October 26th, 2009

The public option: by hook or by crook

It’s no secret that the health care reform bills in both the House and the Senate are both almost certain to contain some version of the public option. We don’t know the details yet, but the intent to include a public option is there, and has been clearly expressed by Congressional leaders Pelosi and Reid.

I don’t think most American would be against a public option if it truly (1) left private options intact and did not compete unfairly with them (2) allowed for choices such as high deductible and/or catastrophic insurance in both the private and the public sectors (3) was actually deficit- and tax-neutral; and (4) covered all uncovered citizens who want coverage, and did not compel those who don’t want it to be covered against their will.

But that’s not the case with the current bills. And since it is virtually impossible to craft a public option that has those features, it’s a safe bet that it won’t be the case for the final bills either.

Polls about the public option are essentially useless in telling us what America actually wants. Most polls don’t even use the word “public option” (many of the polls use the phrase “government health insurance plan to compete with private health insurance plans,” for example, and some even describe it as “similar to Medicare”). None describe the provisions of the bills actually under discussion in the legislature, most of which would not just “compete” with private health insurance but bury it, as well as violating the other three criteria I mentioned above.

That’s not what the American people want, and I don’t think we need a poll to tell us that. Nevertheless, that’s what the American people might very well get.

But why would the Democratic Party want to pass such an unpopular bill? Because they’ve been wanting to for a very long time, because Obama promised health care reform during his campaign, because they favor increasing government intervention in general, and because now’s there a very good chance of success—perhaps the best they’ll ever have—since they hold powerful majorities in both legislative bodies and control the presidency as well. So carpe diem.

[NOTE: I haven’t spent a lot of time in this post describing how it is that the bills under consideration are examples of sleight of hand, pretending to do one thing—preserve private insurance choices and keep costs down—while actually doing another. There have been countless articles in the press and the blogosphere explaining just that (here’s one, for example), so I see no need to reinvent the wheel.

But if you take a look at the details of the Senate bill that supposedly is the leader right now, you’ll see what I mean. Everything about the public option is designed to appear to retain the private insurance choice, while at the same time having the actual affect of making the private option non-competitive, and most likely ultimately phasing it out.]

22 Responses to “The public option: by hook or by crook”

  1. roc scssrs Says:

    I think the strategy is this: Pass some horrible conglomeration that doesn’t take effect till 2011, then goes badly for a year but establishes the principle of government-run health care, then run for re-election in 2012 on a platform of a single-payer system which will save our precious public option from the evil insurance companies, GOP, Fox News, etc. etc.

  2. Assistant Village Idiot Says:

    I find sleight-of-hand sufficient reason in and of itself to disqualify a proposal. That is perhaps an oversimplified, unthinking response on my part, which would eliminate most legislation passed by congress. On the scale of life’s tragedies, however, that wouldn’t be high.

  3. expat Says:

    Both Fred Hiatt and Robert Samuelson of the WaPo have some criticisms of the congressional proposals today. Avi, I agree. If they did there homework and had solid plan with financing, they could explain it and wouldn’t need the smoke and mirrors or hope and change or whatever.

  4. davidt Says:

    The public option: by hook AND by crook.

  5. Baklava Says:


  6. Tom Says:

    The truly repugnant fact is that our elected officials are lying to us. Lying flagrantly, sometimes stupidly, but lying.

    They are not merely spinning, distorting, misrepresenting. These are bald-faced, vicious lies, that start with lies about data and proceed to lies about their fixes.

    They always have lied, of course, but usually about issues that have no impact on each and every one of us simultaneously. McCain, Snowe, Collins, Graham, the RNC, and the rest of the RINOs should be put up against the same wall with their colleagues on the now-totalitarian Democratic side. The RINOs may be the worse of the two; they are the enablers who have yet to start screaming to high heaven. What will it take for them to do so?

  7. expat Says:


    I noticed that Krugman didn’t mention any of the points raised by Hiatt on costs. Of course, Krugman is an economist and shouldn’t be bothered by such trivia.

  8. Tom Says:

    The Krugmans are acting as if we’ve lost. Perhaps we have.

  9. Poor Richard Says:

    Tom, which is worse: that they are lying, or that they believe they’ve fooled us? Or maybe that they have fooled some of us?

    Baklava: As someone who worked in healthcare reimbursement for 10 years, I can tell you with certainty that under “health care reform” there will be no cost reductions, that there will be rationing, that there will be “death panels,” or, as the British call them, “NICE panels,” and that health care in the US will get worse, not better.

    Much as I hate to say, it looks like Ayn Rand was right: from the looters’ perspective, better that everyone gets lousy health care than some get quick access to superb health care and others have to wait in the emergency room.

  10. yaksha Says:

    Their lies are designed to fragment and confuse the voters long enough to get these bills passed. They are obvious, easily disprovable lies and the Democrat party seems to put a minimum of effort into telling them. But once one lie is challenged, they have told us three more lies. Meanwhile, the bills keep chugging along the path to becoming law.

    The Democrat party is going to pass it because this is the best chance they will have to do so for the foreseeable future. It will be a disaster if it passes. But the good news is that the Democrat party already knows how to deal with this disaster: blame the GOP, Bush, Tea Partiers, business(if there are any left), FOX News, etc. They are very good at blaming people, world class. Too bad they have no clue how to govern.

  11. Tom Says:

    To what purpose do they lie?

    I won’t accept the counter that they do not think they are lying, nor the Leahy rebuttal that of course they have the Constitutional authority, nor that they are clueless.

    So I ask, why are they lying about what they are doing their damnedest to pass into law? Do they truly mean us harm? Do they truly mean to provoke us into armed rebellion?


  12. strcpy Says:

    “run for re-election in 2012 on a platform of a single-payer system which will save our precious public option from the evil insurance companies, GOP, Fox News, etc. etc.”

    Ding ding ding – we have a winner. Further if they loose – well lots of things to hammer the Republicans with and blame them for the collapse. You will note that nearly all of these programs are set to really kick in around 2011 or 2012 and it is so for a reason.

    They can currently run on the idea of immediate need from the Republicans screw up and this padding gives them time to blame the Republicans later in another similar power grab. And in a win/win scenario saddle them with the mess if they regain power.

    They have run as an opposition party for so long that they have to be in opposition to something. They have a hammer and it is all they know how to use, therefore a hammer it is!

    Sadly the Republicans are so spineless that they couldn’t lead a starving mouse to a grain barn if they had a block of aged swiss. They have become a whiny Democrat Light, so then why not vote for the same policy with less whine?.

    Both are basically counting on the other side to be worse than them and neither one is willing or capable to lead.

    Our Future For the Loose!

  13. strcpy Says:

    “So I ask, why are they lying about what they are doing their damnedest to pass into law? Do they truly mean us harm? Do they truly mean to provoke us into armed rebellion?”

    A deep focus on the short-to-medium term and the assumption that anything bad for the Republicans is good for them. We saw 8 years of that – no matter the damage to themselves or the country if it hurt the Republicans then it was good. It also won them their current majority so they were not exactly incorrect.

    They see (and by “they” I mean 99.9% of our elected federal officials) see it as a game of who wins and all of us are pawns. As the pawns there is little we can do – right? But then turns out pawns can take a square too and of the king can not go anywhere else, well game over. Everyone understands this to some level.

    It’s not really a power grab per se (even though I use the term above) but an attempt to neuter our ability to metaphorically take a square and challenge the “real” chess pieces. The distinction isn’t so much in what they are doing as to why – the power is just a nice side benefit. It is also why some moves make little sense in terms of gaining and controlling power.

    This is part of the reason why the Republicans aren’t really fighting it that hard – they may currently be on the loosing side but they ultimately see themselves as the non-pawn pieces too and is why the Dems didn’t protest things like the Patriot act or the wiretapping stuff outside of mere rhetoric.

    I also think they mix in enough hubris to think they can manage any fall out on their own side so the longer term consequences are irrelevant.

  14. Baklava Says:

    To be clear. I find Krugman delusional and not very bright.

    He fails to consider many things – and every time.

  15. F Says:

    There is no way the public option can leave the private option unscathed and undamaged. Think about it a moment: the public option is being instituted to do things the private options do not, and to do them cheaper. The only way they can do them cheaper is by putting taxpayer money into the pool, but that does not come out of the individual premiums (premia?) so it appears cheaper. How will private options compete with a program that is partially funded by the taxpayer? It will not, it cannot. The private options will gradually wither and be replaced. Cannot be otherwise. F

  16. TmjUtah Says:

    The Democrats are tools.

    No, really. Tools. Farm implements, if you will.

    Bill Clinton governed as a moderate Republican most of his presidency. The Democrat elite dropped a few elected members but still owned the media and pop culture, and went about the business of being elite.

    From ’96 until Bush the Younger the Republican revolution became the Republican Elite…

    Now in 2009, another hyper ambitious individual has picked the Democrats as his vehicle to his goals.

    Barak Obama understands implicitly that the party of the little guy, the unions, and the poor colored folk is in reality a plantation as prim and prude as any colonnaded South Mississippi river boat landing palace, but that it was tailor made for his use.

    All that populist class leveling stuff the Kennedys, Schumers, Pelosis, and their ilk reflexively spout will make it nigh on impossible for them to go on the attack when Obama finally drops all pretense about his true objective:

    The destruction of the constitutional Republic.

    Regulation, uncertainty, debt, politicized justice, destructive taxes, and the destruction of our manufacturing and health sectors are all competing for primacy…

    … which you wouldn’t know if you watched the news…

    … but you know it’s happening because you work for a living. Your neighbors who still work know it, too.

    If you’ve held a job on a reasonably regular basis… if you’ve paid your taxes on time and in full… if you’ve served your nation voluntarily, or given fair service as a conscript… if you’ve raised children that earn more than they take… if you bought a house you could afford and paid or are paying for it… if you respect your fellow man’s right to a different opinion vice merely “tolerating”…

    then you are at the same time the number one target of the Obama agenda and his worst nightmare. Because once he destroys you, there’s nothing left that stands in his way.

    The Plan is designed to succeed or fail before the 2010 elections. I’m as certain of this as I’ve been of anything in my life.

    Only in a Marxist’s mind could the destruction of the United States be remotely construed as a constructive act.

    I bet “V is for Vendetta” gets watched a lot in the West Wing.

  17. TmjUtah Says:

    On, and I left out the “lose the war” part.

    Count on it. I will be carrying a “Victory or bring them home” sign next tea party.

  18. SAB Says:

    Why should we be forced to “overhaul” our current health care system just to replace it with a sub par government run public option? Are we really that stupid? I think not. I pray not.

  19. Daniel in Brookline Says:

    Slightly off-topic —

    I keep hearing references to “universal health care”. Pray tell, don’t we have that now? Isn’t it possible for anybody at all to go into any American hospital anywhere and get medical services?

    What we don’t have now is “universal I-don’t-think-I’m-paying-for-it-yet health care”. I’m sure lots of people would love to have their health care paid for by someone else. But somebody has to foot the bill in the end.

    By the way, if you needed yet another reason to oppose The Public Option, here you go.

    Daniel in Brookline

  20. Assistant Village Idiot Says:

    Daniel, you are correct that the entire debate is actually about health insurance reform, not health care reform, which is why protestations and statistics about good health care fall on deaf ears. Health care is a diversion, influencing people to get emotional about homeless hamsters. The Democrats are going after a large private industry, insurance, which is only partially under their regulatory control.

    What does not get mentioned is that the insurance industry does not exist in isolation, unrelated to the other pieces of health care delivery. Those – the providers, researchers, and patients – are going to get caught in the fallout. We are the collateral damage in their war against insurance companies.

  21. notherbob2 Says:

    Neo is correct (again). The public option is coming; with lies, damned lies and statistics, damn the torpedoes.

    As you seek to make sense of all this; keep your eye on the outcome of NY 23, NJ and Va. The results in these races, especially NY 23, will, I believe, reveal the future solution to many of these problems, especially the lies from the Beltway elites of both parties. Newt Gingrich is clapping his forehead because he acted too soon and endorsed the RINO in the NY 23 race. He is now desperately spinning that he really only meant to endorse the “choice of local party leadership” and not a RINO. Actually, I don’t think he can escape the consequences of his action by dissembling. But, I digress.

    Connect the dots: Dot: “Poll shows that 40% of America consider themselves Conservative” – up strongly. Dot: “Poll shows 35% consider themselves Moderate”. Dot: “Polls show Moderates deserting Obama”. That is why President Obama is attacking Fox, et al – he must keep the Moderates from joining with the Conservatives to throw the bums out (or in the case of NY 23, et al, letting the bums in.)

    As Conservatives and Moderates begin to rely on their principles rather than the lies of the elites, all that is missing is non-Beltway candidates who can earn their votes. Let’s see if the Progressives in the WH bunker can, by releasing their Panzers, win this “Battle of the Bulge” (current Congressional elections) and turn this thing around. If the Progressives fail, much of the damage done by President Obama can and will be reversed.

  22. Maggie's Farm Says:

    Tues evening links…

    Sipp: Norm Abrams is the real Reality TV
    Thank you Joe Lieberman
    1 in 7 taxpayers flee New York
    The KrautMan on why Barack is like Brazil
    The hopey-changey National Endowment for the Arts
    Gingrich on 23
    The new ACORN $ scandal
    Robert Reich Fess…

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