Should liberals support a reform package that does not include a public option because some reform is better than no reform? Or should we support the progressive caucus and their threats to pull support for a bill that does not include a public plan? Is now the time to make a stand and show that liberals are a credible threat to legislation? If so, at what cost do we make this stand?
I'm truly torn by these questions. On the one hand a public option already was a compromise for many of us, we wanted single payer. On the other hand I truly care about reforming the system to bring some level of immediate relief to people and prolonging the misery, even in the name of better reform, seems cruel.
I do question though if a public plan can ever be passed on its own. I feel like we really have just this one shot to actually get this done. If with a popular new president, 60 Senators and a huge majority in the House we fail then I wonder how we'll ever get reform passed.
1 comment:
Universal access to health care, by any means, matters tremendously as a moral issue. It also has a substantial impact on cost because it eliminates the vicious cycle of cost shifting to people who do have insurance, because it favors low cost doctor's office treatment over expensive ER treatment, and because it favors prevention over cure. None of these benefits require a public option.
Indeed, the public option in the Obama plan was just a frill. It was not, as Howard Dean suggests, a lynch pin of cost reduction. We have non-profits in the system competing with for profits, already: Kaiser and Rocky Mountain Health Plans are two available in Colorado.
The administrative cost reduction we see in single payer also wouldn't be nearly as possible in a mere competing public option.
Further, the idea that a public option is really politically hard to pass in isolation isn't necessarily true. Much of the opposition (and support) now is based on the misapprehension that it would be a creeping form of single payer, which doesn't seem to be born out by the proposal. In isolation, in contrast, where regulation of, and payment for health care is not an issue, and the question is whether an unsubsidized health care plan should be sponsored without changing anything else, I think a public option is pretty political benign.
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