The public option has a pulse

Source: xplosive world

Commentators are expressing surprise at the resurrection of a public option as part the health care reform package. The main reasons cited for its resurgence are the insurance industry’s recent attack on health care legislation, claiming premiums would rise, and polls indicating that a clear majority of the public supports the public option.
Dan Balz has a nice summary of this summer’s health care struggle in The Washington Post. Eleanor Clift, a long time Washington veteran, puts the “tortured history” of reform in perspective at Newsweek, reminding us of Nixon, Kennedy, and Clinton.

Has Obama been passive-aggressive?

One of the issues commentators like to write about is whether President Obama should come out more forcefully for the public option. In the opinion of Jonathan Cohn, writing at The New Republic:

[I]t seems pretty clear (at least to me) that Obama really would prefer a strong public option–but that he, like his advisers, has serious concerns over whether such an option can pass. In other words, he wants a good public plan but he wants a bill even more–and he’s not sure that the former is compatible with the latter. So he’s being careful–more careful, in fact, than some of his Senate allies would like.

The best discussion I’ve read is from Maggie Mahar, author of Money-Driven Medicine. She has a long blog post called “The Public Option: It’s Not About Politics; It’s About the Economics of Reform.”
Mahar has always been optimistic about the prospects for a public option. All summer she’s been saying we shouldn’t pay too much attention to the distraction of political antics. Here’s her take on exactly what Obama is doing (emphasis added by me):

Last week-end, Hot Air’s Ed Morrissey lashed out, accusing the president of failing to lead by refusing to call out for the public option: “It’s a passive-aggressive approach that leaves both progressives and moderates in Obama’s own party twisting in the wind. Obama wants his advisers to take all of the flak from progressive action groups that will result from a retreat on government-run health insurance, but doesn’t have the stomach to take that hit himself. The end result is confusion among legislators on Capitol Hill, and further entrenchment on either side of the issue.”
This notion that “the president doesn’t have the stomach to take the hit” seems to me a sophomoric reading of White House strategy. The president simply wants Congress to share responsibility for the final health reform bill. Wisely, he doesn’t want it to be “Obamacare.” That would make it too easy for anyone and everyone to blame the White House for anything they don’t like about reform. …
It is imperative that the president is not seen as imposing his ego on the nation. Consider how much damage was done when the Clinton healthcare plan became known as “Hillarycare.” Whenever the political becomes personal, the long knives come out.
In some circles, President Obama is just as controversial as Hillary Clinton was back then. He has enemies eager to demonize him, and then destroy him. It’s critical that the majority of Congress “owns” the final bill. This will give legislators a vested interested in making it work.

There won’t be a filibuster

Here’s part of Mahar’s thinking on why the Republican threat of a filibuster (in the Senate) will fail and health care legislation, including the public option, will pass:

[W]hile moderate Democrats may well vote with Republicans to block a health care reform bill they don’t like, when it comes to cracking a Republican filibuster, they will stand with their party. First Democrats would break the filibuster with 60 votes, then when the vote came on a plan that contained a public plan 58 votes (or even 50 votes) would be enough to send it sailing through the Senate.

One more point from Mahar’s very long post (it’s over 2700 words – most blog post are closer to 500). Further grounds for her optimism come from the conservative American Enterprise Institute. They had this to say:

[N]o one in this coalition [of special interests] is arguing with much conviction that private plans should be preserved because of their potential ability to control overall costs. …
[C]ircumstances (and some special interests) have long conspired to keep consumer-voters mostly ignorant about just how much they are actually paying for their current coverage with all its wasteful features. …
As long as health insurers’ only significant function is the simple one of financing health care, government itself is probably capable of performing that role nearly as well as they do, without incurring competition’s added costs.

I’m a big fan of Maggie Mahar. See Related Posts for more on the documentary based on her book.
Related posts:
Money-Driven Medicine, the documentary, available on the web
Doctors in the trenches speak out – Part One
Doctors in the trenches speak out – Part two
Doctors in the trenches speak out – Part three
Why are US health care costs so high?