President Obama referred to the creation of a public program to compete with for-profit health insurers as a mere “sliver” of his reform agenda and then told a Colorado town hall meeting that: “The public option, whether we have it or we don’t have it, is not the entirety of healthcare reform.”
Secretary of Health and Human Services Kathleen Sebelius said the public option is “not essential” to addressing what ails a broken healthcare system.
Those statements, obvious signals of a slackening in commitment to take on the insurance companies, caused an outcry.
The outrage was best summed up by Congressman Anthony Weiner, D-New York, who has emerged as a key backer of real reform.
“Having a plan that doesn’t have a public option is worse than having doing nothing at all,” said Weiner. “Leaving the insurance companies in charge of this is kind of like leaving a pyromaniac in charge of the fire department.”
Without the public option, “I’m gonna’ be a ‘No’ vote and so will a lot of other people,” Weiner said, expressing a sentiment that was shared by a good many House Democrats.
It quickly became clear that, without some sort of public option, Obama would have to struggle to get progressive Democratic votes for any plan he and his allies in Congress might advance. It was not just a matter of liberals being disappointed, although that was a factor. The real issue was this: the administration and key Democrats in the Senate have hinted that they will propose “reforms” that would undermine the stability of Medicare and Medicaid programs in a number of states in the upper Midwest. Without a public option, Democrats from that region would be inclined to oppose a plan that tinkers around the edges of reform while harming their home states.
So, now, the White House is scrambling to suggest that no signals were being sent over the weekend about backing away from a public option.
Suggesting that there was “an overreaction to what Secretary Sebelius said,” White House spokesman Robert Gibbs now claims: “It’s crazy. It’s not a signal.”
Gibbs is, of course, spinning — or, perhaps, a better word is stumbling.
Note that he does not deny the White House might abandon the public option. Indeed, he suggests that the weakening of Obama’s commitment to real reform is old news that “just got picked up on.”
According to The Hill newspaper: “Gibbs reiterated that the president’s preference to create competition and quality in health insurance is through a public option, but Obama is willing to listen to other ideas that would achieve the same outcome.”
Rest assured, despite the spin, the public option is definitely on the chopping block. And the blade is hovering.
Even if the public option is not hacked off by Obama, this is still an exceptionally dangerous moment for real reformers.
The danger is that the administration might insert a weak public option in a plan, hoping that this would be enough to unify Democrats.
But real reformers need to recognize that a weak public option — one that lacks the resources, the quality and the authority to effectively compete with private insurers — is meaningless.
The fact is that the public option is, itself, a compromise.
The best fix would be a single-payer plan, of the sort that Weiner and other real reformers support.
If single-payer is not to be, then it is essential that progressives in the House and the Senate give their support only to reform plans that contain a robust public option and that give states the option of implementing regional single-payer programs.
It may be true that “the president’s preference to create competition and quality in health insurance is through a public option.”
But a weak public option is a compromised compromise that no one should support.
Thus, it becomes necessary to defend not just the concept of a public option but the reality of a robust version of it.
Otherwise, what is called “reform” will really just be a plan to put the pyromaniac in charge of the fire department.