podesta-emails
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Why the Public Option Is Not “Fading”—Just the Contrary
The Sunday New York Times ran a front page story headlined “The Fading
Public Option.” Since the beginning of the health care debate in April, the
main stream media and purveyors of the Conventional Wisdom have regularly
pronounced the public option dead and gone. But in fact they continue to be
dead wrong.
In fact, the prospects that there will be some form of public option in
the final health insurance reform measure this fall have actually increased
over the last month. Here is why:
1). The odds have dropped that some sort of “bipartisan” consensus will
become the final template for a bill. That has reduced the ability of
Republicans to tube a public option as a condition of their support.
From day one, the Republicans were never going to support a public health
insurance option for everyday Americans. The Republican party staunchly
opposed Medicare forty years ago. Despite former House Speaker Newt Gingrich
’s hope that it would “wither on the vine,” Medicare is now an
unassailably popular public health insurance option for seniors. The Republicans and
private insurance industry will do everything they can to prevent the
American people from having access to another – undeniably superior – public
health insurance plan.
The insurance industry desperately wants to protect its “right” to raise
prices and take home huge profits – to skim off as large a portion as
they can of every dollar spent on health care..
So the insurance industry and Republicans were never going to agree to a
public option. What has changed is that the Republican decision to try to
block health insurance reform has completely eliminated their leverage over
what will be in the final bill. In the end, Democrats are increasingly
clear that they will have to pass health insurance reform with Democratic votes
– which we can – either by using reconciliation rules or by securing 60
votes for cloture from Democrats and 50 votes for final passage.
2). The pundits ignore the legislative facts on the ground. Four of the
five committees with jurisdiction in this debate have reported out bills
with a strong public option. The bill that passes the House at the end of
this month will include a strong public option. Whether or not the bill that
passes out of the Senate has such a provision, the House-Senate conference
committee will likely send a final bill with some form of public option to
both chambers for final passage. That’s because a bill without a public
option will have a hard time passing the House and a bill with a public
option can, in fact, get more than 50 votes in the Senate.
3). The President has made it very clear that he not only supports a
public option, but he will demand some mechanism to assure a competitive market
place and drive down costs.
The Republicans played right into his hands with their new talking points
on this week’s Sunday news shows. Virtually every Republican argued that
the Massachusetts plan – that requires everyone to purchase health insurance –
has the highest health care costs in the country. Precisely. You can’t
force everyone to purchase insurance from private health insurers unless
you create competitive pressure to control costs by giving consumers the
right to choose a public health insurance plan.
The private insurers would love the government to require every citizen
and most businesses to buy their product –who wouldn’t.? What they don’t want
is regulation – or worse yet, competition – that prevents them from doing
whatever they can to make as much as they can. And remember that the
insurance companies are exempt from the anti-trust laws that seek to assure
competition in other markets. They can collude, divide up territories and
drive up prices until they’re blue in the face.
An AMA survey, released in late January, gives a score gauging the
concentration of the commercial market for 314 metropolitan statistical areas. The
report showed 94% had commercial markets that were "highly concentrated" by
standards set by the Federal Trade Commission and Justice Department.
In Maine, for instance, one company – Wellpoint – had 71% of the market.
The second competitor was Aetna with only 12%.
There is another way to control the behavior of the private insurance
companies when we mandate coverage – serious rate regulation – treat them like
regulated public utilities.
Rate regulation is an even more serious political lift than a public
option – which is also a much more efficient means of assuring competitive
prices than rate regulation.
The pundits, insurance companies and Republicans need to get used to one
idea. Many Democrats – including the President – will ensure that the
final bill have some robust means of ensuring competition and controlling
prices, and a robust public health insurance plan is the best option on the
table.
4). Giving Americans a choice of a public health insurance option remains
incredibly popular. A poll conducted for Americans United for Change by
the respected firm of Anzelone and Liszt – completed last Friday – shows
that, by a 62% to 28% margin, likely 2010 voters would be more inclined to
support President Obama’s healthcare reform plan if it included a public option
that gave people a choice between private insurance plans and a public
health insurance plan.
Voters like the idea of making a choice themselves – and not having the
choice made for them by Republicans who are trying to defend the profits of
private health insurers. The voters have been unaffected by the insurance
industry-generated talk that giving them that choice would prove the demise
of the private health insurance industry.
There are three major forces that keep pushing the notion that “public
option is dead.” First are the Republicans and insurance industry that want
to weave a “public option is impossible” narrative in order to create a
self-fulfilling prophecy. They hope that if public option proponents think
it is impossible, they will give up. That motivation is completely
understandable, but Progressives shouldn’t fall for it – or contribute to it.
The second is a desire in the media to create a story that President Obama
has “mishandled” the health care debate. That is simply wrong.
President Obama has moved us closer to giving America universal health care than
any other President in 60 years, and the odds are very good he will succeed
where all others have failed.
But the third is the most insidious. It is the cynicism in the media –
and Washington Conventional Wisdom – that anything fundamental cannot pass
out of Congress. That there isn’t any hope that everyday Americans can
defeat the special interests. It is the same cynicism that convinced most of
the “sophisticated” in-the-know Capitol Hill insiders that Barack Obama
could never be elected President. And to that cynicism I give the same
answer that we gave then, and that thousands gave at the President’s Minneapolis
health care rally on Saturday: “yes we can.”
Robert Creamer is a longtime political organizer and strategist, and
author of the recent book: Stand Up Straight: How Progressives Can Win,
available on _Amazon.com._
(http://www.amazon.com/Listen-Your-Mother-Straight-Progressives/dp/0979585295/ref=pd_bbs_sr_1?ie=UTF8&s=books&qid=1213241439&sr=8-1)
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