One observation I am led to on health care based on discussions at the cafe is that many members of Congress seem either to have gotten the message that there is considerable support for including a public option in the final bill, or were disposed to want that anyway.

The other observation is that, given the propensity of members of Congress to want to try to please everyone, just having a public option begs the question of whether it will work in the way advocates want it to, given what the health insurance market looks like as a result of any legislation that gets passed.  

If the terms of the legislation leave open effective ways for employers and private insurers to retain most of the less-expensive-to-insure (actuarially speaking) employees in the private, employer-provided (subsidized) market while funneling the most-expensive-to-insure people towards the public plan option, then the legislation simply won't work to accomplish any of the important and worthy goals that we need from health care reform. 

Rather, it will ghettoize the public plan, ensuring its failure and resulting, very probably, in Congressional repeal of that option in the near future, as well as long-term stigmatization of any sort of public plan option going forward. 

This is precisely what the private health insurance lobby wants.  Employers are desperate to lower their health insurance costs any way they can.  To the extent they can offload the expensive employees onto taxpayer-funded health insurance, they're delighted as well. 

So the public option in whatever gets enacted, if something is enacted, needs to be robust and not unfairly disadvantaged and doomed to fail. 

Can cafe management bring Maggie Mahar back--and ask others to write about this issue specifically if they can also help--to help us sort out what a fair, workable bill would look like along this dimension of not unfairly disadvantaging the public option? 

It seems to me as though the whole issue of how to think about "fairness" towards both the public option and to private insurers really needs discussion soon, given the speed with which the legislation is moving. 

Maggie...wherever you are...help!