Monday, November 23, 2009

The Public Option

Josh Marshall's a smart guy, but I think he's about as wrong as wrong can be on the public option.
Now, there are many people who look at this and say that the bill(s) under discussion are so anemic that they're maybe not worth fighting for at all. And that's certainly a legitimate opinion. But I think there's another question. Considering how down to the wire this is, is it really worth holding up everything else contained in the bill when the point of contention, the public option, is as measly as it is?
The same thing probably could have been argued about the first version of Social Security or the first version of Medicare - "It's measly, so what's the big deal if it doesn't pass." Well, whether you like or hate the current version of those programs, I don't think you're apt to argue that they're "no big deal". People like David Frum and Martin Feldstein wouldn't be telling us that any public option, no matter how "measly", will inexorably bring about the end of private health insurance if the opponents of the public option shared Marshall's perspective. It's easy to hobble the public option, version 1, but it's very difficult to stop the public option from later being made viable.

Marshall follows up with a valid point about "up and down" votes, but I think he's jumping the gun:
If you go back to the earlier part of this decade when the cloture/filibuster issue became a big deal, largely on the Supreme Court nominations front, the right made a big push on the outside about the issue of allowing up or down votes (i.e., 51 vote majorities) simply as a matter of principle
So why not do that right now? Because the bill is advancing without that type of push. The best time to call for an "up or down vote", and to press people to "allow an up or down vote" is when the bill's up for final passage. Do that too soon and not only do you give opponents of the bill time to prepare and rehearse rebuttals, you risk inspiring a yawn from the media on the fourth, fifth or sixth round of voting when you want the headline to be, "Health reform opponents block up or down vote."


  1. The fact remains that big insurance by refusing care to patients and reimbursement to doctors over typos has ticked everyone off. They have a monopoly over the whole process and a well financed lobby team (including Lieberman's wife) and representatives on both sides of the isle.

    A friend of mine recently laid off just he and his spouse is paying $2,500.00 dollars a month for his COBRA. Health insurance costs more than his mortgage. Anyone taking up the insurance industry's cause doesn't know what they are talking about.

    If you think the insurance companies are going to voluntarily lower their cost while having a monopoly over the process – you are being disingenuous …Over 60% of all US bankruptcies are attributable to medical problems. Most victims are middle class, well educated and have health insurance - (The American Journal of Medicine)

    The insurance companies and their representatives in Congress would love to perpetuate a business model that is crippling our overall economy – a bunch of great Americans aren’t they?

    90% of the wealth concentrated in 1% of the population is no way to run a country but a heck of a way to establish a royalty ruling class. Yacht sales can not sustain 350 million people. I'm for the public option, competition and a level playing field or break up the big insurers like we did AT&T.

    A slavish focus on profit margin might be good for the individual or a business, but it is one helluva lousy way to "govern" a Country. The GOP being a wholly owned subsidiary of Corporate America has a hard time with that concept.

    Paul Burke
    Author-Journey Home

  2. A few years back I was paying COBRA rates for what I'll admit was a very good policy. Over the course of a year the cost rose from $1,500 for a family of three to just about $2,000. I would expect that the price would now meet or exceed what your friend is paying. (I hope your friend qualifies for the COBRA subsidy). Dropping insurance at that time was not an option, but when I priced out alternatives I was finding policies available for the same amount or more for far fewer benefits, along with both higher copays and higher deductibles.

    I would not hold up the plan I was using as a model for a national health insurance plan - that wouldn't be sustainable. But Canada's Medicare plan costs less than half that amount per family, per year - for a plan far superior to any of the "group rate" plans available to me as an individual.

    Of itself, doesn't the fact that COBRA is deemed necessary, and is often the best choice for a person who loses employment, demonstrate a serious failure in the health insurance market for individual consumers, as well as for the "group plans" they can obtain through various membership organizations?


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