He Loves the Public Plan, He Loves It Not


The debate over whether or not a health-care bill should include a public plan — a government-run health insurance option much loved by liberal health-care reformers — is often portrayed as a difference of policy, fought over questions like: Is the public plan just a single-payer Trojan horse? Will it actually lower the cost of insurance premiums? Might it put private insurers out of business? But these days, the president's stance on the issue seems to hinge less on these questions and, instead, on pure political calculation.

The health-care question of the week amongst anxious reformers has been whether or not Obama actually supports a public plan, and if so, how much. The president has spent a fair amount of time selling the virtues of a public option. But in a recent press conference, Obama refused say that a public plan was a must-have, and earlier this week, White House Chief of Staff Rahm Emmanuel irked public-plan supporters when he said that the administration might be open to some kind of compromise — perhaps including an Olympia Snowe-style "trigger" mechanism that would significantly delay the implementation of the program — on the public plan.

But now Emmanuel is trying to walk back his waffling. And the Congressional Progressive Caucus, whose members believe that a strong public plan is the only effective check on private insurers, are being vocal about their displeasure with the short shrift they feel has been given to the public plan. This puts the White House, which has signaled that a desire to make health-care reform a bipartisan affair, in a tough spot: Centrist Republicans like Sen. Chuck Grassley and some conservative Democrats like Sen. Mary Landrieu are opposed to a public plan on the grounds that it would shift too many people off of private insurance.

So for the president, at least, what's at stake here isn't a matter of policy, but personal political capital. Obama supports a public plan, probably in its strongest form, but he's more than willing to water it down or perhaps even scrap it altogether if that's what it takes to pass a health-care bill. Right now, health-care reform is the single biggest item on Obama's legislative agenda, and if it fails, he'll take a huge hit politically. His top priority is protecting his own political future, and he isn't going to let legislative details, regardless of their importance, get in the way.

Last week, I wrote about shaky support for the public option. Shikha Dalmia asked for presidential honesty on health-care reform. The complete archive of Reason's health-care coverage is online here.


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  1. Apropos of this post, I went over to DailyKos.

    On their front page they have an article about Karl Rove, a video of Sarah Palin, and not one, but two posts on Sarah Palin…

    I’m beginning to feel sorry for the Kos kids. With Obama’s victory, they seem so… lost.

  2. Let’s hope Barrack n Rahm waffle so much that this legislation gets bumped for the new flavor of the week.

  3. But these days from day one, the president’s stance on the issue seems to hinge less on these questions and, instead, on pure political calculation.


    I think the prospects of meaningful legislation on healthcare are sinking fast.

    Which means less than you think; CMS (the Medicare agency) long ago cast off the shackles of Congressional oversight and the Constitution, and has long controlled what it pays for, how anyone who it pays runs their business, and how healthcare that it pays for is delivered, without benefit of legal authority.


    It’s official. America and the World are now in a GLOBAL PANDEMIC. A World EPIDEMIC with potential catastrophic consequences for ALL of the American people. The first PANDEMIC in 41 years. And WE THE PEOPLE OF THE UNITED STATES will have to face this PANDEMIC with the 37th worst quality of healthcare in the developed World.


    We spend over twice as much of our GDP on healthcare as any other country in the World. And Individual American spend about ten times as much out of pocket on healthcare as any other people in the World. All because of GREED! And the PRIVATE FOR PROFIT healthcare system in America.

    And while all this is going on, some members of congress seem mostly concern about how to protect the corporate PROFITS! of our GREED DRIVEN, PRIVATE FOR PROFIT NATIONAL DISGRACE. A PRIVATE FOR PROFIT DISGRACE that is in fact, totally valueless to the public health. And a detriment to national security, public safety, and the public health.

    Progressive democrats the Tri-Caucus and others should stand firm in their demand for a robust public option for all Americans, with all of the minimum requirements progressive democrats demanded. If congress can not pass a robust public option with at least 51 votes and all robust minimum requirements, congress should immediately move to scrap healthcare reform and request that President Obama declare a state of NATIONAL HEALTHCARE EMERGENCY! Seizing and replacing all PRIVATE FOR PROFIT health insurance plans with the immediate implementation of National Healthcare for all Americans under the provisions of HR676 (A Single-payer National Healthcare Plan For All).

    Coverage can begin immediately through our current medicare system. With immediate expansion through recruitment of displaced workers from the canceled private sector insurance industry. Funding can also begin immediately by substitution of payroll deductions for private insurance plans with payroll deductions for the national healthcare plan. This is what the vast majority of the American people want. And this is what all objective experts unanimously agree would be the best, and most cost effective for the American people and our economy.

    In Mexico on average people who received medical care for A-H1N1 (Swine Flu) with in 3 days survived. People who did not receive medical care until 7 days or more died. This has been the same results in the US. But 50 million Americans don’t even have any healthcare coverage. And at least 200 million of you with insurance could not get in to see your private insurance plans doctors in 2 or 3 days, even if your life depended on it. WHICH IT DOES!

    If President Obama has to declare a NATIONAL STATE OF EMERGENCY to rescue the American people from our healthcare crisis, he will need all the sustained support you can give him. STICK WITH HIM! He’s doing a brilliant job.



    Join the fight.

    Contact congress and your representatives NOW! AND SPREAD THE WORD!

    God Bless You

    Jacksmith – WORKING CLASS

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