Tommy Thompson, the former Wisconsin governor who was George W. Bush’s first Secretary of Health and Human Services predicts that a public option will pass.
Nobody else picked up on this, so I will pass it along:
Thompson made that prediction Tuesday at the 51st annual meeting of the National Association for Business Economics where he was a keynoter. Here are the further details of how Thompson predicted it would go:
- The mergers of the House and Senate bills would yield a House bill with a public option and a Senate bill without one.
- In conference committee Speaker Nancy Pelosi and the House Democrats would insist on a public option, and they would ultimately win.
- Thompson said the resulting bill would be forced into budget reconciliation in the Senate, and needing just a simple majority to pass — which it would get.
- The final vote would take place just before Christmas.
That’s actually fairly close to a worst-case scenario for the Democrats — albeit well worth it if a strong public option is the end that justifies the means.
The conference committee process, if it goes as Thompson predicts, would create lots and lots of drama — in both caucuses. One has to imagine, too, that there will be lots of name-calling and high dudgeon from the usual suspects in the conservative punditry. And going to reconciliation in the Senate is probably not what Harry Reid wants to see happen. One can imagine this would strain some relationships in the Democratic caucus, and bipartisanship, what little of it remains, would likely be dead for a long period of time — a kind of nuclear winter following the use of the "nuclear option."
I don’t see this as all downside for the Democrats, though. For one thing, if you have Thompson’s endorsement, alongside support of folks like Bill Frist, Michael Bloomberg, Mark McClellan, Howard Baker, Bob Dole, and Arnold Schwarzenegger, then it’s the Congressional Republicans, and any Blue Dogs that follow them, who come across as being out-of-touch. As long as the Democrats can keep good message discipline and not say something in front of a microphone that would damage their goodwill with Independent voters, then they can secure electoral support in future years
But Thompson said the most dire and dramatic outcome would be for the private insurance industry. According to David Nicklaus at the St. Louis Post-Dispatch, Thompson said this:
"With or without reform, there’s going to be consolidation. Every one of the private health insurance companies went down in membership last year. When you look at that handwriting on the wall and you add a public health plan ... a lot of health insurance comapanies are not going to make it. There is going to be consolidation and changes, and they are going to have to change the way they sell health insurance."
Full disclosure, I work in business intelligence for the health insurance industry, and I think Thompson’s right. Insurers that serve Medicare and Medicaid members will come out OK, and those that sub-contract services like back-office functions, claims processing and the like, should survive if they can adapt their business models to a new world (drawing on examples like Xerox and Kodak). But a lot of me-too companies with nothing to differentiate them from the competition will go away.
Thompson, by the way, told reporters he would like to return to Wisconsin to run for governor (again) or senator, but is reluctant to give up his business interests, which include a seat on the board of Medicaid health insurer Centene Corp., a St. Louis company that would stand to benefit in an environment where Medicaid eligibility is raised to 133 percent of federal poverty level, and government-sponsored insurance options are expanded.