Not-So-Robust Public Option

The public option was always a compromise for serious supporters of
health-care reform, who -- like Barack Obama when he was running for
the Senate in 2003 -- knew that a single-payer "Medicare for All"
system was what America needed to provide health care to everyone while
controlling costs.

But, in the reform legislation debuted Thursday by House Speaker Nancy Pelosi, the compromise was even more compromised than had been expected.

Pelosi says the legislation is "historic," and celebrates the fact
that is does still include a public option -- a component many pundits
had said was destined for abandonment.

But, while there is a public option, it is anything but robust.

Progressives believe Pelosi has bent to far to the right.

And The New York Times suggests as much in its analysis, which declares that:

Under pressure from moderate-to-conservative members of
the House Democratic caucus, Speaker Nancy Pelosi has decided to
propose a government-run insurance plan that would negotiate rates with
doctors and hospitals, rather than using prices set by the
government...

Ms. Pelosi said the public plan, which she prefers to call a
"consumer option," would compete with private insurers. But the speaker
was apparently unable to muster the votes needed for the 'robust'
liberal version of a public plan, which she has repeatedly said would
save more money for consumers and the government.

Translation: The "public option" Pelosi and her team have proposed a
plan that would not make payments for care based on Medicare rates, as
the Congressional Progressive Caucus and key Senate Democrats have
proposed.

Rather, under the Pelosi plan, the rates be tied to those of the big
insurance companies. That's a big, big victory for the insurance
industry, as it will undermine the ability of the public option to
compete -- and to create pressure for reduced costs.

Pelosi's plan also drops a number of provisions that had been
advanced at the committee level to promote consideration of "Medicare
for All" models and to allow states to experiment with single-payer
plans.

That's an especially bitter pill for House progressives, who has won support for state-based experimentation in committee votes.

Groups such as Progressive Democrats of America
were quick to raised alarm bells because some of the most innovative
responses to the health-care crisis are being forged at the state
level. While single-payer proposals are being blocked at the federal
level, PDA national director Tim Carpenter says the single-payer fight
is ramping up in the states.

"Last week, members of the PDA national team traveled to
Pennsylvania for a rally at the capital rotunda in Harrisburg, in
support of Healthcare for All Pennsylvania and their single-payer
bill," notes Carpenter. "The momentum for single-payer healthcare grows
daily. It appears Congress will have to be forced to follow the lead of
states like Pennsylvania, California, Illinois, Ohio and Massachusetts
--- all working to implement single-payer healthcare at the state
level."

House progressives were quick to express disappointment, as they
were counting on the House to advance a strong alternative to the
Senate Democratic leadership's very weak public option proposal --
which would allow states to opt out of the plan.

Reviewing the details of Pelosi's plan in a passionate speech on the House floor, Ohio Congressman Dennis Kucinich,
one of the chamber's most ardent advocates for reform asked: "Is this
the best we can do? Forcing people to buy private health insurance,
guaranteeing at least $50 billion in new business for the insurance
companies?

Kucinich continued:

Is this the best we can do? Government negotiates rates
which will drive up insurance costs, but the government won't negotiate
with the pharmaceutical companies which will drive up pharmaceutical
costs.

Is this the best we can do? Only 3 percent of Americans will go to a
new public plan, while currently 33 percent of Americans are either
uninsured or underinsured?

Is this the best we can do? Eliminating the state single payer option, while forcing most people to buy private insurance.

If this is the best we can do, then our best isn't good enough and we
have to ask some hard questions about our political system: such as
Health Care or Insurance Care? Government of the people or a government
of the corporations.

Congressional Progressive Caucus co-chair Lynn Woolsey, D-California,
said she and her allies would continue to battle to muscle-up the
public option.

"It's not even the fourth quarter,'' said Woolsey, who noted the
public option had only recently been dismissed as dead by many pundits.
"We will be insisting on (the option) being as strong as it possibly
can be.''

Woolsey and other progressive Democrats are set to meet with President Obama Thursday.

"He needs to hear from us that he needs to support the public
option,'' Woolsey told the Los Angeles Times. "He's not saying it loud
enough. We want to make sure he lets the Senate know he wants a public
option in the bill."

The focus on Obama is appropriate. He has the authority, as a man
with a bully pulpit and a veto pen, to tell Pelosi that a soft public
option is insufficient. At the same time, he can and should be more
involved in challenging the absurd proposals -- advanced by
conservative Democrats and moderate Republicans -- for "opt-outs" and
"triggers," which threaten to weaken the public option to the point of
meaninglessness.