Is The Healthcare Reform Public Plan Option DOA?
Is the public plan option DOA in the ongoing Congressional discussions on President Barack Obama’s stalled healthcare reform plan? Several reports suggest it could well be. The best summary comes from Bill Press, writing on The Hill’s Pundit Blog:
Don’t look now, but Democrats are about to abandon their commitment to a public plan option, if they haven’t already done so.
In every public appearance, President Barack Obama continues to push the public plan option as an essential element of any healthcare reform legislation. But, from the White House, different signals are being given.
For the second day in a row yesterday, Press Secretary Robert Gibbs told reporters the president was open to all options for providing more choice and more competition, including the insurance cooperatives proposed by the Senate Finance Committee. In fact, Gibbs told NBC’s Chuck Todd that at this point the president had “no preference” between the co-ops and the public plan option.
No preference? That’s a long way from the full-throated endorsement of the public plan option we’ve heard from President Obama on the stump.
What’s going on? I think it’s pretty clear what’s going on: The White House is laying the groundwork for dumping the public plan option in order to win a few Republican votes for healthcare.
Press considers this a “total betrayal” of what Obama has advocated so far, arguing that regional and “nonprofit insurance co-ops may be a good idea, and they have worked in some rural parts of the country, but they’re no substitute for a national, Medicare-like, affordable public plan option..”
Meanwhile, a key Republican says Republican and Democratic Senators are “on the edge” of a healthcare reform deal.
But is the White House losing the message war? NBC’s Chuck Todd, Mark Murray, Domenico Montanaro, and Ali Weinberg:
Perhaps the biggest thing that stood out to us at President Obama’s AARP town hall yesterday was that the White House appears to be losing the message war on health care. How do we know? Just listen to the questions the AARP callers had. Several of them asked about “rumors,” and they also brought up GOP talking points on “rationing” or the government coming to your house to ask how you want to die (!!!). Also, Obama’s closing statement at the town hall was particularly telling. “Sometimes I get a little frustrated because this is one of those situations where it’s so obvious that the system we have isn’t working well for too many people and that we could just be doing better,” he said. “We’re not going to have a perfect health care system; it’s a complicated system, there are always going to be some problems out there. But we could be doing a lot better than we’re doing right now.”
….Bottom line: The president is showing his frustration, and he appears to be TRYING to tweak his messaging.
What’s likely going on?
1. One way of looking at it is if the public option is out, Obama has been trumped. Another way of looking at it is that whatever emerges will have the support of elements of both parties and be both more bipartisan and centrist (a filthly word to many on the right and left since as they correctly point out just because something is centrist does not mean it is automatically the best solution).
2. Whatever emerges (if it passes) will be something upon which future administrations can build – if the public and political support can be built. Just because there is no public option this time doesn’t mean there can’t or won’t be one in 10 or 20 years if the Democrats win big again (history shows cycles so don’t hold your breath for whopping increases by the Demmies in 2010). And, as we have seen recently, just because the Democrats have the numbers doesn’t mean they have the unity on a given issue.
3. The apparent loss of message control on the part of the administration again underscores how many Republicans will fall into line once an official party line emerges — whether it emerges from politicians or from talk show hosts who seemingly give Republican politicians what becomes the attack line. I have been truly amazed in recent months at how people who are hurting financially and who wanted change have shifted to talking about Obama being a Muslim, not having a birth certificate, etc. and basically dumping past postion on what needed to be done to echo whatever is said on Rush or Sean. Conservative talk remains a powerful weapon for the GOP, since it gathers the political troops, puts out a party perspective and marching orders and many in the GOP do fall into line. Many conservative talkers seem like virtual RNC rip-n-readers although there are some highly independent ones (read THIS great New Yorker profile of highly independent conservative talker, Michael Savage which does capture the essence of him).
4. It continues to underscore how Obama’s political skills will be tested – skills involving aggregating political interests, communicating with the public, using the communication tools of his office effectively and wisely and convincing the public. The jury is out as to whether Obama will be another FDR, LBJ, Ronald Reagan or Jimmy Carter (even though partisan juries made up their minds the second he was sworn into office). He remains the political player to watch.
UPDATE: Dick Polman sees the seeds of Democratic party vote erosion in 2010 — as angry liberal Democrats stay home:
Watch how grassroots liberals react in the days ahead to the health care reform process on Capitol Hill. Democratic negotiators, in their quest for some kind of bipartisan measure, seem increasingly willing to jettison some of the provisions that liberals deem crucial to the cause of reform – namely, any government-run “public option” health plan, and any language that would require employers to provide health care. If a watered-down reform package ultimately passes and Obama signs it, will liberal voters register their ire by staying home on congressional election day 2010? It’s worth recalling that liberal base apathy helped sink Bill Clinton and the Democrats in the ’94 congressional elections, following the Clinton health care debacle.
But in fairness to Obama, he’s stuck on defense at the moment, trying to assuage the public’s most irrational fears about health care reform. During a town hall meeting yesterday, somebody actually asked him whether government bureaucrats would go to door requiring people to fill out forms on how they wanted to die. Obama had to spend valuable time hosing down that ridiculous notion: “You know, I guarantee you, first of all, we just don’t have enough government workers to send to talk to everybody, to find out how they want to die…I just want to be clear: Nobody is going to be knocking on your door; nobody is going to be telling you you’ve got to fill one out. And certainly nobody is going to be forcing you to make a set of decisions on end-of-life care based on some bureaucratic law in Washington.”
How bold can Obama afford to be on health reform, when there are citizens who actually think this way?
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21 Responses to “Is The Healthcare Reform Public Plan Option DOA?”
Nate Silver has an excellent summary of how Obama let a bunch of self-appointed “moderates” who claim to speak for “the average citizen” got away with saying whatever they wanted.
What matters is now is setting a good foundation that cannot be ruined by future fiddling. So the lobbyists managed to get their representatives to prevent any real change, but its still possible to lay a strong basis for slow and steady changes that will invariably overwhelm them in the coming decades.
I think I know what Congressional democrats are up to. But they need to consider another tack. Attacking the issue from a Constitutionally-guaranteed right, an new Amendment as a corallary to the guarantees of life liberty and pursuit of happiness, or perhaps corallary to the rights to bear arms to defend against enemies [ill health]? Arming oneself for defense of life is not limited to weapons of metal, gunpowder and such. Some of the greatest threats to human life have defense weapons we are all not allowed access to, or are financially barred from. What constitutes a weapon anyway? Isn't the base description one of a tool that defends the life of someone? Follow me?
Use the right to bear arms against the GOP. Watch as they gyrate between the right to defend ones life by bearing arms and their insistance on removing that right at their whim. That should be entertaining…
*pops popcorn*..
“How bold can Obama afford to be on health reform, when there are citizens who actually think this way?”
Makes one wonder how any brakes can be put on a downwardly mobile status quo when we have a citizenry so gullible and stupid as to believe every cock and bull story they have put before them. Good grief…
CO-OP = Public Plan = nationaliztion. That's why Obama doesn't care which “option” is chosen. The end result is the same. Damn you people are gullible.
“Damn you people are gullible.”
The fact is, the most gullible are the most fervent remaining core of “challenged” people who actually want this current initiative passed, and are upset at the slightest lack of idiotic charging “forward” [sic], or loss of “momentum,” on this (and to a similar extent, on other, earlier Dem initiatives), no matter what concerns more intelligent people have had all along with it; the most gullible people actually want _anything_ passed that has “health care” as its subject and is written by the activist Dems, and purports to give people something.
Obviously the result is increased federal intervention in, and provision of, health care, no matter in what name or form. Even the Republicans are largely conceding this trend (which, despite the silliness of the current Dem initiative's remaining “challenged” fervent proponents, is not limited only to it), despite very strong legitimate concerns with this current initiative.
This initiative, and any better substitutes later or follow-ups later, is all about increased federal health care interventionism and entitlement creation. (Libs and Dems have contempt for constitutional federalism and I doubt they've thought for one instant about any initiatives by state and local governments instead of by Washington instead. “Why waste time or trouble on the irrelevent?”)
The proponents want more entitlements, anyway, not even bothering to concern themselves with the costs (which they'll expect magically to be paid by Others somehow, if they ever think about it later); do you believe they, or the Dems in Washington, will ever address and work on entitlement reform?
Polls show something in the 80% plus range of people like the health care they currently have, and even their insurance. The like their President by barely over 50%, and their Congress by a mere 33% or so. So the President and Congress want to fix…health care?
uh, how does a nongovernmental nonprofit coop = government intervention? oh well, the GOP and it's adherents here shrieking about anything but corporados as the gatekeepers, will likely have their way. We'll see how you all feel when your premiums double and coverage declines, you lose your insurance in some downsizing and are bankrupted by medical costs. Hey, that's what you want to preserve and good luck with that.
Greendreams, I'm afraid you'll need to adopt the Bizarro world logic of old Htrae if you ever hope to fully appreciate the arguments put forth by our resident reactionaries. Reason alone won't cut it.
“[U]h, how does a nongovernmental nonprofit coop = government intervention?”
Who is designing and who is managing this cooperative? Whose idea is this?
(That was too easy. No need to address the other emotional stuff… [sigh])
“Polls show something in the 80% plus range of people like the health care they currently have, and even their insurance. The like their President by barely over 50%, and their Congress by a mere 33% or so. So the President and Congress want to fix…health care?”
And, of course, they're not “repairing” it, but _replacing_ it (replacing private with public health care in the incrementalist form they've currently strived hurriedly to concoct). Their ineptitude as well as dishonesty, frequently, as well as deliberate evasion at the start of costs and payment for this have been a greater source of ever-growing widespread public concern than the transparent nature (the lies about which only the most stupid or “faithful” are willing to believe) of their incrementalist shift from private to public care.
“So the President and Congress want to fix…health care?”
Actually, specifically, they claimed earlier to intend to reform entitlements (which they robotically as well as rabidly opposed during the Bush years, with no alternative offered at that time to the issue, which was to save Social Security and Medicare and make them sustainable, finally), yet specifically, this, the first logical thing for them to do (especially during a recession, which they profess to be on track to “cure”), has (along initially with paying the costs of this new health care initiative) has been deliberately _avoided_.
(In other words: If they want to “fix” health care, why don't they start by fixing Medicare?)
DLS, that's only 4 posts in a row. I think you're losing your sense of commitment.
I like the comparison you’ve done with the percentage of people that like their medical insurance compared to the percentage of people liking Obama. Obama stated last week that Medicare is the reason why our country has the deficit we have. Why do people think that the government would handle 1/6 of our economy better than Medicare???
“Attacking the issue from a Constitutionally-guaranteed right, an new Amendment as a corallary to the guarantees of life liberty and pursuit of happiness, or perhaps corallary to the rights to bear arms to defend against enemies [ill health]?”
The bogus arguments involved have been laid to rest elsewhere, already. Now a real amendment, on the other hand, ratified and all, would settle this, as well as be remarkably refreshing from Washington and a completely alternative universe from what we face with the Democrats there now.
I have been saying for a long time now that we are destined to 'leapfrog' past the single payer plans in other countries and create a more diversified system.
Single Payer is dead for now in the USA. We have to live with that. The future belongs to smaller organizations and arrangements, not bigger ones. We need more diversity – more options, rather than fewer. What about ways to improve your health that are much more forward thinking than standard medical practice, which is still too much oriented to diagnosing and treating disease? Single Payer not only locks you into the government, it also locks you into standard medical doctors and standard medical thinking, along with the same old prescription drugs, medical devices, etc. Join me in creating a co-op (for lack of a better term) that is smaller, not bigger. It takes a village to raise a child? OK, I say, it takes a village to improve your health. That is what we'll prove works better than all these other 'plans' and financial schemes.
Being a Utah health insurance underwriter for http://www.BenefitsManager.net and http://www.DentalInsuranceUtah.net I have the opportunity to consult within many state insurance committee meetings. Some interesting changes took place in Utah with the passage of House Bill 188 that other states should pay attention to and perhaps the federal legislation. The bill created a state insurance pool requiring private health insurance carriers to come together and underwrite risk. Through governmental guidelines (which I have traditionally opposed in the past) they created a arena of underwriting rules that essentially guarantees the participating insurance carriers a ?no loss? or ?no gain? over each other. What this essentially means is that they pool the underwriting medical risk and spread it evenly among each carrier. All the sudden, we see guaranteed issued policies. We see rates drop by as much as 13% In Utah, our average monthly family rate is $867 for a $500 deductible plan. Some of the family rates within the ?Utah Insurance Exchange Portal? are approaching $700.00 now. To see more of HB 188 and see how Utah wrangled change without increasing taxes or rationing go to: http://www.prweb.com/releases/utah_health_insurance/health_care_reform/prweb2614544.htm
The private insurance sector can be corralled into cooperation where they can meet their goals. You have to understand that health insurance carriers are only looking for a 4-5% administration fee. That is it and they are more efficient as compared to a governmental portal that will cost more money. Take a look at Utah folks!
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I just watched the news and canadians are overwhelmly in favor of their single payer plan. It was 74% i n favor.Two hundred thousand in this country die every year from preventable medical errors and hosptial infections and we pay double than other countries who have a much lower error and infection rate.This does not take into account the tens of thousands who die from perscription drugs errors.
We know about that all to well as our son died from a drug reaction from propofol.In alot of countries that drug is severely restricted like it should be .He was only 26 and we would not have known if we hadnt had his medical care reviewed by a fine doctor.The hosptial did not tell us the truth .
as in any debate, the president needs to DEFINE public option. Somebody needs to do this and then people can argue facts!!!!