We are not talking about health care reform in the right way.
We are talking about the public option as an alternative to the current system of providing health insurance.
But the current system is dead.
I will bet you that most opponents of reform don't know that. So I'll repeat it:
THE CURRENT SYSTEM IS DEAD.
I'm not saying that it's dead because the price of insurance has been and will continue to be going through the root -- although that's true.
It's dead because we're getting rid of pre-existing condition requirements and rescission, and we're requiring portability!
And there is great widespread rejoicing at that from all sides!
There is rejoicing because people don't understand what that means!
Specifically, they don't understand this:
To make this work, we have to have a universal mandate.
(What the heck does that mean?)
We're not explaining that well enough.
And we have to explain that first, before we say word one about the public option.
Here's what the "universal mandate" means:
Unless no reform passes at all, the government will soon mandate that everyone must buy health insurance.
(Note: there will be exceptions for those with low-enough incomes.)
SO: the current system is dead.
People ... don't ... get ... that ... yet.
Start by telling them THAT, and then you can tell them about the public option.
See, right now, psychology is working against us.
The public option seems like a wild new plan, put forth inadequaltely tested by wide-eyed liberal reformers.
(That's not actually what it is; that's just how it seems to too many people.)
People are nervous about change.
They don't realize that change is on the way, like it or not.
Democrats want it. Republicans want it too.
We pretty much all want "prior-existing-condition" reform.
But ask them to think about this:
If you no longer let companies bar people for having prior existing conditions, what keeps them from having only cheaper catastrophic accident insurance and then waiting to see if they get sick before they buy broader health insurance to cover diseases like cancer?
(Most people haven't thought about that!)
You either solve that problem or, by forcing companies to cover people who are already sick, you put the private insurers out of business.
They go out of business not because they can't complete, but because no one could compete when most of one's customers are sick.
(It's like engineering a run on a bank. The bank fails.)
So the way you solve the problem is this:
"Everybody has to have insurance!"
That's what a "universal mandate" means!
That's why all of the bills currently under consideration contain a universal mandate!
Private insurers can live with a universal mandate.
In fact, they'd love a universal mandate!
They'd be guaranteed customers.
We'd have to pay them money just for our being alive!
Just like we have to pay premiums to auto insurance companies if we drive!
Just like Markos would like it if the government said that everyone had to buy a subscription to a progressive political blog that had been around since 2003!
He'd form a cartel with Atrios and Josh Marshall and hike up subscription prices.
And that is pretty much the problem.
With a universal mandate and no competition, insurers have no incentive to bargain for lower costs.
They can just pass the costs along to us.
And we will have to pay. The insurance is mandatory, remember?
Now ...
THAT IS WHERE WE SHOULD PAUSE FOR A MOMENT.
Now ...
THAT IS WHERE WE SHOULD ASK PEOPLE "WHAT DO YOU THINK OF THAT?"
They way that they should feel is ...
.,./.,./.,./.,./.,. a little uncomfortable .,./.,./.,./.,./.,.
And we should let them feel that discomfort for a little while.
And we should remind them that this is going to be what happens this year.
And we should remind them that this is what the Republicans want.
And then we should ask them this:
"How would you feel if you didn't have to be at the mercy of the health insurance companies?"
We can ask them:
"How would you feel if, when by law you have to buy health insurance, you could get it from the government instead of your health insurer, if you wanted to?"
"How does it sound to you for you to have that option?"
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"Does that sound good?"
("Actually, it's sort of a relief!")
Now the "public option" isn't a bold and scary new change!
CHANGE IS COMING ANYWAY!
WE ARE GOING TO HAVE A UNIVERSAL MANDATE!!!
What the public option does is protect us from too much change at once.
It's a safety valve.
But when you just tell people "we need the public option" ... it doesn't sound like that.
So tell them, first, that
WE ARE GOING TO HAVE A UNIVERSAL MANDATE!!!
and then ask them if there's anything we can do to make them worry about that less.
Something like ... making sure that we have a public option to mandated universal private health insurance.
Then the public option doesn't seem so scary.
Not having the public option is what seems scary!
And then they will be on our side.
And the politicians will have to follow them.