The public option was always a compromise for serious supporters of health-care reform, who — like Barack Obama when he was running for the Senate in 2003 — knew that a single-payer “Medicare for All” system was what America needed to provide health care to everyone while controlling costs.
But, in the reform legislation debuted Thursday by House Speaker Nancy Pelosi, the compromise was even more compromised than had been expected.
Pelosi says the legislation is “historic,” and celebrates the fact that is does still include a public option — a component many pundits had said was destined for abandonment.
But, while there is a public option, it is anything but robust.
Progressives believe Pelosi has bent to far to the right.
And The New York Times suggests as much in its analysis, which declares that:
Under pressure from moderate-to-conservative members of the House Democratic caucus, Speaker Nancy Pelosi has decided to propose a government-run insurance plan that would negotiate rates with doctors and hospitals, rather than using prices set by the government…
Ms. Pelosi said the public plan, which she prefers to call a “consumer option,” would compete with private insurers. But the speaker was apparently unable to muster the votes needed for the ‘robust’ liberal version of a public plan, which she has repeatedly said would save more money for consumers and the government.
Translation: The “public option” Pelosi and her team have proposed a plan that would not make payments for care based on Medicare rates, as the Congressional Progressive Caucus and key Senate Democrats have proposed.
Rather, under the Pelosi plan, the rates be tied to those of the big insurance companies. That’s a big, big victory for the insurance industry, as it will undermine the ability of the public option to compete — and to create pressure for reduced costs.
Pelosi’s plan also drops a number of provisions that had been advanced at the committee level to promote consideration of “Medicare for All” models and to allow states to experiment with single-payer plans.
That’s an especially bitter pill for House progressives, who has won support for state-based experimentation in committee votes.
Groups such as Progressive Democrats of America were quick to raised alarm bells because some of the most innovative responses to the health-care crisis are being forged at the state level. While single-payer proposals are being blocked at the federal level, PDA national director Tim Carpenter says the single-payer fight is ramping up in the states.