| Ezra Klein interviewed Sen. Kent Conrad (D ND) about his compromise to a public option. Essentially he's proposing a that a series of "federally-chartered co-ops" play the role as public health insurance in opposition to for-profit insurance. That is, they're not-for-profit health insurance alternatives that aren't controlled by the government.
Klein and Robert Reich both express concern that the co-ops "won't have any real bargaining leverage to get lower prices because they'll be too small and too numerous." Klein also thinks this compromise won't appease those seeking a full public option, "because, quite frankly, co-ops don't represent what they're looking for: A chance to test the thesis that government is a superior provider of medical coverage."
Matthew Yglesias:
To put it most crudely, the available evidence appears to overwhelmingly indicate that governments can provide health insurance of equal quality at lower cost to the private sector. It's also true that a certain kind of ideological dogma says this can't possibly be true. The view behind the public insurance option is that the dogma ought to be put to the test through competition. Proposals that aim to do something, not that don't aim to put the dogma to the test, are not a compromise. Indeed, the idea of a "public option" is itself a compromise between ideological dogma and the evidence in favor of single payer. The health co-ops seem like an interesting idea to me, but anything that drops the public plan is a proposal to drop the public plan not really a public plan "compromise." That said, insofar as Congress is inclined to do this it ought to be done well.
Personally, as an avid supporter of a robust public option, I don't give a rat's *ss what proves whose theory. I just want access to portable, affordable, and reliable health insurance, which I ain't getting on the market. That is, if the public option is public, fine. If it's a federally-chartered co-op, fine.
In Yglesias' post, he quotes Ivor Volsky's requirements for such a co-op to ensure it's not set up for failure from the beginning - which includes making it a national co-op large enough to negotiate low prices.
Of course all this talk about co-ops could very well be moot:
House Speaker Nancy Pelosi told the Huffington Post Thursday that a health care overhaul that did not include a public option wouldn't make it through the House because it 'wouldn't have the votes.'
...Asked by HuffPost if she would allow a reform package without a public option out of the House, she responded: 'It's not a question of allow. It wouldn't have the votes.'
The bill would lack the votes because the GOP generally opposes Democratic reform proposals, and the 77 member Congressional Progressive Caucus -- rarely heard from on the Hill -- has been particularly vocal in its commitment to oppose any reform that doesn't include a public option. The public plan's popularity extends beyond progressives and is broadly popular with the Congressional Black Caucus, Congressional Hispanic Caucus and even two-fifths of Blue Dogs, the conservative Democratic coalition.
Pelosi, during the press conference, also rejected a compromise proposal by Sen. Kent Conrad (D-N.D.) to create private, nonprofit, regional health care cooperatives instead of a national public option.
Pelosi wasn't having it: "Not instead of a public option, no," she said.
Sometimes those of us that write about bills or reforms working through Congress forget there's another body other than the Senate, a forgivable error given the difficulty of finding 60 votes in the more conservative body to avoid filibuster. But it looks as if House Democrats are going to insist on real health care reform. Looks like we'll have an intra-Congressional tussle to watch...
Update: Naturally Ezra's already posted an interview with Rep. Lynn Woolsey, leader of the 80-member House Progressive Caucus on the group's insistence a public option be included in any health reform bill. Woolsey: "There are 80 members. And we have drawn a line in the sand. And we're serious about it."
I think I have a new hero. |
