In my previous diary I gave an overview of the Dem plan for offering a "public option" as part of their health care reform plans and offered some suggestions on how to address concerns raised by various folks about such a plan. Now, I still think that my suggestions are valid and may be tactically useful in getting health reform passed that still includes some form of a public option while at the same time getting (at least some) bipartisan support. However, I did hear some valid criticism of--if not my ideas--at least my intent with the diary. In this diary I will address those criticisms and try to offer some new thoughts on how to sell the public option to Congress and the public.
From paradocs2:
Your analysis of real time political manouvering is frankly clear and concise and easy to understand.Yes, it is true the powers that be are out to save the insurance industry. Conventional wisdom and, seemingly, White House practicality says they seem to be succeeding. Nonetheless, we should not be creative about how to accommodate to the forces of inertia. We need to be powerful to mobilize the forces of change.The goal here must be to maximize healthy outcomes and promote social justice in health, and to create a system that will do this in an efficient and affordable fashion, i.e. a public system like Medicare-for-All.
Well put. We should avoid triangulation. We all know how that works: when we try to always take the centrist path (i.e.: take a position that is between that of the left and the right) the right will only push further and further to the right until we end up taking a position close to what they wanted to in the first place. We must use our creative energies to push for what is right and not waste them on crafting creative compromises.
Meanwhile DFWMom says plainly:
Challenge the concept of "unfair"
This is straight forward and to the point. What we really should be spending our creative energies on is framing the issue. When we accept their frame for the issue we lose.
HeyMikey sums up her point:
Yes, the complaint of the private insurers against the public option is that it would be TOO EFFICENT. TOO CHEAP. TOO AFFORDABLE. No shit, that's what they're complaining about. We need to repeat that over and over.
This is the frame that we should use.
I also read the following letter to the editor of the NYT from an Alan Goldfarb of California:
...it appears that the main argument against Medicare-like coverage is that private insurers would be unable to compete with government on costs, and might be driven from the market.
Isn’t that like saying we should not strive for a peaceful planet because it would be bad for the armaments industry? Am I missing something?
Another way to frame this issue would be to change the scope of what is meant by "unfair competition". Why only focus on the competitiveness of private insurance against the public plan? Why not look at the competitiveness of American industry as a whole against the industries of other nations with universal coverage provided by their respective governments. It truly is unfair. How can an American company compete with a Canadian company when they pay a hidden tax of 7%+ just to cover their workers' health care costs? Why sacrifice "fair competition" for all other industries for the sake of one?
I believe that the idea behind public-private competition in the Obama/Dem plans is between two separate health care systems--two separate ideas of how health care should be provided will compete--not just added competition between the private plans from one additional plan that happens to be run by the government. We shouldn't try to sell this plan as "no big deal". It is a big deal. It's a paradigm shift. We are offering the American people the freedom to cut out the middleman. The freedom to cut out those who would profit on our sickness. The freedom to cut out those who profit by denying care to millions. By freedom we also mean that those who are happy with their existing plan can keep their existing plan. That's where the "private" part of the public-private competition comes in. This will help us get the support that we need from the majority of Americans who are satisfied with the current system but would still like to see change.
To summarize:
- We must not try to coddle the insurance industry, we must push for what is right.
- We must frame the issue, we must challenge the concept of "unfair".
- We need to repeat that over and over that the complaint of the private insurers against the public option is that it would be TOO EFFICENT. TOO CHEAP. TOO AFFORDABLE.
- We must consider whether it is "fair" for American industries to compete with those of other nations while shackled with private health insurance costs.
- We must emphasize that this is a paradigm shift that will primarily benefit average Americans and there will be losers: those private insurers who can't compete.
- We must emphasize that those Americans who like their insurance can keep it.