What I'm seeing is a lot of confusion about what sort of "public option" is possible.

[clear eye]

I see people abandoning the struggle for HR 676 (single-payer) with the idea that since, theoretically, a public option could be devised that would do all we want and gradually phase out private insurers, one like that is politically more realistic than single-payer. In reality a plan like that has a snowball's chance of even getting on the table, (and less chance of passage than single-payer) for the following reasons:

Health insurance companies aren't stupid about their own interests. They know that such a viable public option is a threat to their continued existence. They're already fighting it tooth and nail, just as they are fighting HR 676, which is the reason nothing like what we would call a "good" public option is being proposed.

If anything like that were to be brought up it would bring on a disinformation campaign all over the media by the insurers, and die a quick death, since Congress could drop it and still look as though they were working toward a decent public option. Congressmembers couldn't put over such a hoax regarding HR 676. Either Medicare for all is created, or it isn't.

Once we have gone down the road to a mixed plan, and given up HR 676 as not "politically feasible", we have used up all our political captital on the issue and are stuck with 'yes' or 'no' on whatever economically and socially disastrous public option gets to the table. We are then forced to accept it or to try to make our Congressmembers vote against all healthcare reform. They would see that as a terrible political move, given the demand for improvement.

In other words, there is equal opposition from insurers to either single-payer or a "robust" public option. The difference lies in what happens next.

With the public option, Congress can fool themselves and many of the public by creating a weak public option of the sort that insurers won't viciously fight, and still claim that they have backed a public option and supported healthcare reform. This gives them an easy out, which most of them will take. That sort of public option leaves serious care and coverage problems, and actually worsens the economics by creating subsidies that the insurers would use to raise their charges (part being paid by the gov't) and adding more administrative costs. This would be a further drain on our already poor economy.

On the other hand, when insurers go all out against single-payer, Congressmembers can only do one of two things and both will be really obvious. Refuse to support it (or remove support they have previously given) and upset the public, or stand firm and get grassroots gratitude.

Unless we get it clear that HR 676 is actually more feasible than anything we would see as a "good" public option, we will be moving in the wrong direction.

(Crossposted from GD.)

[rhett o rick]

1. Help me understand the differences of strong vs. weak public option. nm

[Cleita]

3. A strong option would be like Medicare for all.

Medicare right now is for seniors, however, twenty years of interference from Republicans have made it less robust. If the fee schedules were updated and the deductible and copays eliminated it would be an improvement. Also, many seniors can't afford the premiums for Part B and Part D. Those should go. Now if you extended that to everyone who wants it, you would get a strong public option administered by the government.

A weak one is any option that subsidized insurance for those who can't afford to buy insurance. Of course the insurance companies still have a say in what they will or will not pay for. Most likely you will still have huge deductibles and co pays because most likely it will be only catastrophic insurance. No body will be giving anything away. So basically, the health insurance industry has won.

[rhett o rick]

4. Thanks for responding. What you stated is what I was worried about.

So how is a "weak public option" a public option at all. Seriously, what is the option?

[Cleita]

5. It's not but I have been battling in the main forums all day about this

with DUers who think everything Obama wants and will settle for is sprinkled with fairy dust. Well, they will be disillusioned unless Obama changes his position. I'm hoping he's going to do something intelligent when the final bill comes to his desk for signature that he won't sell us down the road.

[rhett o rick]

6. One of the thing I have heard that disturbs me is that we can pass a weak bill and then strengthen

it later. That is so much bull. If we pass a weak bill, it will stifle the current outrage. And immediately CorpAmerica will go to work to weaken the law further. We need at least a strong public option.

The reason for my concern is that my Senator Cantwell (DLC) has gone until a week ago without committing to a public option. Forced into a corner she choose a public option. I am suspicious of her motives. Maybe her definition of public option and mine are not the same.

[Cleita]

7. I have used the example of Proposition 13 which was passed thirty years

ago in California and which has been destroying that state incrementally since then. No one has done anything to roll it back because it's too entrenched and the little people who are suffering from this legislation don't have the money or clout to fight back. Once a law is passed that benefits greed and an insurance friendly plan will be just that, it will be impossible to change.

[Cleita]

2. Well, the health care reform, which has been relabled as health insurance

reform is shaping up to no more change than making the insurance companies more responsible than they have been. Well that might last a little while until the health care lobby pulls things back to where we are now in a few years. They got the gold mine and we got the shaft.