demand that the cost be contained to match the cost in other countries.
The best way to overcome the US healthcare collusion racket is not to simply return to doing business with the racketeers after we shatter their price-fixing rackets but to shift our business over to local small producers. Locals can be held to account much easier by the local community. In the case of health insurance, a certain number of people are required in the insurance pool for effective risk sharing but the localization of health insurance is easy to manage. All of the local insurers will simply demand a second tier of pooling to be administered by the state governments.
You have to have a goal and a plan. The plan may evolve to better meet the goal, but you have to keep focus on the goal. The over-arching goal is best value in both the markets and public policy, FOR THE PEOPLE.
A public option, miserably funded and poorly administered, essentially a sham, could have been created as a fig leaf. But they couldn't even do that.
YES WE CAN What? Go to war again? Bail out more big shots?
How many Congress lap dogs were bought and paid for my med insurance, pharmaceutical, and med supply corporations? The Congress lap dogs don't even hide their kissing corporate butt anymore. Congress does NOT represent the people. Corporations own and run this country - a corporate fascism. U.S. GAVE billions to big banks and its Wall Street bosses. U.S. is GIVING billion$ to med insurance corporations. People get it up the rear. The 1% RICH "elite" American Ruling Class will always be in control while the serf, ant, expendable people are used. Karl Marx was right.
The problem with having the public option as a compromise is that single-payer itself was never seen as a realistic enough alternative to pose a serious threat.
Therefore, for even a limited public option to get serious consideration in Congress, candidates will have to be elected in 2010 who make their support for single-payer their top priority issue.
BTW, Grassley and Hatch have both served long enough, in my opinion. I would love to see both kicked out of office by a strong grassroots campaign. Don't people in Utah and Iowa want health care reform?
At this point, I hope no bill passes. What we have "on the table" is even worse than the staus quo, which is very bad indeed.
A pitiful public option so hamstrung and actuarially unsound that it is bound to fail three or four years after it kicks in. And even that embarrassing half measure does not start untill 2013. Who worries about defeat if this is victory. I agree with the conservatives-- let's hit the reset button. Let's fight for SinglePayer again either on the state level or during the 2010 election with primary challenges to dump some of the blue dogs and general elections to unseat Republicans. Blame the Bluedogs and the Republicans for failure of health reform and make them pay electorally.
So that's your strategy? Go back to bed and come back next election?
How about mass demonstrations in the streets? This NY Times/CBS poll finds 60% of Americans and 87% of Democrats preferring Single Payer!
We should not swallow this pill!
Max "the Health Insurance Industry" Man, can you say early retirement? I bet you can if the good people of Montana wake up.
AD
The Democrats who did this are like beaten spouses abusing their children instead of beating back at the abuser ! Thanks for proving that party and ideological labels don't matter. At this point, we might as well be stuck with Sarah Palin running the White House and bleeding the country to death and tears !
There's a LOT of support for single payer and a straightforward system.
Let's junk this bill and start over.
It is time for John Nichols and a few others at the "Nation" to stop playing "pin the tail on the Donkey" and take off the blindfolds. What is happening here is the result of Obama and Rahm Amoral restricting the possible outcomes. I would almost be willing to gamble on the idea that the forms of "public option" presented by Rockefeller and Schumer were only put forward because they KNEW they would be defeated. This has all been a pretense. Wall Street is running this nation. You can look for the constitution on E-bay.
Single payer or single term.
Public option is not an option.