Progressive Memo to Obama: Pitch In on the Public Option
I hope there is no truth in the reports that the White House is telling Reid it will not help cement the 60 votes for an up or down decision on a Senate bill with the opt-out public option -- Option Squared we might call it. This is the least Obama can do -- stand firmly behind this compromise. He and Emmanuel need to cajole and bargain and speak up to get this done!
If Obama's White House does not come through, progressives should let him understand that we will have little enthusiasm for him and for Democrats going forward. It is not just Congress that has skin in this game -- so does Obama for 2012 and for all his policy decisions going forward. Many of us on the moderate left have put up with a lot of wavering and disappointing decisions from him. We won't accept a betrayal of even Harry Reid (!) on the last reasonable prospect for a public option in health care reform. Indeed, we will not accept anything less than enthusiastic mobilization for this public option.
Get off the dime, Obama! Tell your weak-kneed Clinton advisors to stop signalling cave-ins or "I told you sos" that will just encourage backsliding in the Senate. Back up the Democrats in making something of a once-in-a-lifetime opportunity in heath care reform. If you want continued support with other steps toward middle-muddling-caution, this is the price: get a decent health reform law signed into law. Otherwise, face fired up Republicans versus tepid and disillusioned Democrats. You will not like the result.
It seems, as usual, we have contradictory stories coming out of the media. Chuck Todd says one thing, Mike Lux says something a bit contradictory -
My new rule: ignore them both and just keep pushing the WH and Congress on the PO. I keep my sanity this way.
October 27, 2009 12:27 PM | Reply | Permalink
And while we're pushing, let's push to improve the public option so that it is available to everone, the E in Medicare E.
As currently proposed, the health care risk pool is divided into two parts: the high-risk public pool and the low-risk private pool.
The public - through Medicare, Medicaid and now the public option – will cover the elderly, unemployed or underpaid, chonically ill and dying, while the private sector covers the relatively healthy and relatively well-paid. That's a recipe for more gaming, reverse cherry-picking and more skimming by private insurance companies.
The only health care risk pool that makes sense is "everyone." If the public option can't compete with private plans in the low-risk pool, then we have much less chance to improve the quality of health care and bend the cost curve.
October 27, 2009 12:38 PM | Reply | Permalink
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March 25, 2011 2:43 AM | Reply | Permalink
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April 4, 2011 6:40 PM | Reply | Permalink
There's a lot that can get me riled up, for good or ill, about Obama but I really don't think this weak public option is one of them. Theda, surely you see that even if enacted the public option in the Reid bill we even be available to so few of us that it won't really matter.
A true public option, open to every current or potential customer of a private insurance company would be a real game changer. The time for ultimatums about donations and enthusiasm was when a truly robust public option was on the table. This is a watered down drink when only a stiff one will do.
October 27, 2009 12:29 PM | Reply | Permalink
It'd be a fair criticism if all of the tea leaves didn't seem to indicate that Obama would prefer a bill even weaker on the public option than that mighty progressive Harry Reid has put into the Senate bill.
October 27, 2009 12:36 PM | Reply | Permalink
It's also a clue as to how much weaker he'd let it get in every other respect. Watch out for the poison pills!
October 28, 2009 6:55 PM | Reply | Permalink
I would agree with you if we were talking about a triggered public option, but this particular fall-back, while of course not ideal, is a useful entering wedge.
I analyze compromises by considering the types of political arguments and battles they are likely to set up going forward. Health reform will play out politically over the next decade. This Option Squared version allows a national program with many big states in it, and it can demonstrate a capacity to deliver good care at reasonable prices. That will inspire a lot of citizen and business pressure to get it expanded in two ways: open to MORE people/businesses in the opt-in states and opened to the people/firms of the opt-out states. These battles will be very helpful to both moderate and liberal Democrats, because they will force conservatives and the insurance industry to argue AGAINST expansion of choices. These battles will also increasingly pit businesses against private insurers -- exactly what has to happen to shift the leverage going forward.
None of this is as good as Medicare for All. But this version of the compromised public option is well worth fighting for as a progressive entering wedge.
October 27, 2009 12:42 PM | Reply | Permalink
Thanks for the response, Theda. I fear that once this is enacted with such limited access to society at large that lifting those restrictions, even if it's popular, will be very difficult. I mean, look at it this way: Medicare for all is a popular idea but we're not getting that. Sure, people might want into this Reid public option but America's Health Insurance Plans will use its considerable clout to keep them out.
October 27, 2009 12:47 PM | Reply | Permalink
I agree... but this isn't the final deal.
This is the deal put forth to get it through the Senate.
Once that's done, it has to be reconciled with the more robust House Bill.
THEN there's the final vote...
All we need at that point is 51 Votes.
I see this as a good step in that direction.
October 27, 2009 12:55 PM | Reply | Permalink
First of all Theda, they aren't even discussing a decent healthcare reform bill so unless there's a dramatic change he won't be signing anything more than an insurance reform bill into law that has as it's centerpiece an insurance subsidy program that will be about as popular as the bubonic plague.
But more importantly Theda, your post seems to take for granted that it is Obama's weak-kneed Clinton advisers and not Obama himself that is the cause for all his mealy mouthed, less than supportive positioning no the public option. What if you premise is just wrong and that Obama is not at all what you believe him to be but is instead the problem? What if he is weak-kneed too?
I can't think of a single major issue important to the left where Obama's position could be characterized as friendly or even promising. When is it time to abandon the charade that Obama is in any way progressive? I don't think there's much evidence to support the idea that he is. I think there's a whole helluva lot of evidence to support that he's a DLC/Republican Lite, very typical, DC corporate Democrat.
I really would be quite interested in your take on this.
October 27, 2009 12:36 PM | Reply | Permalink
Heck, I think we've long known he isn't particularly liberal. I think a great irony of the primaries is that it came down to Obama and Clinton and all of us argued about who was more progressive when the two for sure have more political points in common with each other than they do with any of us.
October 27, 2009 12:43 PM | Reply | Permalink
Well, my take on Obama is that we just do not know yet whether he will come through on some progressive priorities. I am certain there ARE arguments among his advisors, and on this issue Emmanual and the other Clinton veterans are the most weak-kneed. They are fearfully fighting the last war -- and they also have a poor idea of the price Obama might pay if moderate-left Democrats become totally disillusioned. I think they are kidding themselves. They probably do not care too much about Dems in 2010 -- or they just see the threat in terms of Blue Dogs propitiating the middle. But they need to get the message that lack of enthusiasm among mainstream Dems is a problem both in 2010 and 2012.
Much remains to be decided in health reform. The devil is in the details. Compared to 1993-94, there is much more moderate progressive pushback on critical details of imperfect health care reform. Whatever passes has to be decent on two vital issues: subsidies for the uninsured, and an entering wedge public option.
October 27, 2009 12:49 PM | Reply | Permalink
"we just do not know yet whether he will come through on some progressive priorities"
When exactly do we make a determination on this? How much of the DLC platform does Obama have to adopt before we decide maybe, as Bill Maher said on his show a few weeks back, "This guy isn't even a liberal."
October 27, 2009 1:02 PM | Reply | Permalink
I should add, thank you for responding! It is always good to read your commentary.
October 27, 2009 4:00 PM | Reply | Permalink
"When exactly do we make a determination on this?"
I, for one, am willing to wait on deciding whether his administration has been a success or failure (based on my own criteria, of course) until I have another chance to vote for or against him. After only ten months, I think it's silly to spend so much of our time denouncing the current president who, believe it or not, is the most liberal occupant of the Oval Office since (arguably) LBJ, or at least since Carter.
October 28, 2009 7:42 PM | Reply | Permalink
There is already nascent enthusiasm for a Democratic challenge from the left in 2012.
October 27, 2009 1:39 PM | Reply | Permalink
Sanders for President!
October 27, 2009 3:44 PM | Reply | Permalink
I am certain there ARE arguments among his advisors, and on this issue Emmanual and the other Clinton veterans are the most weak-kneed.
Really? I'm not seeing that. Lately, I am struck by just how tone-deaf, supercilious, late to the party, and awkward these White House folks are where progressive issues are concerned. I can't discern one fire-breathing lefty in the whole bunch, not even a lonely devil's advocate lefty. Obama's economic team is entirely run by 90's-style Wall Street-hugging neoliberals, the same smarty-pants Ivy turds who crashed our economy in the first place. I think every last one of them hates the left, and that their only "arguments" are over how many lies they have to tell and misdirection plays they have to run to try to keep us on board.
I think there are plenty of people in Congress fighting the good fight in the progressive caucus. But it's an uphill fight against the losers in West Wing.
Obama is either a fool or a fraud. He hired a crappy team full of neoliberal retreads with old, bad ideas, and turned his potentially exciting administration into a DLC dead zone of intimidated submissives. I see nothing bold, brave or interesting coming out of these guys. They don't get it. They're perpetually behind the times, behind the curve and behind the eight ball. They suck.
October 27, 2009 7:14 PM | Reply | Permalink
Unless war and financial bailouts are progressive priorities, I think we know all we need to know. I mean the guy isn't exactly out there trying to drum up jobs for the little guy is he?
October 28, 2009 7:00 PM | Reply | Permalink
Don't be surprised if at the 11th hour the Repugs show up with their NEW HEALTHCARE REFORM PLAN!!!!
And ask for a delay while we discuss it's merits...
October 27, 2009 1:21 PM | Reply | Permalink
Temporary tax credit for people with fevers over 100 degrees.
October 27, 2009 1:54 PM | Reply | Permalink
While a Medicare for all model may be the way to go, Medicare, as it is right now, for all would be a disaster for health care providers.
Sure,a few specialists are raking it in, but most primary care providers and many, many not-for-profit hospitals take Medicare partly due to their largess, and partly due to their ability to charge non-Medicare patients extra to make-up for some of their Medicare break-evens and losses. Medicare is underfunded. Enlarging the program would enlarge a very real health care problem.
Public Option,while not the "be-all", is a great idea. But, like any great idea it can be executed brilliantly or poorly. Likely the actual implementation (of policy that is yet to written!) will be somewhere in between. An activist's work is never done.
October 27, 2009 2:26 PM | Reply | Permalink
Just in case Destor drops back in . . .
Howdy Destor... about this watered down public option business. I don't disagree, although ...
Don't miss my reply here in one of your posts from yesterday.
~OGD~
October 27, 2009 5:03 PM | Reply | Permalink
Amen, Theda. You share my sentiments. I'm glad someone put into writing what many of us moderate Progressives are no longer able to fudge or deny.
October 27, 2009 9:21 PM | Reply | Permalink
Leadership from the White House surely is needed. I have been so disappointed in the lack of leadership that I am considering seriously doing something I have not done since 1968. I think I'll vote for a third party candidate.
October 28, 2009 12:58 AM | Reply | Permalink
Lieberman really owes his career to President Obama and I suspect he would not do this except at the President's request or, at the very least, his permission. I find it strange there was never a peep from Lieberman until Reid went with the Opt Out Public Option , reportedly, against the President's wishes. It is starting to look like a well played chess move by the President with Lieberman as the Presidents shield. I will work until the end for a Public Option but in the end, for me, it is simple, "No Public Option = No Obama in 2012."
October 28, 2009 2:06 AM | Reply | Permalink
Darn good point.
The President needs to use his political capital to support the public option. He's really leaving the progressives in Congress high-and-dry. The bully-pulpit has long been an excellent tool for managing the national conversation and set priorities. President Clinton did a masterful job in that regard.
Please, President Obama, get it together and toss your hat into the ring.
October 28, 2009 3:06 PM | Reply | Permalink
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February 6, 2011 1:46 PM | Reply | Permalink
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