The public option fight is just beginning

by: Jay Stevens

Mon Oct 26, 2009 at 15:40:51 PM MST

Still, that it got in the bill is a huge victory for the progressive activists who fought for it. Huge. Despite being outspent by industry lobbyists, despite not garnering the frenzied media coverage that the Teabaggers did (memo to self: blog while armed), despite the attempts at marginalization by both Congressional and White House Democrats and the open hostility of some single-payer advocates, a lot of good people stirred up a big fuss, and a public option will be in the final bill.

We were wanted for door-knocking and phone-calling and t-shirt-buying and our votes, but we weren't wanted when it came time to craft policy. Well, despite the public option's relative insignificance (compared to say, real health care reform in the form of a single-payer system), we've forced a place a the table. And we're not going away. We'll be there for climate change legislation, immigration reform, bank regulation, Net Neutrality, consumer protection legislation, gay rights, tax reform, and on and on and on.

Get used to us.

Thoughts below the fold.  

Like the bill that will probably emerge from Congress, the Massachusetts reform mainly relies on a combination of regulation and subsidies to chivy a mostly private system into providing near-universal coverage. It is, to be frank, a bit of a Rube Goldberg device - a complicated way of achieving something that could have been done much more simply with a Medicare-type program.

Krugman's optimistic. He points out that Massachusetts' system has nearly achieved its goal - universal coverage - and that it's popular. He admits that system, and this bill, have little in them to control costs, but as in Massachusetts, the reform will be a framework that spurs more reform. Krugman: "The new health care system will be criticized; people will demand changes and improvements; but only a small minority will want reform reversed."

I agree, although I'm a little more pessimistic at the bill's outcome. Massachusetts voters didn't have the same expectations national voters do. America's voters are expecting health care reform - they'll be getting a weird insurance welfare bill with a convoluted payment system and no real change for most policyholders, other than higher premiums. And nothing will happen until...when? 2013? And you think this is a recipe for success?

Second, the next big thing we have to fight for is an open health insurance exchange. Without it, reform is going to be meaningless for most of us. We all should have the right to ditch our health insurance policy if we don't want it, and shop for a policy on the health insurance exchange - a policy that's subject to the community standard regulations.  I don't want a policy owned by insurers who will search my medical records for a reason to deny my claim. Likewise, I want the option to buy the public option - at any time.

Third, the Senate is a mess. Its use of the filibuster has impeded that body's constitutional duty. And it's not just healthcare. Thanks to Republicans filibustering nearly every bill and judicial appointment, the Obama administration is essentially handcuffed to enact the change it promised - if, of course, it's actually interested in reform. But we are, and the Senate has become an unreasonable obstacle. All the power of the Senate is vested in a few corporate-controlled "moderate" Democrats and Republicans - Mark T's bogeyman Democrat come to life. Senate Democrats need a new leader, one that's more progressive and more aggressive, who'll work to strip vacillating Democrats of their committee chairs and break Republicans of their knee-jerk filibustering.

Harry Reid: supporting an opt-out public option is not enough.

Fourth, the biggest reasons politicians pull sh*t like this bill is because of fear. Fear they won't be re-elected. But the support for Democrats is bottoming out. Why? Because Democrats and Independents want real progressive change. It's hard to get fired up about this healthcare bill. It's the ugliest kind of compromise: assembled by committee, dedicated to preserving the status quo with taxpayer subsidies, and pleasing to no one. If the GOP wins back a few dozen House seats in 2010, it won't be because of conservative "values" - the Republican party is almost universally loathed - it'll be because Democratic supporters, who worked so tirelessly to completely turn DC around in two elections and two short years, will have little to show for their work and will stay home.

If you want to preserve power, do something bold.

Next up: climate change!

Of course, the carbon tax has already been pushed off the table...and the Senate promises to strip all of the meaningful provisions from the already-stripped-down cap-and-trade bill...

Sound familiar?