Examiner.com1
Senate Democrats have ceded two key components of President Obama’s health care reform proposals: The proposed Medicare buy-in for those ages 55-64 and a public option.
Democrats had wanted to see Medicare expanded so that people aged 55 and over can buy in to the government-run plan, which currently covers senior citizens aged 65 or older. A public insurance option would have offered competition to high priced private insurers and allowed citizens to purchase low-cost policies through government markets.
These components of the bill were apparently dropped in a cave-in to Republicans, centrist Democrats, and Joe Lieberman (I-CT). Sen. Lieberman, a crucial vote if the bill is to garner 60 votes, threatened to join Republicans in a filibuster of the bill if it includes either the Medicare buy-in or a public option. On CBS’s Face the Nation, Lieberman said that in order to get 60 votes in the Senate, “You got to take out the Medicare buy-in. You got to forget about the public option. You probably have to take out the Class Act.” According to The New York Times, “Mr. Lieberman is also insisting that he will not vote for a fallback public option that would create a government-run program if the legislation otherwise fails to accomplish its goals. The Class Act is a reference to a proposed long-term care insurance program that was included in the bill.” Lieberman’s other condition is eliminating a government insurance program focused on home health care for the disabled.
According to Reuters, when asked whether Democrats had truly dropped both the Medicare buy-in and the public option provisions, Senator Max Baucus (D-) said, “It’s looking like that’s the case.”
Some Senate Democrats attempted to rationalize the concessions by suggesting that the passage of any bill is better than no bill at all. According to Bloomberg News, Sen. Evan Bayh (D-IN) said, “The general consensus was that…we shouldn’t make the perfect the enemy of the good and in order to get all the insurance reforms accomplished and a number of other good things in the bill.” Dropping the Medicare expansion “would be necessary to get the 60 votes.”
“This bill, without public option, without Medicare buy-in, is a giant step forward toward transforming American health care,” said Senator Tom Harkin (D-IA). “That’s reality, there is enough good stuff in that bill that we should move ahead with it.” Harkin, currently replacing Sen. Ted Kennedy as chairman of the Senate Health, Education and Labor Committee, had once been one of the public option’s most staunch defenders.
“At some point you have to switch from the sentiment, the emotion of the words, to the facts,” said Sen. Jay Rockefeller (D-WV) . “And then you’ve got to decide, ‘If I didn’t get what I want, in the form that I wanted it, am I willing to cashier 31 million Americans? I want a bill.’”
Even Sen. Roland Burris (D-IL), who threatened to filibuster any bill that does not include a public option, appeared to cave-in. “I know how difficult it has been to get this far. My colleagues may have forged a compromise bill that can achieve the 60 votes that will be needed for its passage but until this bill addresses cost, competition and accountability in a meaningful way, it will not win my vote,” he said, according to The Hill.
In lieu of a public option, the bill would have the Office of Public Management (OPM) oversee private insurers who accept clients under federal subsidies. Jacob S. Hacker, a professor of political science at Yale University and an expert on U.S. health and social policy, claims that a robust public option is essential for any meaningful health care reform. In The New Republic he writes:
Offering one or a few national plans under the auspices of the OPM won’t provide what a public plan can–the choice of a broad, transparent, accountable, and affordable plan that doesn’t deny needed care, restrains the growth of premiums over time, and serves as a benchmark for private plans. Indeed, because Blue Cross and Blue Shield (BCBS) is the most likely national non-profit to take advantage of this new opening, and because the Blues dominate most states, the plan perversely amounts to trying to increase competition and choice by encouraging Blue Cross and Blue Shield to compete against, you guessed it, Blue Cross and Blue Shield. That’s competition?
It is unclear exactly what Democrats are referring to that will remain in the bill constituting significant health care reform besides a ban of insurance companies denying coverage due to pre-existing conditions. The bill would include mandatory private sector insurance, which would be a profit windfall for big insurance and pharmaceutical companies on the backs of millions of the poorest Americans who currently cannot afford coverage.
Any bill that might pass Congress at this point will be a flawed compromise, one that will deeply disappoint the Democratic base and one that will leave unaddressed major flaws in the health system. Perhaps no bill at all may be a better choice at this point.
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Dec
15
Public Option Out
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