The biggest obstacle to enacting public option into law is President Barack Obama.
There it is. I said it. It’s a reality that we all have to accept.
The President has been playing the insurance industry, Republicans and Democrats like a violin. He has used public option and the threat of reconciliation to scare the crap out of the insurance companies and the conservadems in order to get buy-in on the insurance reforms that he describes as the ‘80% of the bill that everyone agrees on’ (eliminating the rescission, outlawing denials based on pre-existing conditions, eliminating lifetime benefit caps, and setting up an insurance exchange for the uninsured, underinsured and small business to purchase health insurance).
He has used the Senate finance committee ‘discussions’ to create a road block to bringing public option up for floor votes. He has used the Senate finance committee to cut deals with industry. He has also used the GOP/industry engineered riots to his advantage as he can scare liberals into supporting him and giving up public option and scare conservative Democrats into voting for cloture. He has also stymied the GOP because he is painting the GOP as the obstacle to reform, which gives him a bigger upside to passing legislation.
However, he never intended to pass public option into law and always intended to cut a deal where he could get buy-in on these other items and leave private industry to operate with a better, more consumer-friendly environment. He favors incremental reform, not a fundamental overhaul of the market for private health insurance.
So expect the President to lean on liberals to give up public option, either now or in conference (see comments from Steny Hoyer undercutting Pelosi). His continued mixed messages on public option will erode the support of blue dogs in the House, making it harder for Pelosi to pass a bill with public option. The risk of not passing a bill would end up hurting both Obama and Congressional Democrats, but with mid-term elections in 2010, it’s the Congressional folks who are under more pressure.
So what should progressives do?
In order to win this debate, we need to play a game of brinksmanship. One side has to show that it’s crazy enough to throw the steering wheel out of a moving car before the other side will blink.
Here is what I think we can do.
1. Keep contacting our allies in Congress.
All you need to do is read your daily Slinkerwink to know what to do.
2. Contribute to our stalwart supporters on Act Blue.
All you need to do is read a Hekebolos diary to know what to do. I would also contribute to the DCCC as this will be important leverage for Pelosi. The more independence she has from Obama, the better the chances for enacting public option into law.
3. Highlight the cost savings aspect of public option.
We have done a very poor job of this to date. The WAPO editorial calling for Obama to dump public option did not mention its cost savings, because if it had, WAPO would not have been able to write the article with a straight face. No one on the cable tv shows, (including our friends like Rachel, Ed or Keith) mentions often enough that, according to the CBO, public option will save $100-$150 billion over 10 years while covering millions. Imagine Chris Matthews grilling a conservadem and getting him/her to acknowledge the CBO study on national television. That’s what we need. We should be stating this upfront and challenge all of those who oppose public option to show that their alternative can do better. In particular, we need to force Conrad to reveal his co-op proposal. He doesn’t have anything other than a few scribbles on a back of napkin.
4. Attack the weaknesses in the President/Senate Finance Committee’s Proposal.
We know what their proposal doesn’t have (according to Olympia Snowe): public option. That’s all we need to know.
The weakest link in Obama’s argument is the implication that cost savings can be achieved without public option. There are no proposals to date that come even close to achieving what public option does. His proposal for a universal mandate without public option in a market monopolized by private insurance companies will create a second doughnut hole, where people don’t have enough money to pay for the rising cost of insurance and Federal subsidies are capped. We need to make the White House address this issue. We need to call out the President for his intellectual dishonesty and force the White House to put up or shut up.
The next weakest link in Obama’s implied argument against prioritizing Public Option is that the President needs a bill and can’t afford to fail. The truth is we can’t afford to have a bad bill. Bill Clinton got two terms as President because many of his key policies were economically sound. People respected his ability to run government, and that respect extended even to those who hated him. Bush II drove his party out of power with bad policies and bad bills (e.g., war in Iraq, tax cuts, no child left behind)
5. Write to columnists, cable tv show hosts, letters to the editor.
I did this a lot during Bush years, and it really worked. When people receive a thoughtful note, it gets them to think. Many will write back if they feel like you helped them look at an issue a different way. A simple note on the issue of public option’s cost savings should be enough to get DC reporters to start pressing the White House to explain why public option isn’t the most central aspect of the reform given that it is the only proposal that yields demonstrable cost savings.
6. Pick a few leaders to lead the fight for public option and to challenge the President.
We need to identify people who have the gravitas to stand up to the President and who command respect among progressives. We already have Howard Dean, but need folks who are currently in Congress. In my view, in the House that is Nancy Pelosi and Anthony Weiner. In the Senate, we desperately need Chuck Schumer to stand with us. Senator Rockefeller has also been strong, but the guy that should be a natural ally but hasn’t spoken up much is Senator Kerry. He sits on the finance committee and he should be much more vocal and find ways to disrupt the Baucus cabal. I want Senator Kerry to go crazy and create a nightmare for the White House. What does he have to lose?
If we can highlight the cost savings potential of public option and expose the weakness in the President’s arguments, more members of Congress will be inclined to vote against any bill that omits public option with less fear that they are somehow undermining the President. That will shift the balance of power towards the progressive Democrats and away from the Senate Finance Committee and blue dogs.
7. What would I give up Public Option for?
There will be a negotiation between Pelosi and Schumer on the one hand and the White House on the other. So Rahm Emmanuel is going to ask what we want in exchange for dropping public option. Here are my proposed answers:
- "I'm not giving it up. You're wasting your time, Rahm"
- "Go fuck yourself."
- "Before any discussions, show me what plan you have that matches public option’s coverage and savings benefits and keeps the insurance companies honest."
- Keep telling Rahm to ‘fuck himself’ for 2 months until we get into December, while we continue to beat up the White House and conservadems on line and on radio/tv. In the interim we hold health care rallies in support of public option all around the country and force the media to take a serious look at its benefits.
- Drag this thing out for the month of October and November.
Then, I would consider the following proposals:
- Demand that co-ops and public option both be included within the insurance exchange.
- Demand that co-ops can score competitively with public option and insist on federal regulation, not private.
- Open the door to the possibility of capping P.O.’s membership for the first year to give insurance companies time to adjust, but then the cap gets lifted permanently.
- Allow people to buy into the Federal employees health insurance program. At least that program will have sufficient regulations to keep the insurance companies honest. This might be better than only leaving them with a brand-new, untested insurance exchange.
- Insist on Kucinich’s optional single payer provision be included in the final bill (this can be leverage to show we’re as crazy as Mao Tse-Tung).
In the worst case scenario, if our members lose resolve and the President wins out, then I think we need to at least insist on the right for the uninsured, small business and cobra recipients to buy directly into the Federal employees health insurance program. I don’t trust an insurance exchange with a weak co-op and weak oversight.
Those are my thoughts. I’d like to read your comments.