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Key support is lining up for a public option in pending health care reform. That includes incoming HHS Secretary Kathleen Sebelius, who declared her supportffor it in testimony yesterday in her first confirmation hearing.

"If the question is do I support a public option side-by-side with private insurers," Sebelius said, "yes I do."

She faced questions on the issue as she testified before the Senate Health, Education, Labor and Pensions Committee. Sebelius said she didn't support fully government-run health care.

An exchange with Sen. John McCain, R-Ariz., over the Obama proposal was perhaps the most heated in a low-key 2 1/2-hour hearing. Sebelius pledged that if confirmed, "health reform would be my mission."

"Inaction is not an option. The status quo is unacceptable, and unsustainable," said Sebelius, citing high health care costs that she said were hurting families and crippling the economy.

This comes along with the news (via Lindsay Beyerstein that the five committee chairs that have jurisdiction--Reps. George Miller, Waxman, and Rangel and Senators Baucus and Kennedy all support the public option, though Baucus has been a bit wavery on that one. (Which makes Gov. Dean's public advocacy effort on a public option still very relevant.)

The insurance industry and conservative opponents don't want a public option because it's the primary way to ensure that private options are affordable and provide adequate coverage. That's in a system that includes private insurers, which seems to be the system this Congress and this administration is intent on giving us. We need a public option to compete and keep the private insurers honest, and to potentially pave the way to single payer. As Atrios sez, "the only system which has a chance of not being corrupted and looted is one with a viable public option."

On another key health care reform note, kudos to Waxman for recognizing that lack of insurance isn't the only barrier, and calling for more primary care doctors and nurses in health care reform. Having an insurance card doesn't do one a whole lot of good if there isn't a doctor or nurse practitioner available to treat you.

Originally posted to Daily Kos on Wed Apr 01, 2009 at 05:20 PM PDT.

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Comment Preferences

    •  All I can say is (4+ / 0-)
      Recommended by:
      Paul in Berkeley, skyounkin, mcmom, soms

      I am much healthier since the elections.  Plus I can do the 100 yard dash in 10.5 minutes.

      Let's pause for a moment of science...

      by cleverblogname on Wed Apr 01, 2009 at 05:27:07 PM PDT

      [ Parent ]

      •  Me too (3+ / 0-)
        Recommended by:
        tmo, cleverblogname, soms

        In my car, that is.

        I let my health insurance lapse in December, because I just can't afford $175/month at this time (and I know, that's a lot less than most people are struggling with).  I'm hoping to sign on with a plan being offered by San Francisco for SF residents (I actually live there, despite my moniker).  The major downside of that plan is that it only covers someone while they are in San Francisco. If I get injured in Oakland, I'd have to crawl back across the bay to get care.

        In loving memory: Sophie, June 1, 1993-January 17, 2005. My huckleberry friend.

        by Paul in Berkeley on Wed Apr 01, 2009 at 05:32:08 PM PDT

        [ Parent ]

        •  I never thought I would live to see the day (4+ / 0-)
          Recommended by:
          Catesby, cleverblogname, filby, soms

          that a president, much less Congress, even entertained the idea of a public health option.  Of course the insurance companies haven't begun wheeling in the cartloads of cash yet, either.

          "In this world of sin and sorrow there is always something to be thankful for; as for me, I rejoice that I am not a Republican." - H. L. Mencken

          by SueDe on Wed Apr 01, 2009 at 05:38:22 PM PDT

          [ Parent ]

  •  Who was dissing Kathleen again?? (8+ / 0-)

    Wake me up...we won..

    by soms on Wed Apr 01, 2009 at 05:23:13 PM PDT

  •  I watched that exchange (14+ / 0-)

    it made me very glad McCain lost the election

  •  I wish I agreed with Atrios (6+ / 0-)

    As Atrios sez, "the only system which has a chance of not being corrupted and looted is one with a viable public option."

    As long as lobbyists can bring mega-campaign bucks to a politician, any health care system with private insurers is very apt to be corrupted.  

    Sure, we may get a public option, and it may even be viable -- at first.  But after a few years of AHIP lobbying it seems all but inevitable that the public option would be inadequately funded, hemmed in with restrictions to reduce its appeal, and eventually reduced to Medicaid-like apartheid status: a dumping ground for the sick, expensive "covered lives" private insurers don't want anyway.

    No matter how we form a public option now, sabotage will be the unending intent of AHIP and its purchased politicians.  Only two ways out I can see: single payer, or publicly financed campaigns.  Me, I'd take both, but either would work.

    Dear Republicans: You can't repeat a lie enough to make it true.

    by Dallasdoc on Wed Apr 01, 2009 at 05:25:18 PM PDT

  •  What welcome news! -n/t (5+ / 0-)
    Recommended by:
    Paul in Berkeley, ferg, mcmom, soms, mdmslle

    Senator Al Franken. Have I died and gone to heaven? Not yet. While Al's in Limbo, MN is in Purgatory.

    by NM Ward Chair on Wed Apr 01, 2009 at 05:27:02 PM PDT

  •  Even our family doctor is for govt. (19+ / 0-)

    health insurance. He told Joe, aka Old Timer, a couple of days ago, that Medicare is much better run, and the paperwork he as to do is much less than for private insurers. He also said it is criminal that they have an overhead of 16-17%, compared to Medicare at 4%. Nice to have a family practitioner that really cares about the families!

    I think, therefore I am. I think.

    by mcmom on Wed Apr 01, 2009 at 05:29:28 PM PDT

    •  Framing the public option. (12+ / 0-)

      The Republicans' complaint about the public option is that IT'S TOO EFFICIENT. IT'S TOO AFFORDABLE. IT DOESN'T TAKE ENOUGH MONEY OUT OF THE POCKETS OF ORDINARY AMERICANS. Yes, they are saying with a straight face that private insurers won't be able to provide comparable healthcare as cheaply as a public option, and they claim that's a public-option bug and not a public-option feature.

      I, for one, hope they keep saying this loudly, often, and on camera.

      "The true strength of our nation comes not from the might of our arms or the scale of our wealth, but from the enduring power of our ideals." - Barack Obama

      by HeyMikey on Wed Apr 01, 2009 at 05:37:03 PM PDT

      [ Parent ]

      •  yes - the public isn't stupid this time (2+ / 0-)
        Recommended by:
        HeyMikey, mcmom
        •  It won't last. (0+ / 0-)

          The public will again be stupid. It's just a matter of time. Democrats have to be bold, get done everything we can while our brief window of opportunity remains open.

          Even now, Repubs are saying, "You can have everything you want, and you don't have to pay for it, and if it doesn't work out then it must be the fault of the [liberals-criminals-furriners-blacks-welfarequeens-gays / insert demon du jour here]." This is what people want to believe, and before long they'll start believing it again.

          "The true strength of our nation comes not from the might of our arms or the scale of our wealth, but from the enduring power of our ideals." - Barack Obama

          by HeyMikey on Wed Apr 01, 2009 at 06:42:35 PM PDT

          [ Parent ]

    •  And even if the Medicare paperwork (2+ / 0-)
      Recommended by:
      mcmom, BaritoneWoman

      is still there, at least things would be easier if there's only one kind of paperwork to do, rather than have this hodgepodge of competing plans with differing paperwork.

      The crooks are leaving have left office, unprosecuted and scot-free.

      by BentLiberal on Wed Apr 01, 2009 at 06:29:01 PM PDT

      [ Parent ]

  •  I really like this woman. (14+ / 0-)

    I wanted her for VP, so I'm really hoping she becomes part of the Obama administration.

    John McCain is a nasty old man. Even his own daughter knows that McCain is the past of the Republican party. He knows the ride is almost over, and he is going to go out in a blaze of glory, as only a selfish flyboy can.

    "The difference between the right word and the almost-right word is like the difference between lightning and the lightning bug." -- Mark Twain

    by Brooke In Seattle on Wed Apr 01, 2009 at 05:30:52 PM PDT

  •  Two requirements (5+ / 0-)
    Recommended by:
    SueDe, BaritoneWoman, soms, Losty, pstoller78
    1. Eligibility criteria cannot consider individual medical risk.
    1. Insurer must be able to absorb lifetime medical costs.

    If these two requirements are met, any entity can offer medical insurance.

    Problem is the 2nd item. What private insurer can guarantee that they will insure people over an 80+ yr lifespan?


    Ergo, single payer under government aegis.

    Private sector can compete to be care and service vendors, but not the payer.

    -2.38 -4.87: JustAShotAway's friend Ryan: "Go big or go home"

    by grapes on Wed Apr 01, 2009 at 05:35:37 PM PDT

    •  Absolutely. (1+ / 0-)
      Recommended by:

      If the public plan has a lifetime limit on benefits, it will just assure that eventually many people will be without insurance again.

      My friend's daughter was diagnosed with brain cancer in the 90's.  It took about five years to reach their policy's $2 million lifetime benefit.  Now they can't get insurance on the girl at all.  It's a disgrace.

      "In this world of sin and sorrow there is always something to be thankful for; as for me, I rejoice that I am not a Republican." - H. L. Mencken

      by SueDe on Wed Apr 01, 2009 at 07:06:42 PM PDT

      [ Parent ]

    •  Another big part of the problem (2+ / 0-)
      Recommended by:
      grapes, HCKAD

      if that rates per person vary wildly depending on whether they work for themselves, work for a small company or work for a large company.

      Which has nothing to do with the costs of administering their policy, or their actual risk.

      Insurance companies say it's because of the larger 'pool'.  Completely forgetting that all of their members are supposed to form one pool.

      We should outlaw different rates for different sized groups signing up.  It's completely unfair that an individual is completely priced out of a policy just because they don't work for IBM.

  •  That's great and all... (2+ / 0-)
    Recommended by:
    0wn, soms

    but I'm still miffed about signing that bullshit sonogram bill.

    I know, I know, political expediency, blah blah blah.  But still, with liberal pro-choice women like that, who needs anti-choice petri dish fetishists?

    Please, President Obama, remember the ladies and be more generous and favorable to them than your ancestors.

    by Kaili Joy Gray on Wed Apr 01, 2009 at 05:37:07 PM PDT

  •  This is good to hear (3+ / 0-)
    Recommended by:
    JanL, filby, soms

    Now all we have to do is flood Max Baucus' in-box.  As a Montanan, I can almost guarantee you that he will stand in the way of this.

  •  YES! (5+ / 0-)
    Recommended by:
    JanL, filby, soms, Situational Lefty, cdub24

    We have people in high places that want a viable public option. We must "make them do it" by keeping the pressure up.

  •  I hope they do a cost analysis (8+ / 0-)

    of a Single Payer plan as recommended by Bernie Sanders. They will find this is the most cost effective solution.

    Why do we need the Insurers as middlemen?  Obama mentioned that getting rid of bankers providing student loans and converting to a govt system is most effective.  Why not with Health Insurance also.

    Republicans : Socialism for the rich, capitalism for the poor

    by ctsteve on Wed Apr 01, 2009 at 05:42:17 PM PDT

    •  Sigh.... (3+ / 0-)
      Recommended by:
      soms, Losty, theone718

      Single Payer is NOT going to happen.  Obama said if starting from scratch it would be fine.  But the problem is, there are people who like their employment based insurance, despite the fact of you telling them the wonders they would get through Single Payer system, I guarantee you that gives a HUGE opening to the republicans who will then grab wavering democrats and say how Obama wants to take people's health care.  If you don't believe me, look at the Stimulus fight.  With a willing media, they made a good legislation, bad, very quickly.  

      The best option is the public option with private partnership to fill the gaps.  Plus it has the benefit of actually getting passed through Congress.

  •  I REALLY want the public option (13+ / 0-)

    I'm a moderate in DKOS terms, and prepared to go along with a lot of compromising on the part of the Obama administration, especially on stuff that's largely symbolic.  Nothing has made me happier with the new administration than putting health as the top priority in the first year.  And one thing that the Obama Administration CANNOT compromise on is the inclusion of a public option in health care reform.

    Disclosure.  I'm 60 years old and my wife, whom I met in Japan, is 55.  Retirement plans for us rest strongly on whether I can find a health care plan that will cover her when I turn 66.  I know many, many people about my age whose retirement decision hinge on access to health care in the late 50s and early 60s.  This could mean a difference of millions of jobs that could open up for you young folks.  

    Also, I lived 6 years in Japan, my daughter was born there.  This is a conservative, pro-capitalist society, and no one ever has to think for one minute about the cost of health care.  For the pro-business Japanese government, this is not a question of charity, it's a question of investment in the nation's future (as is excellent public K-12 education).  Once you've experienced a system like this, it's hard to settle for the madness that is the American health care "system."

    "I may have fucked my life up flatter than hammered shit, but I stand here before you today beholden to no human cocksucker." Whitney Ellsworth, "Deadwood"

    by John R on Wed Apr 01, 2009 at 05:42:54 PM PDT

    •  yeah i really don't get it... (1+ / 0-)
      Recommended by:

      why people don't want single payer health care

      if they've ever experienced it (i lived in france for over a year) they'd never want anything else.

      I got sick in France - got treatment. That simple. No copay. Nothing. Done. Happy.

    •  I get where you are coming from (0+ / 0-)

      I am an American, but my husband has tri-nationality for the UK, New Zealand and Australia.

      We are really having to start to consider where we are better off, now we are getting to our middle years.

  •  conservatives don't like th public option (8+ / 0-)

    They don't like it because it proves that their ideology is only an ideology and not a practical way of running a system that is required by every person in the country.

    Geez, we spend billions of dollars paving roads so that people can get places safely, but we can't manage to provide a basic level of healthcare for every American so that we don't die as a result of not having money?

    If you can't stand up to Rush Limbaugh, how can you stand up to The Axis Of EEEEEEEEvil?

    by otto on Wed Apr 01, 2009 at 05:44:26 PM PDT

    •  I disagree (2+ / 0-)
      Recommended by:
      otto, vernonbc

      As an American raised abroad (so I talk funny), with an English/NZ/Australian husband, I find a lot of Republicans here in our conservative community ask us about how things work in other countries - especially regarding health care, unemployment and retirement.

      If you explain it logically, they are actually really quite sold on the idea.  Trouble is, most Americans are not in the position to be able to argue from experience.

      •  I agree (2+ / 0-)
        Recommended by:
        ferg, vernonbc

        If you explain it to an individual, they'll tend to agree.  

        That's a different story than fundamentally altering the system in an abrupt manner.

        The way I would change the system would be by offering all children cost free insurance.  If parents wanted to keep them on a private plan, great. If not, great.

        Then, you keep insuring those kids as they grow to be adults.  It's an incremental increase that would slowly draw down the for profit insurance industry.

        If you can't stand up to Rush Limbaugh, how can you stand up to The Axis Of EEEEEEEEvil?

        by otto on Wed Apr 01, 2009 at 07:42:30 PM PDT

        [ Parent ]

  •  Kudos to Sebellious n/t (3+ / 0-)
    Recommended by:
    soms, Situational Lefty, cdub24
  •  We need a cure for health care.. (0+ / 0-)

    In East Tennessee, profit care comes ahead of patient care.

    There will only be change when those unaffected are as outraged as those who are.

    by quidam56 on Wed Apr 01, 2009 at 05:47:19 PM PDT

  •  We don't need a public "option" (6+ / 0-)

    we need Medicare For All

    If you're in the U.S., you get medical care, paid for by the general tax revenues. Nothing "optional" about it.

    Resist much, obey little. ~~Edward Abbey, via Walt Whitman

    by willyr on Wed Apr 01, 2009 at 05:47:47 PM PDT

    •  I agree (4+ / 0-)
      Recommended by:
      ferg, filby, vernonbc, soms

      It's not politically feasible at the moment, but when it is shown the businesses would rather work with a cost effective government plan, it will increase the likelihood of a single payers system.

      If you can't stand up to Rush Limbaugh, how can you stand up to The Axis Of EEEEEEEEvil?

      by otto on Wed Apr 01, 2009 at 05:50:51 PM PDT

      [ Parent ]

      •  Sorry. It IS politically "feasible" (2+ / 0-)
        Recommended by:
        ctsteve, cdub24

        at the moment.

        This IS the moment. If we let the moment pass and the for-profit health care "system" is allowed to have their way--once again--we are screwed.

        The majority of the American people want single-payer, health care for all.

        This is a seize-the-day moment in history, and we best seize it.

        Resist much, obey little. ~~Edward Abbey, via Walt Whitman

        by willyr on Wed Apr 01, 2009 at 05:56:40 PM PDT

        [ Parent ]

        •  Sorry (1+ / 0-)
          Recommended by:

          You keep telling yourself that it is.  

          There's movement towards it, but it's not going to happy the way you want it to happen, or actually the way I want it to happen, because we both agree that it's the best way.  

          When Canada implemented theirs, they didn't just roll it out. From my understanding it was  very province by province sort of march towards a successful national healthcare plan.

          The US' plan will most likely have a strong state by state component to it.

          If you can't stand up to Rush Limbaugh, how can you stand up to The Axis Of EEEEEEEEvil?

          by otto on Wed Apr 01, 2009 at 06:52:48 PM PDT

          [ Parent ]

      •  I am a business owner (0+ / 0-)

        count me in.  Health care is killing us, but I don't have the lack of concience to get rid of it.

  •  We are (2+ / 0-)
    Recommended by:
    ferg, soms

    making progress.  The Public Option is the pathway to affordable, accessible, and appropriate health care for all.  The argument about Health Insurance and Health Care - is where we can win.

    Demographics do not equal destiny.

    by dr fatman on Wed Apr 01, 2009 at 05:50:24 PM PDT

  •  Sounds like (0+ / 0-)

    she's due to be spending some "quality time" with the Emmanuel brothers in the near future.

    "Ever get the feeling you've been cheated?" ~J. Lydon

    by ActivistGuy on Wed Apr 01, 2009 at 05:52:27 PM PDT

  •  Capitalism and Socialism side by side (1+ / 0-)
    Recommended by:

    I've always wondered if Americans would opt in or out of a particular system.  

    If they want universal health care and other free bees like child support by state funded nannies they could OPT IN to that system.  They would be taxed accordingly.  

    For those who wished to be "off the grid" in capitalism, their taxes will be low and they will be given nothing.  They will have to buy everything they need.

    Why is that not on the table?  Or is it and I just missed it?

  •  I've not gotten the whole meme about how... (9+ / 0-)

    . . . because Dashle was so "knowledgable" about health care it was a big loss to the Obama Admin to lose him as Sec. of HHS.

     How about a Sec of HHS who just says, "Fuck you" to the Health Insurance industry and GOP.  That's all the "knowledge" I need.


    "Unseen, in the background, Fate was quietly slipping the lead into the boxing-glove." -- P.G. Wodehouse (via Bertie Wooster)

    by BenGoshi on Wed Apr 01, 2009 at 05:54:22 PM PDT

  •  lol but shez not Howard Deeen, m i rite?!?!?! (2+ / 0-)
    Recommended by:
    soms, Escamillo


    Where are all the Sebelius bashers at now?

    Celebrate good Obama, come on!

    by Namtrix on Wed Apr 01, 2009 at 06:04:36 PM PDT

  •  mcjoan (0+ / 0-)

    What's wrong with excluding the public option in order to get Republican support?  Your old boss, Sen. Wyden, has a pretty good bill that excludes the public option, and can pass the Senate with 60+ votes.

    •  no public option = no change (2+ / 0-)
      Recommended by:
      ferg, Catesby
      •  Disagree (0+ / 0-)

        Change is guaranteed health insurance for everyone.  The Wyden bill provides that.

        The mission is universal coverage -- not allowing a public option.  I can think of much bigger dealbreakers than not having a public option -- namely, insufficient subsides, allowing insurance companies to refuse coverage to applicants, and allowing insurance companies to operate across state lines in order to circumvent consumer protection laws.  [These were the core flaws of the McCain/Bush plan.]

        •  I pay $1700 per month (2+ / 0-)
          Recommended by:
          tmo, ferg

          I am only 46.  I have never been ill apart from the flu.

          My crime is I own a small business, and I live in a different state than where my company is located.

          Guaranteeing health insurance is not going to help me with the dollars they are gouging every month.

        •  There's no way to ensure any of those (0+ / 0-)

          Interesting, I was coming at this discussion with the assumption that, without a public option, there will be of course be insufficient subsidies, insurance companies will of course be allowed to refuse coverage, and they will of course be allowed to operate across state lines. With regards to the first, I don't see how you will ever be able to make for-profit insurance affordable for unemployed people. I think it would be easier to include a public option than to prevent any of those other problems.

          A word after a word after a word is power. -- Margaret Atwood

          by tmo on Wed Apr 01, 2009 at 07:02:13 PM PDT

          [ Parent ]

  •  I remain hopeful about the public option (2+ / 0-)
    Recommended by:
    tmo, ferg

    It's the bare minimum needed, from my POV.

    A single payer program, extending Medicare to those of all ages, is of course what's needed.

    The crooks are leaving have left office, unprosecuted and scot-free.

    by BentLiberal on Wed Apr 01, 2009 at 06:27:16 PM PDT

  •  It Really Is An Outrage (0+ / 0-)

    That Americans have to suffer a health care system that's all about draining them of money whether through insurance premiums or prescription drugs. The health care industry has really got a stranglehold on the politicians and I pray that this can finally be the end of that.

    The Road to 2010: More Democrats. Better Democrats.

    by Splicer on Wed Apr 01, 2009 at 06:34:55 PM PDT

  •  Topeka ain't the Hill (0+ / 0-)

    And farmer-90 day legislators ain't senior Congressman or senior Senators or well-paid, highly effective lobbyists.

    She is over her head when it comes to overhauling health care.

    Whenever you find yourself on the side of the majority, it is time to pause and reflect -- Mark Twain.

    by dcrolg on Wed Apr 01, 2009 at 06:51:02 PM PDT

  •  Good on ya, Kathleen! I'll still push for single (2+ / 0-)
    Recommended by:
    tmo, ferg

    payer, but I'm really getting into this Overton window idea, which i found out about right here on the Orange.  I agree with whomever it was that suggested we add some purple, although i'd go lavender, i think.

  •  Thank you Sebellius (0+ / 0-)

    Public option is the only way I will ever be able to afford actual care, as opposed to insurance. So the administration apparently has not given it up to the insurance lobby yet.

    Yes we did, yes we will. President Obama

    by marketgeek on Wed Apr 01, 2009 at 07:10:02 PM PDT

  •  Not going to work (0+ / 0-)

    Only single payer solves the health insurance crisis...and creates 2.6 million new jobs: a two-fer.

    And a no brainer.

    Obama used to be for single payer before he came out against it.

    by formernadervoter on Wed Apr 01, 2009 at 08:35:49 PM PDT

  •  Here's why this won't work (0+ / 0-)

    "Public Plan Option in a Market of Private Plans
    By David Himmelstein, M.D. and Steffie Woolhandler, M.D., M.P.H.:

    The "public plan option" won’t work to fix the health care system for two reasons.

    1. It forgoes at least 84 percent of the administrative savings available through single payer. The public plan option would do nothing to streamline the administrative tasks (and costs) of hospitals, physicians offices, and nursing homes, which would still contend with multiple payers, and hence still need the complex cost tracking and billing apparatus that drives administrative costs. These unnecessary provider administrative costs account for the vast majority of bureaucratic waste. Hence, even if 95 percent of Americans who are currently privately insured were to join the public plan (and it had overhead costs at current Medicare levels), the savings on insurance overhead would amount to only 16 percent of the roughly $400 billion annually achievable through single payer — not enough to make reform affordable.
    1. A quarter century of experience with public/private competition in the Medicare program demonstrates that the private plans will not allow a level playing field. Despite strict regulation, private insurers have successfully cherry picked healthier seniors, and have exploited regional health spending differences to their advantage. They have progressively undermined the public plan — which started as the single payer for seniors and has now become a funding mechanism for HMOs — and a place to dump the unprofitably ill. A public plan option does not lead toward single payer, but toward the segregation of patients, with profitable ones in private plans and unprofitable ones in the public plan."

    Obama used to be for single payer before he came out against it.

    by formernadervoter on Wed Apr 01, 2009 at 08:44:20 PM PDT

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