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When I heard the news last night, it was an emotional punch to the gut for me and I still feel winded from it. I've been working so hard with all my heart in the past seven months for a public option in the final health insurance reform bill, and to have this happen from the party that I'd also worked to put into office in 2006 and in 2008, is heart-breaking. I was motivated in my fight for the public option by the thoughts of people making phone calls day in and day out, attending town halls in the summer to defend the public option, and seeing pictures like these below:


When I initially heard that there was no price control on private insurance premiums save for the public option, I decided that I'd fight for the public option because I couldn't stand the thought of us being mandated to buy private insurance with no price controls on rising premium costs. That'd be sentencing Americans to a lifetime of wage slavery to one industry---private insurance companies. It's why I agreed with President Obama during the campaign about the public option helping keep premiums low by being a competitor to private insurance companies, which would keep them honest:

President Obama: I think one of the options should be a public insurance option. (Loud cheers) Let me clear. It would only be an option, nobody would be forced to choose it. No one with insurance affected by it. But what it would do is provide more choice and more competition. It would keep pressure on private insurers to keep the policies affordable, to treat their customers better. I mean think about it. It's the same way the public colleges and universities provide additional choice and competition to students. That doesn't inhibit private colleges and universities from thriving out there. The same should be true on the health care front. Minnesota I have said I'm open to different ideas on how to set this up we're going to set this up but I'm not going to back down on the basic principle that if Americans can't find affordable coverage we're going to provide you a choice.

I also agreed with President Obama during the campaign when he stated his opposition to mandates:

Obama: "Senator Clinton believes the only way to achieve universal health care is to force everybody to purchase it. And my belief is, the reason that people don’t have it is not because they don’t want it but because they can’t afford it."

My worries about the public option being dropped from health care reform started in late November when Senator Max Baucus's white paper was released, and instead of assuming the public option as being in the bill, he laid out several choices, some of which didn't include the public option, and that concerned me. I wrote about the possibility of it being dropped and why we had to fight for it on November 20, 2008:

Let me explain to you why the use of mandates would be a political killer, especially with the health care reform we need so badly. The insurance companies win if health care insurance is passed with everyone being forced to buy coverage from crappy insurance plans and the public option is only limited to the elderly aged 55 to 64, and the disabled, as was shown in the Baucus health care proposal.

The stifling of the public option as being a true competitor against the private insurance companies is what will happen in the eventual health care insurance legislation. If the public option isn't a viable player with comparable benefits and is constantly underfunded like the Massachusetts health care public option, then that means that only the sick and the elderly get shunted off onto the public option, with others being forced to stick with private insurance plans with no capped premiums, rising deductibles, and co-pays. The insurance companies still would deny claims. It'd still be murder by spreadsheet on their own terms but on a national scale.

And that's the kind of "universal health care" reform we'll see because that's what Senator Max Baucus has indicated in his legislative proposal. Remember, all health care proposals go through his committee. He also would like to see health care reform passed as separate bills. Senator Kennedy wants it to be passed in one bill. Now, why does Senator Baucus want the health care reform bill to be broken up into separate bills? To kill off the progressive elements of the plan in the Senate.

If health care reform doesn't pass due to the mandates as a political killer, then the insurance companies win anyway because they get to keep on practicing the same policies.

The only way that private health insurance companies can lower their premiums, deductibles, and co-pays is if the public option is a true competitor and allows EVERYONE to participate in the public option, not just the elderly and the disabled and the poor.

Barack Obama campaigned against the idea of mandates for universal health care. He'll likely give in on this since the insurance companies will only come to the table if they get the guarantee that Americans will be forced to buy their crappy insurance products through the use of a mandate.

And here we are now, with no public option in the Senate bill. To me, a public option with a trigger on it is not a public option at all. I won't be fooled by Democrats that say that. We had a President that saw why mandates wouldn't work for Americans, and that he saw that the real issue was of affordability in health care, not access to health insurance. We had a President that supported the public option because he saw the excesses of private insurance companies, and he thought it'd be the best way of keeping them honest.

We had a President that campaigned on drug reimportation, and allowing Medicare to negotiate drug prices. Here's what he said during the campaign:

BARACK OBAMA: The pharmaceutical industry wrote into the prescription drug plan that Medicare could not negotiate with drug companies. And you know what, the chairman of the committee who pushed the law through went to work for the pharmaceutical industry making $2 million a year. Imagine that. That's an example of the same old game-playing in Washington. I don't want to learn how to play the game better. I want to put an end to the game-playing.

And now he cut a deal with PhRMA at the expense of Americans. He didn't put an end to the game-playing, he just learned how to play the game better.

My concern is that even with the regulations, private insurers will still cherry-pick as was pointed out by the Washingotn Post, game the system, and raise their premium prices with no real price controls. We've seen very weak enforcement of regulations in other industries such as the banking industry and the credit card industry, and it's why I'm dubious about the value of regulations in the House bill given our party's track record. And that the triggered public option, and the FEHBP exchange of non-profit private insurance plans within the exchange, will not provide the kind of meaningful competition necessary to keep private insurance premiums down and keep them honest.

And that the delay of reforms to 2014 for much of the regulations, exchanges, and actual affordable buy-in of Medicare (which won't be subsidized until 2014) will backfire on the Democratic party when Americans continue to see no change until 2014, and see their premiums going up, and more Americans go without coverage because they can't afford their premiums.

The safer thing for the Democratic Party to do would be to actually listen to their Democratic base and a majority of Americans on the public option, increase subsidies to 500%, and provide a higher level of policy than was provided during the ongoing health care reform debate. They didn't----they listened to conservative Democrats instead and allowed them to hijack the process just like they allowed conservative Democrats to hijack the stimulus.

Right now, we're circulating a petition to President Obama against the trigger on the public option.


And I'm with Markos on this:

This is so freakin’ obnoxious I can hardly stand it. We are about to get a turd of a "reform" package, potentially worse than the status quo. We have the insurance industry declaring victory, Republicans cackling with glee, and the administration is using that piece of shit to raise money?

Obama spent all year enabling Max Baucus and Olympia Snowe, and he thinks we’re supposed to get excited about whatever end result we’re about to get, so much so that we’re going to fork over money? Well, it might work with some of you guys, but I’m certainly not biting. In fact, this is insulting, betraying a lack of understanding of just how pissed the base is at this so-called reform. The administration may be happy to declare victory with a mandate that enriches insurance companies, yet creates little incentive to control costs or change the very business practices that have screwed so many people. But I’ll pass.


Senator Joe Lieberman says that he'd still oppose a bill even with a triggered public option, and isn't so ready to jump on the Medicare buy-in proposal:

"I am encouraged by the progress toward a consensus on proposals to send to the Congressional Budget Office to review.  I believe that it is important to pass legislation that expands access to the millions who do not have coverage, improves quality and lowers costs while not impeding our economic recovery or increasing the debt.  

"My opposition to a government-run insurance option, including any option with a trigger, has been clear for months and remains my position today.  

"Regarding the ‘Medicare buy-in’ proposal that is being discussed, we must remain vigilant about protecting and extending the solvency of the program, which is now in a perilous financial condition.  

"It is my understanding that at this point there is no legislative language so I look forward to analyzing the details of the plan and reviewing analysis from the Congressional Budget Office and the Office of the Actuary in the Centers for Medicare and Medicaid."

Originally posted to slinkerwink on Wed Dec 09, 2009 at 10:00 AM PST.

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