Beefing Over the Public Option.

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So I just got done having a spirited argument with Latoya over the White House’s pussyfooting around on the public option. (Gibbs downplayed Sebelius’s statement from the day before and said that the administration’s orientation toward the government option hasn’t changed.) Latoya thinks that Obama needs to start pulling rank and cracking heads in the Senate — a “no-bitchassness mandate,” in her words  — to make sure any reform passed includes the public option. Full stop.

I share her frustration and think the public option is the ideal way to go, but it doesn’t have the votes. (The public option is being held up, in large measure, by senators from states with populations smaller than Brooklyn’s.) Open Left says there are 43 Senators who have stated they were on-board. Again, not far from 50. But a lot of the Democrats standing in the way are conservatives like Blanche Lincoln and Kent Conrad, who come from very red states and are facing re-election next year.

I’d be willing to part with the public option  — for now — if we could get strong, passable legislation that included:

  • Employer and individual mandates, backed by subsidies that helped people without jobs buy insurance, which would necessitate…
  • Guaranteed issue, and an end to that “pre-existing conditions” bullshit.
  • Ending rescissions.
  • Community rating.
  • Substantially broadening the threshold to qualify for Medicaid.
  • (Along some “libertarian paternalist” lines, we should also incentivize healthy habits and preventive care.)
I’m missing some stuff, but this seems like a fairly good skeleton that we can add more meat onto later — and I think that a public option will have to be part of that (the government option will  push premiums down for everyone way  more quickly than any of these things). Getting the aforementioned stuff passed will be difficult but is very doable, and would still qualify as a major accomplishment both in human and political terms.  (I keep telling myself that the dawdling on DADT/DOMA is designed not to fan any culture war flames while trying to get this done, and it’s proving to be hard enough without those things as major distractions.) I suspect that getting this done would mollify his liberal flank on this issue, for awhile at least.

UPDATE: Latoya talks to Angie Drobnic Holan of Politifact to get some answers about the nuts and bolts of the three bills.

6 thoughts on “Beefing Over the Public Option.

  1. reetamac August 18, 2009 at 1:26 pm Reply

    your thinking is exactly what i feel the endgame will be. i don’t think people recognize that public option is a summary of how operationally a non profit/quasi governmental entity would likely ‘run’ health care. the administration is trying the play the middle ground, and i think politically, the left has to say ‘public option’ in order to get the traction for any groundwork that will lead to a system where insurance is provided to poor, youth, uninsured and working adults, as well as push health care costs to normalize in affordable ways for everyone. this is just round 2 of sweeping reform pushed by a generation that’s coming into power now. there will be more reform as everyone comes to understand how the change benefits them or needs correction.

    i also agree that DADT/DOMA is flailing because the class warfare over health care reform takes precedence.

    we’ll see. i heart O but i do feel like he needs to get his swagger back. beer summit through him off his game.

  2. LupinePredator August 19, 2009 at 2:18 am Reply

    The word socialism is one that has been bandied about lately, as though it spells the complete end of the American way of life, as though we will all become drones marching to the drumm of the government will. What people fail to realize, and will not listen to when it is pointed out to them, is the fact that two significant portions of our population already benefit from forms of “socialized medicine.” One of those segments is our senior citizens, and the “socialized” program is medicare. The other segment is our veterans, and the program is the Veterans Administration Health Care system.

    What I would ask is this: Why is it okay to force two large segments of our population to live with “socialized medicine,” but allow the rest of us to escape this bane of the American way of life? If socialized medicine is so very horrible, why is permissable to force our veternas and our seniors to rely on it?

  3. rikyrah August 19, 2009 at 11:55 pm Reply

    without the public option, the bill is watered down, useless bs. there are times where NO BILL is better than a bad one.

    • G.D. August 20, 2009 at 12:01 am Reply

      how would a bill with those provisions be ‘bad’?

      Not ending rescissions is worst than no bill at all? Not eliminating the “pre-existing conditions clause” would be better than nothing at all?

  4. keke August 20, 2009 at 11:38 am Reply

    At this point, the public option is dead, we are not going to get it. I don’t think Pres Obama is going to push for it at all. I believe is his willing to compromise on the public option in order to maintain support from conservative Democrats and Independents for the midterm elections and for his shot at a 2nd term.

    Given that we won’t have a Public Option, we do need a strong reform bill that has addresses all of the issues stated in this post. Unfortuanetly, I am really concerned that we won’t get a strong “insurance” reform bill either. We will see what they come up with.

    • G.D. August 20, 2009 at 12:44 pm Reply

      actually, the public option isn’t dead. The White House is giving indications that the Dems are set to try and go it alone. http://www.nytimes.com/2009/08/19/health/policy/19repubs.html?_r=2&partner=rss&emc=rss

      WASHINGTON — Given hardening Republican opposition to Congressional health care proposals, Democrats now say they see little chance of the minority’s cooperation in approving any overhaul, and are increasingly focused on drawing support for a final plan from within their own ranks.

      Top Democrats said Tuesday that their go-it-alone view was being shaped by what they saw as Republicans’ purposely strident tone against health care legislation during this month’s Congressional recess, as well as remarks by leading Republicans that current proposals were flawed beyond repair.

      Rahm Emanuel, the White House chief of staff, said the heated opposition was evidence that Republicans had made a political calculation to draw a line against any health care changes, the latest in a string of major administration proposals that Republicans have opposed.

      “The Republican leadership,” Mr. Emanuel said, “has made a strategic decision that defeating President Obama’s health care proposal is more important for their political goals than solving the health insurance problems that Americans face every day.”

      The Democratic shift may not make producing a final bill much easier. The party must still reconcile the views of moderate and conservative Democrats worried about the cost and scope of the legislation with those of more liberal lawmakers determined to win a government-run insurance option to compete with private insurers.

      On the other hand, such a change could alter the dynamic of talks surrounding health care legislation, and even change the substance of a final bill. With no need to negotiate with Republicans, Democrats might be better able to move more quickly, relying on their large majorities in both houses.

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