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.