Tuesday, August 18, 2009

The Public Option Lives On

Robert Gibbs is coming out to say that Barack Obama remains a public option lovin' man. Nancy Pelosi, of course, is a public option lovin' woman, and the four bills that have gotten through committee are all public option lovin' bills. I think things are looking a lot better for every good man and woman's favorite health care provision than the last couple days of media coverage would have people think.

Like Ezra, I really didn't see strong evidence that the administration was changing its position in any way -- they'll push for it, I'm sure, though it's always been clear that they'll accept less if they can't get more. This may leave them in a weaker bargaining position in some respects, but it's still not a bad situation, because it's not clear that Republicans will be in any position to force them to take less. It mostly depends on who's in the conference committee negotiations, and how much hardball we play. I'm hoping for some Medicare Part D style brutality, except with the Republicans on the whacked end of the stick.

You can count me among the public option lovers. Certainly, as Ezra says and Nick's wonderful charts show, the current legislation isn't going to extend the public option to that many more people. It's an open question what rates it'll be able to bargain at, and access to the exchanges will be limited. But these are the sorts of things that I'd expect Democrats to fix in the future legislative utopia where historic health care reforms have already passed in a glorious victory, taking fear out of the moderates and emboldening the progressives. Being able to bargain prices down seems like the thing to get before exchange expansion. If you can demonstrate that the public option gives people a good deal, more people will want it, and corporations and individuals alike will clamor for exchange expansions so they can get into some of that cheap, delicious, single-payer-flavored government health care.

3 comments:

Petey said...

"Certainly, as Ezra says and Nick's wonderful charts show, the current legislation isn't going to extend the public option to that many more people. It's an open question what rates it'll be able to bargain at, and access to the exchanges will be limited. But these are the sorts of things that I'd expect Democrats to fix in the future legislative utopia..."

No utopia is needed.

The entire concept behind the public option is that it will generate it's own self-sustaining political constituency that will make future reform politically possible.

The public option was never about Year One. It was always about Year Five and Year Ten and Year Twenty.

The entire point of the Hacker plan was that progressives were giving up single-payer in the short-run in exchange for a situation that would create a self-sustaining political constituency that would allow single-payer to develop over time.

The public option is all that separates the current healthcare reform push from what we would get under a President Mitt Romney.

No public option in the final bill means progressives in the House should vote against the final bill.

Petey said...

"I'm hoping for some Medicare Part D style brutality"

I know you're talking politics, but it's worth noting that without a public option, the bill will be some Medicare Part D style brutality in terms of policy.

Expanding coverage via ultra-massive giveaways to the healthcare industry = some Medicare Part D style brutality with the citizenry and public treasury on the whacked end of the stick.

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