Amy Smoucha has worked on health care issues for Jobs with Justice for three years now. That's dozens of months, hundreds of weeks, and thousands of hours. And that makes her expertise on the subject worth listening to. So I did. When the e-mail below arrived in my inbox, I paid attention--especially to her fourth point.
In fact, within a few days, I will write in more detail about the "national, non-profit, publicly accountable option for health insurance coverage" contained in the Senate bill. Suffice it for now to say that rather than fight the screaming mob about the public option, the Senate did an end run: it eliminated that program and substituted a plan that has the potential--minus the right wing hysteria--to achieve the same thing. An analysis of how useful (or less than) those two programs may turn out to be will be part of my upcoming posting.
But for now, see what Amy thinks of the progress Democrats have made so far:
An open letter to progressives: ideology kills people
I have been amazed at the rancor and deceit that many politically "right wing" and conservative leaders have demonstrated during the long, heated struggle to pass health reform legislation. I'm amazed that for political, partisan and ideological reasons, Republicans and Libertarians are willing to lie to their own voters. I'm awestruck at the monumental steps people are taking to protect corporations, defend outrageous profits and protect a status quo that working people in any political party cannot afford much longer.
Of course, we expect that sort of vitriol and cynicism from the right wing and from conservative political operatives who have lost ground in the last election and are bitterly losing the health care fight.
I am having a much harder time understanding the fierce attack by some folks who are thoughtful, independently-minded and progressive. Like any significant human and civil rights struggle, we are in a place where we've won a lot, we've lost some of our demands, and there's more work to be done to get a final bill out of conference. Both the House and Senate health care bills represent an incredible step toward real, affordable, quality health care for every person in our country. Neither of them accomplish everything we need.
I hope we all evaluate the bills and what they accomplish based on the ambitious reforms they include and an understanding of the context in which the measures are proposed. The bils do many things for our communities--like funding clinics and doctors. It's important to consider the flaws in the bills alongside a balanced understanding of just a few examples of what we are gaining and winning:
1. The Senate bill delivers health coverage to 94% of Americans --31 million uninsured people will gain access to affordable health coverage. (The House bill would cover 36 million-95%.)
2. The proposed expansion of Medicaid will provide a lifeline to 15 million low-income and disabled Americans. Congress is about to enact a significant expansion of Medicaid for both individuals and families up to 133% of the federal poverty level. Currently in Missouri a family of three is eligible for the state health insurance program if their income is less than $292 a month. Both House and Senate bills lift the income rules for the whole country to about $2029 a month for that same family of three. For the first time adults without dependent children will get this coverage. These 15 million uninsured, low income individuals will gain insurance through a public health insurance program that is affordable and has very nominal out of pocket costs. This provision will help laid-off workers and part-time workers. This expansion will revolutionize life for people with disabilities and people living with mental illnesses. For many of us, when disability strikes, we will no longer have to prove that we are "permanently and totally disabled" and unable to work just to have access to the public option of Medicaid. We won't have to stop working just to get health care.
Writing about the "ersatz public option", Robert Reich pointed out that private insurers, Big Pharma, Republicans and "centrists" wouldn't hear of Medicare for all 300 million of us--too much like Canada.
So the compromise was to give all Americans the option of buying into a "Medicare-like plan" that competed with private insurers. Who could be against freedom of choice? Fully 70 percent of Americans polled supported the idea. Open to all Americans, such a plan would have the scale and authority to negotiate low prices with drug companies and other providers, and force private insurers to provide better service at lower costs. But private insurers and Big Pharma wouldn't hear of it, and Republicans and "centrists" thought it would end up too much like what they have up in Canada.
So the compromise was to give the public option only to Americans who wouldn't be covered either by their employers or by Medicaid. And give them coverage pegged to Medicare rates. But private insurers and ... you know the rest.
He covers each succeeding compromise, concluding with this description:
It's a token public option, an ersatz public option, a fleeting gesture toward the idea of a public option, so small and desiccated as to be barely worth mentioning except for the fact that it still (gasp) contains the word "public."
Sunday evening, I participated in a conference call with Jon Walker of Firedoglake. If you've been reading any of the FDL health care updates posted here daily for the last several weeks, you know the name. Walker knows the health care turf. And various remarks he made about the public option indicated that, although he might not go as far as Reich did, he's well aware of how anemic the public option is. So I asked him whether he thought having it in the bill was of any account and whether the weak cost controls in the bill would end up costing the Democrats in future elections. He said that a strong public option would have saved the government $110 billion and consumers $200 billion over the next ten years. So Walker is bemused by the fact that conservatives and "moderates" keep insisting on cost control but refusing to support the one obvious means for that--a robust public option. He hasn't seen a senator yet step up with actual proposals for serious cost controls. Mark Warner of Virginia says he plans several such amendments. We'll see whether he, or any other senator, proposes real measures.
As far as what dramatic steps are needed, he points out that in every country that isn't single payer, a single rate setting agency exists. Either the government decides what a given MRI will cost or a coalition of insurance providers and health care providers decides. Procedures in this country cost 30 percent to 100 percent more than they do elsewhere, partly because of the incredible waste of having a thousand different health care providers negotiating with dozens or hundreds of different insurance companies.
Risk adjustment means transferring money from insurers whose clients are healthier than average to insurers whose clients are less healthy, enough to neutralize the effect of varying health status. If it worked perfectly, insurers would have no incentive to seek out the healthy and drive away the sick because they would receive the same amount for each.
Joe Lieberman assumes everyone is stupid. His assumption is correct when it comes to our useless old media. It's too bad for Joe Lieberman that Al Gore (you remember him Joe?) had a hand in the development of the Internet. We can now easily search for all kinds of information.
...."This is a kind[ ]of 11th hour addition to a debate that's gone on for decades," Lieberman told reporters tonight. "Nobody's ever talked about a public option before. Not even in the presidential campaign last year."
I asked in response, "How do you reconcile your contention that the public option wasn't part of the presidential campaign given that all three of the [leading Democratic] candidates had something along the lines of the public option in their white papers?'
"Not really, not from what I've seen. There was a little--there was a line about the possibility of it in an Obama health care policy paper," Lieberman said....
....If you do not have insurance you can choose to enroll in the new public plan, which will offer benefits similar to what every federal employee and member of Congress gets. Or you can choose private plan options through the national health exchange...
[emphasis added]
Uh, Joe, the Internets are forever. Or until some narcissistic group of putzes does something to pull the plug.
Claire McCaskill twittering earlier today about the public option:
All sound and no fury. CBO estimate in: 2% of Americans would potentially use public option.
In case you don't know what she's talking about, she links to this article in the St. Louis Post-Dispatch which discusses the Congressional Budget Office (CBO) estimates that few would use the public plan, those who did would be sicker than the average and, as a result, premiums would be higher.
Perhaps McCaskill should stop gloating and take into consideration the fact that the public option makes such an anemic showing in the CBO analysis because folks like her have worked so hard to handcuff it. As Jon Walker of FDL notes:
This illustrates a serious, reform-crippling problem with the House's bill. It has an insufficient "risk adjustment" procedure. The risk adjustment mechanism should be a re-insurance program that redistributes a large amount of money among the plans on the exchange based on the health of their different customer bases. Without a strong risk adjustment mechanism you are literally guaranteeing it will be impossible to get high-quality, low-hassle insurance on the new exchange.
Seems like McCaskill, who likes to strut her financial skills stuff, should be able to figure this out. So why doesn't she have the honesty to come out and confirm what many have suspected for some time now: our Democratic senator would sooner support a plague of locusts than an effective public option - and her smug twitter means that she thinks she may be off the hook at last.
First Claire McCaskill wanted to handcuff the public option; now she wants to trigger it or let states opt out, anything to sideline it. After all, she says, it isn't the main course when it comes to health care reform, just one of the little vegetables on the side.
Remember when McCaskill told the unruly teapartiers at one of her town hall meetings that she didn't want to have to use her "mom" voice? Perhaps she needs to call on some more generalized mom skills now and recollect that it is just as important to eat your vegetables as anything else. Otherwise, she could get a lesson in nutrition next election when some of her erstwhile supporters decline to feed the campaign kitty.
Update: If you want to get an idea about the harm done to health care reform by those quibblers and ditherers like McCaskill whose lack of support weakened the public option, you might be interested in this TPM report.
Right wingnuts aside, people want a public option as a part of health care reform. They understand what it will do - cover people who can't get health insurance now at a cost they can afford and at the same time holding down overall health care costs. That's considered a good thing by people who aren't batshit crazy.
And in Warrensburg, Missouri the local paper is conducting an online "poll" (it's not scientific):
Should health care reform include a public option versus only private coverage?
As of this writing "Yes" is getting 62% of the responses.
Uh, Claire, the teabaggers of August have run their course. They have never voted for you and they never will. And they're in a very small minority.
Senator Claire McCaskill (D) yesterday via Twitter:
I'm confident that we will have plenty of time to examine bill before Senate debate. It will be posted on internet too. about 9 hours ago from web
I'm for a public option, as I have said here many times. @msstagabout 9 hours ago from web
I'm not sure that everyone understands that a public option will only be available to those who don't have insurance coverage, not everyone. about 9 hours ago from web
Is that so insurance companies continue to price gouge everyone else?
And there has to be a limit on federal $ to public option, with same rules as private companies that will be available to choose from. about 9 hours ago from web
I'm waiting for the proviso that any public option must have a 30% overhead cost so as not to put insurance companies at any disadvantage.
We're all just hoping that Claire's legislative impact on health care reform doesn't cause a similar result to her legislative impact on cutting back the stimulus. And we'll be watching those votes.
We are getting close to the final stretch on health care reform, and the coming weeks may well be the acid test for the Missouri Democratic Congressional delegation. Who will stand up for Democratic principles, and who will cave to what is perceived to be political expediency?
As of today, one Missouri Democrat has already fallen by the wayside. Ike Skelton has announced that he will vote against health care reform legislation, and, in particular, against the public option. To justify this betrayal, he regurgitates a few lines from the same lame script Republicans have been using; he claims that the public option "could drive private insurers out of business," adding that:
...he also is concerned that the House proposals could make large cuts to Medicare and hurt rural health care providers.
These objections are balderdash, and it is a sure bet that Skelton knows that fact very well. Could it be that he is really worried because NRCC thinks he's vulnerable and has targeted him with an ad claiming that he wants to cut $50 billion dollars from Medicare?
Somebody should warn weak-kneed Missouri Democrats like Skelton that, no matter how abjectly they try to appear "moderate," they may not be doing themselves much good in the long run. As Michael Tomasky convincingly argues, failing to enact health care reform is likely to hurt Democrats in red or purple states far more than those in blue states:
Imagine that Obama loses on healthcare. His approval rating sags to 42%. The Republicans stand to make gains in 2010. Where are they going to make them? Not in the navy-blue districts represented by the solons who are certainly going to vote for whatever plan emerges. They're going to make their gains in the marginal, gettable districts and states.
That describes Missouri as far as I am concerned, and I would argue that the same factors will come into play even if a weak reform package is passed and the public comes to believe that more effective health care reform was sabotaged by corrupt and/or weak congress members. Skelton, like all the timid little Democrats cowering in fear that their constituents might discover that they stand for something, might well be shooting himself in the proverbial foot.
Is Claire McCaskill taking her cues from Jay Nixon now? It seems, according to a DailyKosreport, that she shares Jay's graphophobia when it comes to putting pen to paper and signing a letter to Harry Reid demanding a public option. Thirty of her Democratic colleagues have no such fear, including even a straight down the center moderate like Dianne Feinstein and Republican-at-heart Arlen Specter, but McCaskill, who claimed to support a public option earlier this summer, has evidently declined to make her support public in a meaningful way.
Perhaps the bipartisan "gang" McCaskill began hanging out with in September, Joe Lieberman, Kent Conrad, et al., have been a bad influence on her always somewhat mushy convictions. That would explain the tone of this tweet from yesterday:
CBO says HC bill from Finance is deficit nuetral [sic] and will reduce the deficit over time. Good news. Still needs work(public option or coop)
A bit cryptic, admittedly, but sounds to me like McCaskill would be perfectly satisfied with the pathetic Senate Finance Bill if it were enhanced with provisions to create the equally miserable coops rather than a real public option.
From the few tea leaves I get to see, I'm getting the sense that people on The Hill are not even having the conversation about just how unpopular forcing people to buy shitty insurance they don't want is going to be.
...The Baucus bill is a mandate with no price controls, because it lacks a public health insurance option to increase competition with private insurance...
....Question: Thank you for coming today. And many people whine about taxes., but my family, we're paying like over seven thousand dollars a year in health premiums. And I'd much rather trade that in for a national health care system. And I appreciate what my taxes buy. [applause]
Senator McCaskill: Well, thank, thank you for that. Does anybody mind if I read another. [laughter] You know, I, I do not think we'll do a, the President doesn't support, and I don't support a single payer system. I think competition in the marketplace and choices is very, very important in health care. Now, if we enact these reforms and , but I have a feeling that this is gonna work, because I think we're gonna have the kind of competition that will drive down costs. And, we gotta make sure that the government run health program is fair, because we don't want it to be so overwhelming that it stamps out all the private insurance. 'Cause we want that healthy friction in competition, between the two. We certainly have had competition as it's related to the, the, some of my friends on the other side of the aisle want to do with health care what we did with Medicare D. Which is a government sponsored but completely private program. Well, you know, yeah, there's competition there. Sometimes there's so much competition it's confusing, seniors don't know whether they're going or coming, whether drugs are covered or not, whether they're getting a good deal or a bad deal. But the problem with that is, we built into that program six billion dollars worth of profit on taxpayers for the pharmaceutical industry. Well that doesn't seem right to me. They actually put in the bill that we couldn't buy bulk to get down prices. Well that's the silliest thing I've ever heard of. So I don't think we want to emulate Medicare D because I don't think we can afford it. I don't think we can afford to plus up certain silos of profit in the health care industry. I think we can figure out ways to provide competition and choices and to bring down costs. And that are the three goals. Competition, choices, and bring down costs. And I'm kind of excited. I think we're actually gonna get a bill this year. I feel pretty good about it. [applause]...
...Question: On the issue of health care, this is a great opportunity to jump right in there, you know there's a lot of [inaudible] thought, you know, early in the campaign health care was really being talked about by the group of [inaudible] candidates, by Barack Obama, by John McCain, so we thought this, the stars were aligned, health care is actually going to get dealt with, but then we had this little economic problem kind of creep up towards in there and everybody said, "It's never going to happen!" But I was wondering if you had any insight, from the outset he picked Daschle, given the appointments that he did, that perhaps the impetus for reform now actually exist than the whole possibility of stimulus, in terms of the economic problems that may actually help push health reform along. So I just kind of wanted your insight on that.
Claire McCaskill: Well, I think Daschle's going to be a very strong - he clearly, I mean I'd recommend his book on health care reform to anybody who hasn't read it. He's really knowledgeable in this area and this was what he really wanted to do because he is driven in terms of wanting to work on health care reform in this country. I think we will get at some serious health care reform within the first, hopefully the first of two terms, but the first Barack Obama administration. I think they'll be some nibbling around the edges on some health care reform, possibly even in the stimulus. Expansion of the ability to stay on COBRA for example. Some, some additional funding for children's health insurance. Potentially some tweaking of the Medicare rates. I think all of those are within the realm of possibility in the stimulus. But nobody is backing off at really taking a whack at the silos of profit in the health care industry and reconfiguring health care so it's more efficient, effective and certainly more preventative. Yes?...
"...I don't think we can afford to plus up certain silos of profit in the health care industry. I think we can figure out ways to provide competition and choices and to bring down costs. And that are the three goals. Competition, choices, and bring down costs..."
"...But nobody is backing off at really taking a whack at the silos of profit in the health care industry..."
I was recently visiting in the San Francisco Bay area where I came across this op-ed about the "evils" of the public option in the San Francisco Chronicle. All I can say is when you are at a loss for words at the stupidity of the wingers, just reduce ad absurdam. One could, of course, try this exercise and substitute fire departments, etc. for libraries.
Rumors of my death have been greatly exaggerated. Mark Twain
That quote came to mind immediately - and often - yesterday. I kept getting tweets and messages coming across my phone wailing about the death of the public option - but I was in the company of Senators Tom Harkin and Al Franken - both members of the Health, Education, Labor and Welfare Committee in the Senate - and the pugnacious Harkin is now the chairman, stepping into the large void left by the death of Senator Kennedy.
Personally, after yesterday, I can't think of a better man for the job.
If the public option is on it's deathbed, no one told him, that's for sure. Here he is in pretty much his own words, after taking the podium to thunderous cheers and applause...
The first thing he did was thank his beloved wife of 41 years - and the first Harkin ever elected to public office - for her introduction. "Thank you very much. Ruth, thank you so much for those very kind words, and thank you for 41 years of love and encouragement. Thank you," he said as he took the podium. The audience again clapped for Ruth, a member of the state Board of Regents (Iowa has great schools and colleges). Iowa Democrats love Ruth as much as Tom does.
He then thanked the volunteers and told the assembled crowd that this wonderful yearly event only happens because of them. "We couldn't do this without the volunteers. Thank you all. You've just done a great job, all of you. " He then thanked a long list of accomplished Iowa Democrats, both elected and behind the scenes - from the state Governor and Attorney General, right down to the County Chair and the sign language interpreter who has been with them for the entire 32 years the Steak Fry has been THE event for Iowa Democrats.
He then singled out Governor Culver and thanked him for a long list of accomplishments and examples of solid, competent leadership., especially his leadership during the flood disasters of last year. He also thanked him for his leadership in education, renewable energy, and thanked him for the jobs that have been created across the state in wind energy and biofuels. "Governor, you have been there for us, you have been there for Iowa, and next year we're going to be there for you, Iowa will be there for you, and there will be another four years of the Culver-Judge team leading the state of Iowa!" He went on to proclaim that Iowa Democrats would increase their margins in both chambers of the General Assembly, because "the Iowa Democratic Party is strong, and progressive, and fortunate to count a good number of bright, committed young men and women to provide the future leadership to make Iowa the best it can be," and he beamed as he said he couldn't be more proud of them. Then he launched into his speech.
"So let me just start by saying, this is my kind of town hall meeting! Don't have any of those republicans standing up and yelling 'Keep your government hands off my Medicare!'" The crowd responded to this with loud laughter and applause. "Or shoutin' about those "Death Panels" , how we want to pull the plug on Grandma! I said 'Nonsense! I'm married to a Grandma, and a pretty darn nice one, too!' and the crowd responded with even more raucous laughter.
Then he adopted a serious tone. "Well, of course, not all of the nuttiness has been funny. It was Sarah Palin who came up with that shameful nonsense about "Death Panels" and shame on anyone who repeats it, anywhere in this country," and he paused when a several members of the audience repeated "Grass-ley! Grass-ley!" in a sing-song voice. Going on, he said that "The time for the shouting and the demagoging is over. Now it's time for the truth, and for action, and fighting back, and it started Wednesday night when President Obama addressed the Congress," and he paused for the crowd to applaud and cheer. "That was a great speech, wasn't it?" and the crowd cheered some more.
Resuming the serious tone, he remembered Ted Kennedy and how he was privileged to speak with him in June, and how even as sick as he was, Senator Kennedy was up to speed on where we stood in the fight to reform healthcare in this county. "We lost a great friend. We lost a great progressive. We lost a great leader on so many issues that go to the heart of what kind of nation we are. What kind of people we are. How we extend a helping hand to those in the shadows of life. Well, as has been said..." and he was interrupted by a jet overhead that was approaching the airport at Des Moines, about 20 miles away. While he waited for the noise to abate he made an on-the-spot joke to Al Franken about a flyover by the Minnesota National Guard, and the crowd reacted like there were two professional comedians on the stage. When the noise from the crowd (the jet was long gone) subsided, he resumed his speech. "Well, as you have heard, as has been said, after 22 years on this committee, and working very closely with our leader, Senator Kennedy, it now falls to me to pick up the torch and Chair the Kennedy Committee." He then added that Senator Franken will also have a seat on the HELP committee, and the crowd greeted this information, that the Chairman would have at least one true progressive ally who will fight for the public option, with robust enthusiasm.
He went on "No one - No one - can take Ted Kennedy's place, but I will tell you this - I'm ready for this fight, I'm ready to lead this committee, I'm ready to take charge of it, I'm ready to carry on his work, and I'm ready to get a health reform bill passed and to President Obama before Christmas time!" The crowd came to its feet, and stayed there and got louder when he thundered "And you might as well stay standing because that strong health reform bill - mark my word, I'm the chairman, it's gonna have a STRONG PUBLIC OPTION!
"Well, as we saw at the town halls, there are people out there who oppose any health reform. Now some of these folks simply want to bring down Barack Obama." At this, the crowd said "Grassley" as if the name itself were bitter to the tongue, but Senator Harkin had Jim DeMint in his sights. "And some folks simply hate what we stand for as progressives. So friends, we have got to have the courage of our convictions. We've got a tough battle ahead of us, but we have to stand strong. We've gotta stand united."
He praised the president for taking the lead, addressing congress and going out into the country to address the debate head on and present the case to America, like he did in Minneapolis on Saturday, then he reiterated his intent to see a strong public option as part of the final bill, and thanked Senator Franken for his help in the fight ahead.
"We have got to have the courage of Franklin Roosevelt when he was running for reelection in 1936. In a speech in Madison Square Garden, he talked about those who were attacking him for passing Social Security, he said, and I quote, "We had to struggle with all the old enemies. Never before in all our history have these forces been so united against a President as they stand today. They are unanimous in their hate for me. And I welcome their hatred." He went on to recap seventy years of republican opposition to every single program and law that has made people's lives better, from Social Security to overtime pay to the ADA - which is Harkin's law - and every other piece of progressive legislation in between. All those things have come to pass because progressive Democrats have fought tooth and nail for them and never stopped fighting until the American people - all of them, not just Democrats - won - and never had it been
He finished the serious part of his speech, before introducing the guest of honor, Senator Franken, by imploring the activists in attendance to get to work because the time was now to "fight the lies and distortions." Talk to your friends and neighbors and coworkers who buy into the nonsense and know the facts and set the record straight...because we need a health system in this country that works "not just for the healthy and the wealthy, but for all Americans."
Now, I was there. And I heard him. I talked to him in the press gaggle before the speech and I listened to him as he answered every single question. I have been around the political block a time or two. I can usually tell when I am being led down the garden path - support for Mark Funkhouser, my personal Bay of Pigs, notwithstanding - here's my take: When Tom Harkin tells the party faithful in his home town that he is going to deliver a strong public option, and the people who know him best and who bust their asses every election to get him and other Democrats elected in Iowa, and they believe him with enthusiasm, well, let's just put it this way...I slept real fucking good last night.
Senators Al Franken and Tom Harkin in Indianola, Iowa.
Both Senator Tom Harkin (D), Chair of the Senate HELP Committee, and Senator Al Franken (D) a member of the Senate HELP Committee stated to the press and in their speeches at the Harkin Steak Fry in Indianola, Iowa today that health care reform legislation coming out of the committee would have a strong public option.
There were approximately 1500 to 2000 people in attendance at the Warren County fairgrounds. A tiny group of teabaggers picketed one of the main entrances to the event along Highway 92. They received some encouraging horn honking along with a few single finger salutes.
The crowd of Democratic Party and progressive activists and supporters heard speeches from Iowa politicians, Tom Harkin, and Al Franken. This was a very supportive audience - they liked what they were hearing.
Emanuel Cleaver and Lacy Clay deserve respect and appreciation for their progressive stand on health care reform. The House Progressive Caucus, of which they are members, just sent a second letter to Obama reiterating their demand for a public option and their request for a meeting with the president. They sent a similar letter at the beginning of last week and were supposed to get a meeting with Obama before his Wednesday speech. Somehow, that meeting didn't materialize, but the progressives are not backing down.
Skelton and Carnahan haven't indicated that they'll vote against a bill without a public option, but they'd be happy to vote for one that had it. There are lots of Dems like that in the House, but such reps don't have the numbers to pass the bill by themselves. Pelosi is softening her insistence on the public option, but she cannot get a bill through the House if the Progressive Caucus holds fast. (Passing a bill requires 216 votes. Democrats have 256 members, 83 of them in the Progressive Caucus.)
Blue Dogs in the Senate create the opposite picture there. They'll keep Ds from getting the sixty votes for a Senate bill with a public option. Our own Claire McCaskill might vote against such a bill--not that she has to worry, because the Senate simply wouldn't produce such a bill.
Democrats who want the public option envision a couple of possible scenarios.
Here's one: The progressives hang tight in the House and a bill with a strong public option is passed. In the Senate, the bill is either weak enough to draw Olympia Snowe in (with a trigger) or else Massachusetts gives the Dems their sixtieth senator. Either way, a weak bill is passed. The conference committee writes a final bill with a public option, and Massachusetts definitely gets a replacement for Kennedy to D.C. At that point, any Democratic senator who votes against the final bill is political toast, and we manage to pass a bill with a public option.
The crowd at the Sunday evening health care reform rally couldn't have made it any plainer what they want: "Public option now!" they chanted spontaneously before the OFA bus arrived. Unfortunately, the speakers weren't stressing that. The public option got scarcely a mention in fifty minutes worth of speeches. In the video below, you'll hear the crowd, without anyone leading it, start the chant. Then you'll see how torpid everybody was later while Russ Carnahan spoke--with an occasional shout of "public option now" from someone in the audience. But when Carnahan said the magic words, the crowd went crazy.
It struck me that several of the speakers--Robert Soutier, Lewis Reed, and Charlie Dooley--urged the crowd to chant "Health care now", and the crowd complied. But intensity was reserved for "public option now."
Perhaps that's because the crowd knows that we have the votes to get health care legislation passed but also knows that without the public option to lower costs, reform will be inadequate. And it's not as if passing that crucial element ought to be difficult. Its fate will be decided in the conference committee, where the House will insist on a public option. All we need is enough liberals from the Senate on the conference committee to vote for it.
Enter Harry Reid. He's not so sure he supports the public option. So we can't be sure he'll put the right people on the conference committee. He'd be more likely to, I suppose, if Obama were speaking out unconditionally in favor of it, but I don't hear the president doing that. When I broached the subject with OFA deputy director, Jeremy Bird, after the rally, he reiterated Obama's insistence on "cutting costs", but Bird obviously wasn't authorized to say anything more specific.
Senator Claire McCaskill (D) posted via Twitter today:
3 public forums on healthcare tomorrow. Hannibal,Moberly,Kansas City.Looking forward to explaining my support for a public option. about 3 hours ago from TinyTwitter
The Honorable Kathleen Sebelius
Secretary, U.S. Department of Health & Human Services
200 Independence Avenue, S.W.
Washington, D.C. 20201
Dear Secretary Sebelius,
We write to you concerning your recent comments about the public option in health insurance reform.
We stand in strong opposition to your statement that the public option is "not the essential element" of comprehensive reform. The opportunity to improve access to healthcare is a onetime opportunity. Americans deserve reform that is real-not smoke and mirrors. We cannot rely solely on the insurance companies' good faith efforts to provide for our constituents. A robust public option is essential, if we are to ensure that all Americans can receive healthcare that is accessible, guaranteed and of high-quality.
To take the public option off the table would be a grave error; passage in the House of Representatives depends upon inclusion of it.
We have attached, for your review, a letter from 60 Members of Congress who are firm in their Position that any legislation that moves forward through both chambers, and into a final proposal for the President's signature, MUST contain a public option.
That's the upshot of Bill Lambrecht's St. Louis Post-Dispatch article on Blunt's role in shaping GOP "policy" on health care reform. (I'm not sure you can call it "policy" when you can only produce a slim four page brochure chock full of slogans and devoid of numbers.)
Voters fed up with insurance companies' red tape and denials of claims seem to favor a public option: 70 percent or more endorse the government's entry into the health care competition, recent polls show.
But Blunt has been unstinting in denouncing a public option. He uses the phrase "government-run" to describe a shift that he sees as dangerous both to the health care system and to its clients.
"If there's a government competitor, in the very short term, you wind up with no competitors," he said in an interview. "When voters begin to understand that the government takeover of health care is really the end result of a government competitor in the marketplace, they're not going to like that."
Um, Roy, you might want to take a look at the level of competition among health insurance companies in Missouri. In your own district, 94% of Joplin's citizens are insured by a single insurance company.
In any case, the article cites polling that shows an overwhelming majority of Americans as supportive of a public option, which Blunt opposes. Guess who also opposes the public option?
Not surprisingly, insurance companies are fighting to squelch a public option. Echoing Blunt, Robert Zirkelbach, director of strategic communications for America's Health Insurance Plans - which represents virtually all of the nation's health insurers - said government involvement would "dismantle" the current system and destroy corporate innovations that aid consumers.
"He (Blunt) is certainly very thoughtful on health care issues, and I think he showed that by the proposal they put forth," Zirkelbach said.
Yup. Health insurance companies are ready to stand side by side with Roy Blunt in the battle against the public option and preserve a broken system of rapidly rising premiums and insurance company profiteering.
Yet another reason to contact Sens. Bond and McCaskill right now to ask for a strong and specific stance in favor of the public option. Pressure on McCaskill and Bond is necessary to make sure we have a strong public option and viable health care reform, which is anathema to Blunt and insurance executives.
When traveling in Europe while studying abroad in college, I would occasionally run into people in hostels who had a strange view of traveling. I would ask them where they had just arrived from, and they would reply something like, "Oh, we just did Budapest." Anyone who said they had just "done" a city was hard-pressed to be able to tell me precisely what they had done, other than a pub crawl. Which was annoying, because I liked to find out about travel experiences from other travelers - what was worth the trip, what was nice enough but too crowded or expensive, etc. The "I just did..." response gave me zero information on how great or terrible destination was.
That's the way this article left me after an initial giddiness about the CBO score of $600 billion over 10 years to cover 97% of Americans, including a government-run public health insurance plan. Sure, I'm glad to find out that leading Democrats on the Health, Education, Labor and Pensions Committee included a public option, glad that they had the CBO score the health care plan with the public option this time, and I'm elated that the CBO scored the bill as much cheaper than the incomplete plan submitted back in May. But I still feel like the reporter just "did" the public option.
From the article, all I know is that there's potentially going to be a $60 billion a year government-run health insurance plan. I have no idea from the article whether a trigger will be put in place, a threshhold that will need to be crossed in order to activate the public option. I don't know if the plan will be offered nationally or state-by-state. I don't know if it will be accountable to Congress. I don't know if it will be available to all Americans, or just those who can't currently get coverage. All of these points would make a big difference in whether I would support such a bill or oppose it.
So I'm begging reporters to ask about what a public option would entail when you write about its inclusion in a health care reform bill. And fortunately, dear reader, we don't need a reporter to help us find out where our Senators, at least, stand on these very important questions. Please ask Senators McCaskill and Bond for specific responses.
Do you support a public healthcare option as part of healthcare reform?
If so, do you support a public healthcare option that is available on day one?
Do you support a public healthcare option that is national, available everywhere, and accountable to Congress?
Do you support a public healthcare option that can bargain for rates from providers and big drug companies?
Still haven't heard back from either Bond or McCaskill after two weeks of asking the question.
Yesterday, I posted about some questions Chris Bowers composed to nail down our senators' position on the public option. I e-mailed McCaskill and Bond, and while I've not yet received an official response, I'm told by a McCaskill staffer that they will get back to me.
The questions, again, are as follows:
Do you support a public healthcare option as part of healthcare reform?
If so, do you support a public healthcare option that is available on day one?
Do you support a public healthcare option that is national, available everywhere, and accountable to Congress?
Do you support a public healthcare option that can bargain for rates from providers and big drug companies?
Now, just because I sent my questions in, that doesn't let you off the hook. It's important that Sens. McCaskill and Bond hear from us and respond specifically to our questions. Please ask for specific responses. Don't assume that just because Obama is president and that he has thrown his support behind a public option that a viable public option will automatically come out of the process.
For example, just today Obama's first pick to head the health care reform effort and become Secretary of Health and Human Services, Tom Daschle, came out against a public option.
But we were concerned that the ongoing health reform debate is beginning to show signs of fracture on the public plan issue, so in order to advance the process of developing bipartisan legislation and to move it forward, it's time to find consensus here," Daschle said.
"We've come too far and gained too much momentum for our efforts to fail over disagreements on one single issue," he said.
This despite the fact that 76% of Americans believe that a choice of a public plan offered by the federal government is either extremely important or very important to health care reform. That's a result that surprised even the pollsters who conducted the survey. It looks like the only people insisting on the "consensus" that Daschle describes is the conservative Republicans he's teamed up with to offer a watered down compromise plan.
Still, politicians don't respond to generic polls. They respond to constituents and to people who contribute to their campaigns. The only way we are going to have more of an effect than the donors is if more of us constituents write in support of a public option.
Fortunately, Chris Bowers has teamed up with grassroots group Democracy for America and the Health Care for America Now! coalition to develop some tools and make it extraordinarily easy to ask our representatives these questions, and to collect their answers.
To write a letter, use DFA's Whip Count tool. It's got a sample e-mail you can edit, and it will automatically send the e-mail to the correct senator for you. http://www.standwithdrdean.com...
I'm pleased to know that at least one of our US Senators here in Missouri, namely Claire McCaskill, supports a public option for health care reform. Now, as we've seen with the Third Way nonsense, one can "support" a public option in about the same way George Bush supported "fixing" Social Security, with so many caveats and triggers that the ultimate aim is really pulling the whole thing down. I'm not accusing McCaskill of anything of the sort, but I would like to know a little more about what she thinks a public option should look like.
Chris Bowers over at OpenLeft has come up with a series of questions aimed at getting some more basic information about what kind of public option our senators will put their support behind.
The aim is to get answers from all 59 Democratic senators and some of the swing Republicans (in other words, the two senators from Maine.) And since our elected officials are responsive to constituents first and foremost, the questioning needs to come from us Missourians.
So will you write Senator McCaskill, ask her the following yes or no questions, and find out where she stands on the public option? (Since she has already professed support for the public option, instead of asking her about that, you might want to thank her.) Her e-mail contact form is here: http://mccaskill.senate.gov/co...
1--Do you support a public healthcare option as part of healthcare reform?
2--If so, do you support a public healthcare option that is available on day one?
3--Do you support a public healthcare option that is national, available everywhere, and accountable to Congress?
4--Do you support a public healthcare option that can bargain for rates from providers and big drug companies?
Once you've received a written response (that's the reason we're asking you to e-mail McCaskill instead of calling her office) post it in comments here.
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Jobs with Justice for three years now. That's dozens of months, hundreds of weeks, and thousands of hours. And that makes her expertise on the subject worth listening to. So I did. When the e-mail below arrived in my inbox, I paid attention--especially to her fourth point.
Writing about the "ersatz public option", Robert Reich pointed out that private insurers, Big Pharma, Republicans and "centrists" 
We are getting close to the final stretch on health care reform, and the coming weeks may well be the acid test for the Missouri Democratic Congressional delegation. Who will stand up for Democratic principles, and who will cave to what is perceived to be political expediency?
