Like most progressives, I've been foursquare behind the public option from the beginning. I’ve been ready to give up private insurance and join the new plan the day it became available. I've been frustrated by President Obama and angry at the Blue Dogs. I’ve been signing petitions and I've been shaking my head at Feinstein and Reid.
And then it occurred to me that maybe I hadn't thought this through. Because some day (hopefully many years from now), the Republicans will be back in control of the government. And if there is a public option in place at that time, the GOP will have a remarkable opportunity to use it to do exactly the opposite of what we want the public option to do.
I'm no policy wonk, so I'll be brief. Imagine for a minute if the GOP ran the public option. They would be able to manipulate it to set benchmark prices as high as they want. They would be able to use it to squeeze people more than any private insurance company ever has. Instead of keeping the insurance industry honest, they would be able to help the industry gouge the public in new and creative ways. And what would be be able to say about that?
Some people might see this as an argument for single payer. But in a Bush-like scenario, someone like Cheney could probably find a way to manipulate that approach too.
Maybe it's really an argument for a different kind of option, an independent option, one that would be run by a non-partisan board with a staggered series of lengthy terms of office, a board that would not be subject to political pressure. Not Kent Conrad's discredited "co-ops" idea, but a strong, independent option that can challenge the insurance industry without being easily influenced by outside pressure.
I believe that health care reform is the single most important issue facing this country and, as such, we've got to think this through to make sure we get it right, not just for today, but for the long term.