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President Barack Obama said Monday that Congress should approve a final healthcare bill even if it doesn’t include a public option.

Obama said the House and Senate bills are 95 percent "identical" and downplayed the fact that final legislation is unlikely to include a public health insurance option during an Oval Office interview with American Urban Radio Networks’ April Ryan.

"There's 5 percent differences, and one of those differences is the public option," Obama said.

"But this is an area that has just become symbolic of a lot of ideological fights. As a practical matter, this is not the most important aspect to this bill — the House bill or the Senate bill."
.....

"But either way, whether there's a public option in there or not, if you don't have health insurance, you are going to have now the option of getting it at a reasonable cost," Obama said. "And that's the most important thing."

That would have saved us all a lot of headaches if we'd heard it from the beginning, instead of this from June, or in September, or back during the presidential campaign. I guess that settles once and for all whether he'll push for a public option in the House-Senate conference. Ah, well. And another not so minor quibble--it's less an "option" the American people are getting to buy private health insurance as a mandate, albeit with assistance for many, to do so.

Beyond that, however, the public option isn't an "ideological" triviality. It's been recognized by health economists all the way from Paul Krugman to the wonks at the CBO as a significant means of cost control. You have to look no further than Medicare to know the power it has to save money. And the power it has to scare the crap out of the insurance industry. But calling it an ideological fight diminishes the substantive critiques from the left without actually having to address them on the merits.

The ever diminishing role of the public option in Obama's vision for reform is illustrative of what Drew Westen (Professor of Psychology and Psychiatry at Emory University, founder of Westen Strategies), wrote about yesterday in critiquing Obama as leader.

What's costing the president are three things: a laissez faire style of leadership that appears weak and removed to everyday Americans, a failure to articulate and defend any coherent ideological position on virtually anything, and a widespread perception that he cares more about special interests like bank, credit card, oil and coal, and health and pharmaceutical companies than he does about the people they are shafting....

Consider the president's leadership style, which has now become clear: deliver a moving speech, move on, and when push comes to shove, leave it to others to decide what to do if there's a conflict, because if there's a conflict, he doesn't want to be anywhere near it.

Health care is a paradigm case. When the president went to speak to the Democrats last week on Capitol Hill, he exhorted them to pass the bill. According to reports, though, he didn't mention the two issues in the way of doing that, the efforts of Senators like Ben Nelson to use this as an opportunity to turn back the clock on abortion by 25 years, and the efforts of conservative and industry-owned Democrats to eliminate any competition for the insurance companies that pay their campaign bills. He simply ignored both controversies and exhorted.

Leadership means heading into the eye of the storm and bringing the vessel of state home safely, not going as far inland as you can because it's uncomfortable on the high seas. This president has a particular aversion to battling back gusting winds from his starboard side (the right, for the nautically challenged) and tends to give in to them. He just can't tolerate conflict, and the result is that he refuses to lead....

The time for exhortation is over. FDR didn't exhort robber barons to stem the redistribution of wealth from working Americans to the upper 1 percent, and neither did his fifth cousin Teddy. Both men told the most powerful men in the United States that they weren't going to rip off the American people any more, and they backed up their words with actions. Teddy Roosevelt was clear that capital gains taxes should be high relative to income taxes because we should reward work, not "gambling in stocks." This President just doesn't have the stomach to make anyone do anything they don't want to do (except women to have unwanted babies because they can't afford an abortion or live in a red state and don't have an employer who offers insurance), and his advisors are enabling his most troubling character flaw, his conflict-avoidance.

Drew Westen isn't just any guy with a computer. He's an expert on political communication, the guy who wrote The Political Brain, and as digby says, the "it boy" of the Democratic party. Corporations winning again (remember, they declared victory when Lieberman killed the public option) in this bill reinforces his critique. But right now, in this economy and at a time when so many people are strugging so mightily, this could have been a powerful win for the people.

Originally posted to Daily Kos on Tue Dec 22, 2009 at 06:30 PM PST.

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