A variety of health care reform plans, including the president's, have a public option. As I understand it, all of the plans currently under serious consideration would require everyone to carry health insurance, just as we are required to carry automobile insurance. Yet private plans are enormously expensive and often not available for those who do not have employer coverage. So, most plans set up a health insurance exchange for those people who need to buy on the open market. The public option comes in here; alongside the private plans offered by various insurance companies on the market, there would be a public plan.
Why have one? The idea is twofold. First, it gives people an alternative and, especially in states with 1-2 dominant health insurance companies, the government would provide competition. Second, competition, in turn, would lower costs. As we all know from cable companies, when 1 source controls the vast majority of a market, prices mysteriously rise and quality of service mysteriously falls. Amazing, that.
That's it. Nothing mysterious or strange here. In fact, the justification for a public option matches almost exactly the justification for the TVA when FDR and George Norris put it through in the 1930s. A public power option would keep private plans on their toes. It proved quite helpful.
Yet many so-called moderate Democrats oppose the public option. Yesterday, three Democrats voted against two versions of it in committee: Max Baucus of Montana, Kent Conrad of North Dakota, and Blanche Lincoln of Arkansas. Their arguments are suspect.
First, they claim to care about the deficit. They do not want the program to increase the budget deficit. Unfortunately for them, every single study, including the nonpartisan and respected Congressional Budget Office, states that the public option would save taxpayers money by lowering health care costs through competition. In some studies, the amount is trivial. In others, it is large. But it is always savings.
Moreover, these very same Senators happily voted for Bush tax cuts with no budgetary offsets and the Bush prescription drug plan with no budgetary offsets. In fact, Lincoln and Conrad recently voted to throw away 250 million dollars on abstinence education. The program does not work. That's been proven. It is a waste of money. They don't care. So, their deficit conscience is quite selective.
Second, they argue that a government option might drive every other insurance program out of business. Yes. That's why the Post Office has driven UPS and FedEx out of business and rules the world. Ninety-nine percent of the time these folks argue that the federal government can't run a one-car parade without screwing it up. Now, they want to claim that a public option--just an option--open only to those Americans buying insurance on the private market will drive everyone else out of business? They often try to claim that government subsidies would unfairly boost the public option. But the bills under consideration would not do so. They can't, if they are to make the budget targets Obama has created.
Third, they claim the public option doesn't have 60 votes. That is the cloture figure, the number of votes it takes to close debate in the Senate. They're assuming here that the Republicans would filibuster a health care reform bill on the Senate floor that contains a public option. But there are 60 Democrats. No Democrat has said that s/he will vote against cloture. I'd like to know just who plans on voting against cloture. Who's willing to kill all health care reform efforts and undermine a Democratic president? Several oppose the public option, but it has more than 50 votes; it has a majority. Who among these "Democrats" is willing to vote against cloture?
Fourth, they claim they want a bipartisan bill and Republicans won't sign onto a public option. This would make some sense if any Republicans had offered any deal which would cause them to support the bill. They haven't. Tort reform. Abortion regulations. Coops. No public option. Nothing. Nada. Zero. These moderate "Democrats" are negotiating with themselves. The Republicans want to kill health care refrom and there's no deal to be had here. Lucy will pull the football again, Senators.
It would be nice, I think, if someone among these three (and a few others) would simply tell the truth. They don't want health care reform. Then, its supporters could dispense with them, remove them from their leadership positions in the Senate (and a majority of the Democratic caucus ought to enforce some discipline), and get on with it.
I'm increasingly beginning to believe that Conrad is just stupid, lazy, and uninformed. But the others probably are not. They need to become part of the solution, not part of the problem. Or they need to get out of the way. The majority needs to start acting like a majority.