I have a basic question about the current framing of the healthcare debate:
Exactly how did we end up having to defend "A Public Option"?
From a marketing standpoint it makes no sense. And clearly marketing matters in trying to sell the most significant policy initiative in two generations. It has always been obvious that public opinion - as measured by opinion polls - will be critical.
Consider:
- No one can really define exactly what the hell "a public option" means with full confidence - including supporters; we're introducing a new ambiguous term into a critical debate
- Because of item 1, a "public option," once the details are worked out, could easily wind up being a hamstrung crappy option we wouldn't want to defend
(please forgive me for not implicitly trusting our esteemed Democratic Senators on this)
- Because we're introducing a new term, the definition is open to hijacking by the right
- While the meaning is ambiguous to supporters and open to hijacking, the label does make it obvious to opponents that it must be evil - it includes the word "public"
We should be defending the extension of Medicare for all - and should have been doing so consistently all along.
- Almost everyone who cares about the debate knows what Medicare is - in one word it makes the notion/substance of what we mean by "public option" instantly clear
- Opponents would have a much tougher time opposing Medicare for All because
A) even boatloads of wingnuts like Medicare - its about the most popular program ever; and
B) attacking Medicare is political suicide, so Republican opponents would be endlessly tripping over their words looking to finesse a double bind.
Not only would we win the debate, we would inflict significant collateral damage on a bunch of right-wing industry shills ahead of the 2010 elections, besides.
Plus it would be endlessly entertaining to see Republicans obviously stretching daily for new heights in hypocrisy. (In the current debate, too often someone has to connect the dots.)
Consider further:
When the right wing and insurance industry first tried to establish a beachhead to get rid of Medicare by siphoning subsidies into private plans, what did they call it?
Did you see Republicans on TV demanding "a private option"?
No.
They called it "Medicare + Choice" and later "Medicare Advantage."
When the right wing wanted to try to buy off the eternal support of the insurance industry, pharmaceutical industry, and senior citizens with a new prescription drug benefit, did you see Republicans calling the proposed program "The Privatized Prescription Drug Program for Seniors?"
No.
They called it "Medicare Part D."
What we are talking about with reform (or should be talking about) has more in common with the basic Medicare Program than does "Medicare Part D" - an obscenely inefficient pork sluice.
Note that all of the labels picked by the right when they try to "reform" healthcare have the word Medicare in them - for the obvious reasons mentioned above.
And, hey, in each case the new things must be better than Medicare - its Medicare plus choice! Its Medicare with an Advantage. How could those not be good?
Granted, if we were to actually reference Medicare in talking about a bold reform to extend coverage (and that's really all we're trying to do at this point), you would have to explain the complicated notion that the new program is not just for seniors - its for everyone who needs it.
So people would have to figure out what "for all" means.
Some might also object that the reforms we're talking about may not really be an extension of Medicare for all (even if this is what it should be).
Which raises the obvious question: how parsimonious is our current language to defend "healthcare reform" to what we actually expect to emerge?
In point of fact, if legislators started from the Medicare program as a substantive framework, as well as rhetorical framework, for the reform we would unambiguously end up with a better bill.
Which brings me back to my original question:
Why are we talking "public option" instead of "Medicare for all"?