The public option failed to clear the Senate Finance Committee yesterday which may, or may not, result in its exclusion from the final bill. The health care reform effort is still a work in progress. Once out of the Finance Committee, the bill will go to the floor of the Senate where it will be in competition with another Senate bill. Meanwhile, three bills in the House will be vying for final passage. And once both chambers pass something, there will be a Conference Committee to reconcile the two finalists. Still, it would have been better if the Senate Finance Committee had included a public option.
The television ads that run on CNN are highly misleading. They insist that the problem with the entire health care reform effort is that it amounts to "government-run" insurance and that the public option will force people to abandon the coverage they currently have. Both assertions are wrong and the operative word here is "option."
Democrats, however, have brought some of the controversy on themselves by being too cute by half. For example, while it is true that no one will be forced by the government to select the public option, it is also true that an employer may force her employees onto the public option if it is cheaper than their current plan. Democrats tend to leave out that second half of the equation. And, I don’t see why they do so because doing so points out the lack of freedom in the current system. You are at the mercy of your employer now for your health care, most obviously because you can lose insurance if you lose your job but also because your employer, not you, chooses the plan or plans available to you.
As well, rather than creating a distinct entity, Democrats should have said, "And if you don’t like the private choices you can buy into the plan we in Congress get." Or, even better, allow people to buy into Medicare. The phrase "public option" lacks concreteness in most people’s mind. They know what Medicare is. And, if Republicans attacked a Medicare option, they would have to be careful because some people would think they were attacking Medicare. There is no quicker way to political defeat than to attack Medicare or Social Security.
I suspect there will be a compromise, the so-called "trigger" for the public option. If there are insufficient cost-savings in three or five years without it, the public option would be activated automatically. Indeed, the threat of a public option might achieve what an actual public option is intended to achieve, a reduction in costs by the insurance companies. We could find ourselves, a few years hence, in the almost comic situation where the only way for insurance companies to make gargantuan profits would be to take that threat of a public option off the table, and the only way to do that would be to elect a GOP majority in Congress. But, then, the immediate result of such an election would be a hike in insurance premiums so the GOP would have to threaten a public option too. If that comes to pass, I hope someone keeps a tape of the scare ads they are running today.