Editore"s Note
Tilting at Windmills

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June 3, 2009

OBAMA WANTS A PUBLIC OPTION.... The White House, following up on yesterday's discussions with lawmakers on health care reform, sent a letter today to Sens. Edward Kennedy (chairman of the Senate Health, Education, Labor & Pensions Committee) and Max Baucus (chairman of the Senate Finance Committee). President Obama has voiced tacit support for a public option before, but notice the renewed emphasis.

"The plans you are discussing embody my core belief that Americans should have better choices for health insurance, building on the principle that if they like the coverage they have now, they can keep it, while seeing their costs lowered as our reforms take hold.

"But for those who don't have such options, I agree that we should create a health insurance exchange -- a more market where Americans can one-stop shop for a health care plan, compare benefits and prices, and choose the plan that's best for them, in the same way that Members of Congress and their families can. None of these plans should deny coverage on the basis of a preexisting condition, and all of these plans should include an affordable basic benefit package that includes prevention, and protection against catastrophic costs. I strongly believe that Americans should have the choice of a public health insurance option operating alongside private plans. This will give them a better range of choices, make the health care market more competitive, and keep insurance companies honest." [emphasis added]

Again, this isn't new, but the more the president steps up and shows some leadership in support of a public option, the more likely it is the measure will be included in the final bill. Which is why I'm encouraged by this letter -- Obama could have stuck to broad generalities about his core (but undefined) beliefs. Instead, the president reminded the senators, who are not entirely on the same page on the issue, what he wants to see.

Ezra Klein noted today that the White House "seemed relatively uninterested" in the public option as recently as a few months ago, but "has begun pushing hard for it."

And that, in my reporting, is what seems to be underneath the change. A few months ago, most observers thought the public plan was a bargaining chip. It had a lot of public supporters but few real friends. In recent weeks, that's begun to change. The White House seems genuinely intent on including a public plan -- or at least some form of public competition -- in the final bill. And that's changed the incentives for senators down the line. The public plan was safe to oppose so long as the powerful players weren't really interested in its survival. Indeed, when the policy was going to be bargained away anyway, the incentives were to try to convince the health industry that you'd been their key ally in that victory. But now that the White House has put some muscle behind the policy, opposition has potential consequences. And that's making the policy's opponents rethink their stridency.

Note to the White House: more of this, please.

Steve Benen 3:10 PM Permalink | Trackbacks | Comments (29)
 
Comments

How does one voice a tacit remark? -Kevo

Posted by: kevo on June 3, 2009 at 3:07 PM | PERMALINK

Yes!! More of this, indeed. With enough pressure, even the execrable Baucus and Nelson will smell the coffee and vote for the people instead of the insurance industry that lines their corrupt pockets with ill-gotten gain.

Posted by: Curmudgeon on June 3, 2009 at 3:12 PM | PERMALINK

From today's Raw Story:

"President Barack Obama is leaving the door open to taxing health care benefits, something he campaigned hard against while running for president. Senate Finance Committee Chairman Max Baucus, D-Mont., raised the issue with Obama during a private meeting Tuesday with the president and other Democratic senators and later reported the president's response: "It's on the table. It's an option."

This would be a tax increase for me and every other person whose employer provides health care coverage. When McCain was proposing the very same thing experts said the end result would be that employers would stop providing the coverage. Call me crazy but if Obama flip-flops on this wouldn't it be political suicide??

Posted by: 3reddogs on June 3, 2009 at 3:15 PM | PERMALINK

"How does one voice a tacit remark?" -Kevo

============================

In most, if not all, parallel universes this can be done if you're careful not to move your lips. I'm sure Steve knew that :-)

Posted by: 3reddogs on June 3, 2009 at 3:21 PM | PERMALINK

From the desk of Evan Bayh:

President Obama may support a public option, but I will continue to work with my Republican colleagues to assure that any health care reform is 100% for-profit insurance corporation based.

To have a public option would be unfair to the great work that Health Insurance Corporations have done in providing the world's best health care. A public option would provide lower costs and would drive the for-profit health care insurance industry out of existence. It is unamerican to not make a profit from the medical necessities of American workers.

Yes, my wife Susan receives $350,000 a year for being on the board of directors for Wellpoint, the Health Insurance corporation. However, any inuendos that that has any impact on my positions on health care reform are totally incorrect and insulting.

Posted by: Evan Bye on June 3, 2009 at 3:23 PM | PERMALINK

When McCain was proposing the very same thing experts said the end result would be that employers would stop providing the coverage. Call me crazy but if Obama flip-flops on this wouldn't it be political suicide??

Only if there's no public option. This is, of course, pure speculation on my part, but if you want the whole country to go single-payer but can't get past the insurance companies, making sure the private options are taxed seems like a heck of an incentive for people to sign up for the public option and starve the insurance companies.

If they do it with no public option then, yes, they've screwed themselves.

Posted by: Mnemosyne on June 3, 2009 at 3:25 PM | PERMALINK

I'll believe it when he actually starts pressuring people to do it. He's had an immense willingness to crack down on folks to his left, while allowing folks to his right to do whatever he wants.

I'll believe it when I see it. He doesn't deserve the benefit of the doubt anymore.

Posted by: soullite on June 3, 2009 at 3:33 PM | PERMALINK

The way I see it, a public option is perfect for all the people who insist that you need competition in the health care industry. I'm all for competition: let's see how well for-profit insurers, w/their 30% overhead, compete w/Medicare, w/its 3% overhead.

According to one model of organizations, any organization will do whatever is necessary to survive. This suggests that, given the choice between reducing their overhead + dying entirely, even for-profit insurers will reduce their costs.

Bring on the competition; just be sure that Medicare isn't forced to fight w/one hand tied behind its back (as is the case w/Medicare Part D).

-Z

Posted by: Zorro on June 3, 2009 at 3:39 PM | PERMALINK

OBAMA WANTS A PUBLIC OPTION

And I want a country where public corruption results in more jail time than resisting arrest. Until then, I find it hard to be optimistic.

Posted by: Danp on June 3, 2009 at 3:39 PM | PERMALINK

"The plans you are discussing embody my core belief that Americans should have better choices for health insurance, building on the principle that if they like the coverage they have now, they can keep it, while seeing their costs lowered as our reforms take hold. WHAT ABOUT TAXING MY HEATH INSURANCE OBAMA? WTF!

Posted by: Rick on June 3, 2009 at 3:59 PM | PERMALINK

I think anyone who thinks there is going to be a competitive public plan in the near future is on crack. We might get one, but they will make sure it can not be competitive.

If there is one thing I have to realize since Obama took office is that Corporate America is beyond our control. We gave companies billions in bailout that didn't need it because they argued it was unfair. Then when we asked where it went, they basically said, kiss off, non of your business. Nothing has been done to regulate them and I doubt anything of any significance will.

Expect the same type of complete disrespect for the government from Big Insurance, Big Medical, and Big Pharma. I can only imagine the resources they have reserved for this fight, enough to out resource the federal government.

Posted by: ScottW on June 3, 2009 at 4:05 PM | PERMALINK

I'll believe it when I see it. He doesn't deserve the benefit of the doubt anymore.

I have to say I agree. And if I didn't say it in a previous post, I'll say it here: I won't vote to reelect Obama if he doesn't use his capital to push this through, with a real public option. Otherwise, the country will be so screwed by 2012 that it won't really matter who is president anyway.
If the public option is as awful as the insurance industry suggests, then they shouldn't have a problem competing with it. I just don't understand why these politicians can't find other sources of money besides a supposed healthcare industry that's more concerned with profits than people's lives.

Posted by: Allan Snyder on June 3, 2009 at 4:06 PM | PERMALINK

OK, this public *option* bit sounds good at face, but: don't we have to *make* enough people sign up for the public plan (in the manner of medicare taking a percent of earned income), or it can't get funded?

Posted by: Neil B ♪ on June 3, 2009 at 4:08 PM | PERMALINK

Obama was for single payer before he was against it. A public option isn't even close. It is more bait and switch that Obama is becoming famous for.

Posted by: msmolly on June 3, 2009 at 4:12 PM | PERMALINK

I'm not sure how effective he can be anymore, but Ted Kennedy's involvement is the only thing that gives me some hope here--if he wholeheartedly endorses whatever comes out of congress, then it might be okay. If Evan Bayh gives the thumbs up, we're screwed.

Posted by: Allan Snyder on June 3, 2009 at 4:14 PM | PERMALINK

"...they will make sure it can not be competitive."

I think even that could be useful.

Medicare advantage proves beyond doubt that private insurers cannot compete with medicare's efficiency even if they can cherry pick their subscribers a bit.

The government backed private student loan program proved beyond doubt that private lenders are less efficient and more corrupt than the federal direct loan program.

If they try to put their fingers on the scale to up the price of the public option ten or twenty percent so that the private plans remain competitive it will be clear that private insurance is inferior.

So even if they do manage to handicap the public option the existence of the handicap will prove its superiority.

Posted by: JeffF on June 3, 2009 at 4:15 PM | PERMALINK

Please send emails & messages to all concerned, I have been flooding Baucus' office with them, it is the only way, also look on the web and see who is donating to them, I told Max Baucus it was worrying the number of donations he gets from the health industry. I also emphasize the fact that we are all watching them and not to ever get elected again if they stand in the way of single payer. I think only an avalanche of mail and demonstrations will get to them

Posted by: JS on June 3, 2009 at 4:49 PM | PERMALINK

OK, this public *option* bit sounds good at face, but: don't we have to *make* enough people sign up for the public plan (in the manner of medicare taking a percent of earned income), or it can't get funded? -- Neil B, @16:08

I think that's where the idea of taxing employer-provided insurance, that Obama's now talking about, might come in -- a sort of prod/goad. You tax the health benefits, the employers stop providing it. You then shop around for the cheapest option, which happens to be the govt plan. Thus, you broaden the base of contributors to the govt plan and lower the costs/fund it.

Posted by: exlibra on June 3, 2009 at 4:59 PM | PERMALINK
From CNNMoney:

Perhaps the most controversial proposal tied to health care reform, Obama backs public insurance plans as an alternative to commercial plans, intended to offer coverage to those who currently can't afford insurance.

From John at AmericaBlog:
Wrong wrong wrong. Unless Congress can figure out how to force companies like Blue Cross to give us coverage that doesn't cost an arm and a leg, that doesn't go up in cost 25% a year, that doesn't cap prescription benefits at $1500 a year (and never increase), that doesn't set lifetime limits on your coverage (meaning, if you get really sick, you die) - unless all of that happens, then the public plan is about much more than helping the poor. It's about helping all of us who can't get comprehensive insurance at a decent price - nay, at any price.

No. If there is no public option, which everyone can buy into, there is no healthcare reform.

Healthcaredeniers will continue to screw us; some of us to death.

Fuck private insurers. They got theirs...now we all deserve to have ours...without paying through the nose for the NOTHING which they begrudgingly grace us with.

WE NEED - AND DEMAND - A PUBLIC OPTION FOR EVERYONE! PERIOD!!

Posted by: MsJoanne on June 3, 2009 at 5:02 PM | PERMALINK

To be honest, getting rid of the whole employer based health care system would be a good thing. The only way any sort of market reform (ie: no single payer) of the health insurance industry will work is if everyone has to buy (and choose) their own insurance and has to feel (pay) the full premium price. it sucks but it's true, the only pure way to create a competitive environment in which prices are controlled through market forces is if it's in everyone's direct financial interest to pick and choose based on quality. the employer based model distorts the perception of costs for those covered by it.

As a small business owner i am absolutely scared/angered by the massive cost the baucus plan will be to me since ill come in right above the percentage of the poverty line subsidy. i dont want any targeted bs that increases costs, inefficiencies and makes me beg the govt for handouts. I want equal and fair footing.


As for this latest news, I'll say it again. Are you willing to vocally oppose the Baucus plan after it gets introduced (and the public option amendment they throw up for pr purposes gets voted down).

Posted by: pindar on June 3, 2009 at 5:23 PM | PERMALINK

"But for those who don't have such options, I agree that we should create a health insurance exchange -- a more market where Americans can one-stop shop for a health care plan, compare benefits and prices, and choose the plan that's best for them, in the same way that Members of Congress and their families can."

Being a retired fed employee, I have the same option for insurance as the members of Congress. I currently have BS/BC, which is a for profit company. Depending on what agency you were employed and what union you belonged to, the choices for insurance varied. Some unions offered insurance alongside the for profit companies. What it appears Obama is suggesting is not a "public plan" per se, but rather a clearinghouse similar to what all fed employees have access to. The website is at opm.gov and click on the health insurance link.

Posted by: Dave B on June 3, 2009 at 5:31 PM | PERMALINK

Dave B, that is exactly what I want...the same options that Congress has.

And if they do not give us healthcare, we need to mount an absolutely en masse protest that they should have what we have. Let them see how they fare in the free market.

They would fare as well as us. And that will create a whirlwind of change.

Posted by: MsJoanne on June 3, 2009 at 5:39 PM | PERMALINK

President Franklin D. Roosevelt once said: "I agree with you, I want to do it, now make me do it". Obama should memorize this phrase!
If we want a health plan that works for us we must become a force that will give Obama the backing he needs to confront the money interests.


Posted by: David Chisholm on June 3, 2009 at 6:39 PM | PERMALINK

NO TO GOV. OWNERSHIP I DON'T NEED GOV. CALLIN THE SHOTS....

Posted by: DIZZO49198@AOL.COM on June 3, 2009 at 7:34 PM | PERMALINK
This would be a tax increase for me and every other person whose employer provides health care coverage. When McCain was proposing the very same thing experts said the end result would be that employers would stop providing the coverage. Call me crazy but if Obama flip-flops on this wouldn't it be political suicide?? Posted by: 3reddogs on June 3, 2009

If they require (mandate) insurance then yes it would tax your employer to provide insurance. If they don't require it, but only provide more ways you *might* be able to afford it, then there wouldn't be a tax, but perhaps you would still be spending on it -- your choice.

I doubt McCain was proposing anything like this -- it's a far more Liberal plan than he would have considered. He was probably behind a Massachussetts-like plan which mandated coverage with private insurers.

The issue of government competing with private firms is an important one. If there is to be a public option it must be to serve those who private insurers refuse or who simply can't afford a private plan. Government plans would be the plans of 'last resort'. I would also suggest that it would be terrific if a government plan might be sold or farmed-out to a private firm if that firm wanted it -- there might even be a competitive bidding by several firms if they wanted those customers. But, today they don't serve over 45 million people, so why would they want to take it over just because the government could handle it?

Ensuring people get a lot more options and that private insurers compete more with one another for customers helps everyone get coverage and brings more competition to the market-place.

Obama has no reason to flip-flop. He argues for this and if Congress can't get it done, then he might lose that battle, but win the war of getting health care reform.

Personally, I think he'll get the public option because the public really wants it (and needs it) and the Dems have a significant numerical edge in the Senate.

Posted by: MarkH on June 3, 2009 at 8:04 PM | PERMALINK

@JS on June 3, 2009 at 4:49 PM

Bravo! Nail - Head. Exactly so. I too have been in constant contact with my reps in both houses, and the White House on this, and I will continue to do so with each new revelation I see here and in other media sources. They MUST know that we are watching this closely, and that the single payer public option is what we want without flaws and BS. If we fail to speak, we will not be heard. A few thousand sign-carrying peaceful "visitors" to the steps of congress would also be a grand idea. When do we do it?

I also suggest we put pressure on all reps (both houses) to list on their web pages (or a central listing site), a FULL disclosure and complete accounting of ALL their funds (both in and out) and where those incomes derive from (lobbyists, corporations, PAC's, campaign fund balances, etc.). We have to make them put all of these financial dealings (including their distant PAC affiliations) out in the open for public scrutiny. Spkr. Pelosi started the ball rolling with house expenses, let's get behind it and add to the push, eh? Real, Complete, Transparency should be Law.

Cheers!

Posted by: Otolaryx on June 3, 2009 at 10:42 PM | PERMALINK

MarkH: are you a plant (honest question)? is this the latest trial balloon? a public option that is the dumping ground for those insurance companies dont want is not a good idea. a public option is needed to reduce/control costs (which it does by not having the profit motive, this is ability to reduce costs is eliminated by your idea to contract it out). furthermore it must be open to everyone (not just those insurance companies dont want) in order to be at all financially sustainable. your suggestion doesnt do anything to fix the cost issue and is just another giveaway. if you are a plant, this is notice that that balloon wont fly.

Posted by: Pindar on June 4, 2009 at 2:36 AM | PERMALINK

Single payer universal health care completely separate from one's employment is what is needed and should be demanded by the general public. To even consider taxing health care benefits is outrageous. They don't cost the individual enough already? Businesses would also benefit from a single payer system. It is win-win for everybody except the insurance companies and their bought-and-paid for representatives in Congress and the administration.

Posted by: impartial on June 4, 2009 at 6:19 AM | PERMALINK

More on the comparison between the Canadian and US Healthcare systems. Now a report from Reuters : "Medical bills are involved in more than 60 percent of U.S. personal bankruptcies".

I'll stick with the Canadian single payer, thanks.

Posted by: Polaris on June 4, 2009 at 7:32 AM | PERMALINK




 

 
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