It just may not happen this year.
First I should note that I support a public option (actually would love to see a single-payer system) and my support for such a plan has only increased in the past month.
I am currently in the Netherlands studying abroad, but have kept up-to-date with what is going on back in the States. I live in an international student dorm and have talked to Italian, Canadian, French, Dutch, German, Swedish, and Finnish students about their health care systems. All agree that in no way would the most conservative elements of their countries even attempt to change their national health care systems.
All agree that the American debate is stupid - and the Canadians in particular think that conservatives who ridicule their system are insane.
However, that being said, I am also a political realist and it does not seem that a public option is likely to pass in the current reform package. Also, I think President Obama is a strong supporter of this option and will do what he can to get it to pass, either now or in his next term.
I think President Obama is a strong supporter of the public option and will do what he can to get it to pass, either now or in his next term. Why do I think this? It's really quite simple and I think the rest of us should support his political calculation on this front.
The speech to the Joint Session of Congress was masterful. I won't go over the style as that horse has been beaten to death. What I have not heard from the likes of Rachel Maddow, Keith Olbermann, or any of the other liberal elements of the blogosphere is something that seems obvious to me. That the president will fight for the public option against the moderate Dems and any Republicans willing to listen, but that he will refuse to make it a deal breaker - but this does not mean he will give up the fight. We just need to read between the lines (and no, by that I do not mean he is giving the liberal base the finger).
First, the President says that he is determined to be the last president to work on health care reform. I believe him. Second, he also defended the public option as a necessary tool to keep insurance companies honest, keep costs low, and provide individuals with a basic option (which is necessary if there are going to be individual mandates). Third, he indicated that the public option would be included in the exchange. Fourth, that the exchange will not start for another four years. Thus, even if a public option is passed now it will not be in effect for another four years anyway.
Hmm. Four years? Where will we be in four years? Well, presumably we will be in the period right after his re-election when his political capital will once again be at its peak. Thus, if the public option is not politically feasible now he is indicating that he is willing to expend political capital after re-election to finish the job on health care. In other words, he is willing to kick the public option can down the road for four years if he cannot get a deal this year. I know many on the left do not like this idea and it is risky. It assumes that President Obama will be re-elected. But it also gives the progressive community something to rally behind in four years to ensure that happens.
Liberals have made it very clear how important the public option is to them and rightly so. But if it does not get done now I fully believe the president will make this a central part (if not the central part of his platform in 2012). And in turn it will rally the base and we will still get a public option in place in time for the exchange's launch date.
In the meantime, the politics of the situation are beautiful. He can "sacrifice" the public option now, throw a bone to Senator McCain and the Republicans with the catastrophic coverage stop-gap (even though they won't take it the public will see this positively), and gear up for his re-election by fighting for a public option. If he is re-elected there is little doubt that such a plan would pass as most newly and re-elected president's get at least one major legislative initiative through Congress at the beginning.
Furthermore, the conventional wisdom is that if the public option is "rammed down the throats" of the Republicans it will energize their base and give them some gains in the mid-term. I am not sure if I agree with this, but if Obama and the Dems can buttress the biggest claim of a government take-over by punting on the public option it may take some steam out of the lunatic right. And we have to hold onto as many seats in Congress and state legislatures in 2010 so that we can redraw the congressional districts to lean our way. This is something that cannot be undervalued.
Therefore, I implore the left to keep the heat on the president to support a public option now, but not to be too angry if it doesn't happen. I fully believe we will have another shot at this because the president clearly stated he is determined to be the last to deal with health care. As I said, it really does not matter if the public option passes now or in four years if the exchange will not be available until that time. So keep fighting, but let's look at the big picture too.