Blue Dogs Desperate To Remain Relevant

Yesterday the Blue Dog Caucus sought headlines by trying to strangle the public option by putting enough conditions on it to render it useless.

Conservative House Democrats set strict conditions Thursday for any government-run insurance plan Congress creates as part of a health care overhaul, ruling out support for a plan that resembles Medicare — the option favored by many liberals.

The lines drawn by the Blue Dog Coalition, if adhered to by lawmakers crafting the health overhaul, would result in a government-run plan that works much like private insurance plans [...]

Among their requirements: The public plan must negotiate payment rates with providers; participation in the plan must be voluntary for both providers and patients; premiums and copayments under the plan must pay for its operations; and the plan must follow the same actuarial standards and regulations required of private insurers.

Some conservative health policy experts have questioned whether it makes sense for the government to create a public plan that essentially replicates plans offered by private insurers. A public plan would draw most of its cost-cutting power from its ability to dictate prices, like Medicare, these experts argue; without that ability, it might save the government and consumers little or no money.

I think this is the second fallback option for the forces seeking to destroy the public option. First they'll attach an unrealizable trigger to it, keeping it from implementation unless certain impossible conditions are met. The Blue Dogs support that too, it's at the bottom of their statement of principles. Failing that, they'll boil down the public option until it basically becomes a non-profit health insurer with all the same restrictions as private insurers. The lack of profit motive, less overhead and administrative costs would probably save consumers a little money, but the real money comes from the monopsony bargaining power of using government rates. As Matt Yglesias points out, this doesn't come close to being a fiscally conservative argument - a world where the public plan can use Medicare bargaining rates forces private insurers to compete on price and quality, lowering costs to the system, and therefore costs to the government. And the supposed fiscally conservative Blue Dogs are against that.

If all 51 Blue Dogs actually went to the mats over their twin concepts of strangling the public option, there would be concern. But as is common, their press release simply does not reflect the views of their members. Mike Michaud of Maine strongly supports a public insurance option and criticized the Blue Dog statement yesterday. Patrick Murphy of Pennsylvania said this:

Congressman Murphy stands with President Obama in supporting the inclusion of a public option in health care reform legislation. While the Congressman is a member of the Blue Dog Coalition, he does not always agree with them on every issue. In this case, he does not believe that we should wait several years to see if our currently broken system gets worse before introducing a public option. Including a public plan as one of many choices in a health insurance exchange is a good way to introduce transparency and competition into the insurance market, curb sky-rocketing costs, and hold private insurance companies accountable so that we can finally accomplish comprehensive, genuine reform this year.

The Blue Dogs have a frayed coalition and very few options in the House of blocking strong reform. The action on this bill remains in the Senate, where 37 Senators are on the record in support of a public option, out of the 50 needed to pass it through budget reconciliation. So the Blue Dogs tossed some bait hoping to get media coverage, but in reality, they've got nothing.

If you have a Blue Dog for a representative, you should ask them outright, whether they support slow-walking a public health insurance option or attaching so many conditions to it that it doesn't do much of anything, or whether they support the President and the majority of the American people who want a choice of a not-for-profit alternative. You might remind them that 62% of all US bankruptcies are due to medical bills, that 47 million Americans have no health insurance, that the CEOs of major insurers make millions and millions of dollars while denying care and coverage, and I'm sure you can find a few other data points from your own personal experiences.