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Posted by on Jul 29, 2009 in Economy, Health, Politics | 20 comments

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?