The Public Option

I’ve been following the healthcare debate very closely.  Perhaps more closely than any issue…..ever.  It has definitely been a wild ride, both frustrating and hopeful.  I know that many Progressives are frustrated with Obama about this (including Mrs. desmoinesdem).  I blame the Senate filibuster rules mostly. Well, I blame the Republicans ultimately, but I just assume they oppose everything at this point, so they are just an irrelevant annoyance.  

Obama has never said anything except that he would prefer the public option be included.  However, he rightly won’t let HCR die in its absence.  Remember when the Clintons bestowed their HCR bill on Congress and it blew up in their face?  He may have over learned that lesson, but we are going to have a meaningful — even historic — bill at the end of the day.  Here are my thoughts on the public option debate in the context of the wider HCR debate:

1) A health care bill without a public option is still a huge achievement for progressives.

2) The public option is a relatively minor part of the health care bill if it is the watered down version.

3) Fighting for the public option has done a lot of good, even if we don’t get it.

4)I don’t think that failing to get the public option is a result of Obama not being Progressive enough, I think it is a result of not setting the terms right in the first place.  I can deal with mistakes…..a betrayal would have been much worse.

5)We probably get more out of trading a weak, ineffective public option for Medicare buy-in, Medicaid expansion etc., than we would have gotten for fighting to pass it.

6) This battle has been epic. We didn’t get everything we wanted, but we got a lot in the grand scheme of things.  The absolute worst result, both politically and policy-wise would be NOT passing a bill.  

I could see Obama revisiting healthcare in a second term (or a subsequent Dem in the medium term) and having this bill in place is a much better jumping off point than where we had to start this time.

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BJazz

  • I get what you are saying

    but I think you are wrong about Obama’s role. He says he wants a public option, but he has repeatedly sent subordinates like Gibbs, Axelrod and Sebelius out to say that the public option isn’t a deal-breaker for him, and he’s open to alternatives.

    That’s very different from the way he told Congress on September 9 that he wouldn’t sign a health care bill that added a dime to the deficit (not that he has trouble with a Wall Street bailout or a war supplemental funding bill adding to the deficit).

    Even Harkin said in October that Obama hasn’t done enough on this front:

    After Obama met with Pelosi, Reid and other Democratic leaders Thursday, the White House repeated its message that Obama supports the public option but will not rule out the trigger or any other compromise.

    That is not good enough, Harkin said. “I’ve not been very happy with the White House’s lukewarm support of the public option,” he said, articulating a gripe liberals have been making for months.

    When the president makes clear to the Senate that provision X has to be in the bill, it strengthens the negotiating position of the senators fighting for provision X. Obama is willing to twist arms to get votes on some things (Afghanistan war funding), but he just hasn’t shown the same level of commitment to getting a good health care bill.

    Also, he broke his own campaign promises to support reimportation of prescription drugs from Canada and let Medicare negotiate for lower drug prices.

    There is no question that this bill would be better if Obama had followed through on more of his own campaign promises. Instead, he decided he’d rather not face an all-out assault from industry. So, we’re going to get a bill that’s a windfall for insurance and drug companies.

  • I can see your point too

    but, I think they realized early on that the public option could never get to sixty, so they didn’t want the Progressives to set in too hard and refuse to vote for the bill when it inevitably got stripped of the PO.  Trust me, I wish he would have pushed harder on this too.  Heck, I wish they would have passed the main part of the bill through and then used reconciliation for the public option.  Also, he still does support the re-importation bill in that he will sign it if it passes.  Just because the FDA raised some questions doesn’t mean he’ll veto it.  Again, he could have pushed harder for it, but its not like he’s blocking it.  

    I think a big part of this is that he treats the Congress fundamentally differently than past Presidents.  He kinda sets broad goals and lets them do their thing.  We can argue about the efficacy of this, but I’d hardly consider it a betrayal.  Indeed, part of his platform was to end the imperial Presidency brought to us by Bush/Cheney.

    • that is terrible negotiating strategy

      We were only a few votes away from 60. The White House never even tried carrots and sticks with those last few senators. Everyone has a price–don’t tell me there’s nothing Obama could have said to squeeze a few extra votes out of the Senate.

      I think Obama likes having the Senate as his excuse for not keeping his campaign promises.

      • What exactly could Obama have done?

        It’s is very clear a strong public option was DOA in the senate.  If we get any kind of health care bill, Obama deserves a lot of credit.  Without him making it a priority, we would not be where we are now.  We would get a repeat of the Clinton reform (zero, zip, nada).  Don’t get me wrong, I’m all for single payer system or a very strong public option.  But with only 60 D votes and several moderates and ins. co. owned senators, that is just not going to happen.  Get what reform you can get now, then try to do more later.  That’s how our system works.

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