Beyond The Public Option

Take a look at this ad from America's Health Insurance Plans, the insurance industry lobby.



See what's missing? The words "public option." Or really, any attack on the current plan in Congress at all. The spot associates AHIP with a reform banning denial of coverage for pre-existing condition in exchange for getting every American covered, gently asks for the final bill to be bipartisan, and... that's it.

Similarly, Olympia Snowe, who signed on to the letter calling for a delay in the deadline for reporting a health care bill out of the Senate, positively called for a public option on day one in a speech this weekend in Maine.

What this shows me is that we have now moved beyond the public option as the fulcrum point for the health care debate. We don't know what form it will take or how accessible it will be to all Americans, but if there's a bill signed by the President, it will include a public option. The major players have given up on that score and moved on to other issues to try and derail health care, particularly costs. We've seen much more criticism about cost controls and surtaxes on the wealthy over the last week than any discussion of the public option.

That's because those other facets of the policy don't poll very well, certainly not as well as a public option does. And the forces defending the status quo have found a much easier path by arguing for more delay, raising questions about costs, claiming that Democrats are engaging in class warfare, raising specters about rationing, and generally using that fiscal scold pose, saying we cannot pay for health care reform while protecting federal health care funding for their districts and localities. On the far right fringe you have lies about how the bill "outlaws private insurance," but in general, the status quo forces think they can trap the bill with a discussion about its cost, not its function.

Of course, the larger effort here is to destroy the Democratic agenda and basically ensure a first term without substantive accomplishments. And Obama is right to use Jim DeMint's "Waterloo" line against him, make it famous, and condemn those who would turn an urgent need for tens of millions of Americans into a game of political hardball:

Just the other day, one Republican Senator said, and I’m quoting him now, “if we’re able to stop Obama on this, it will be his Waterloo. It will break him.” Think about that. This isn’t about me. This isn’t about politics. This about a health care system that is breaking America’s families, breaking America’s businesses and breaking America’s economy. And we can’t afford the politics of delay and defeat when it comes to health care. Not this time, not now. There are too many lives and livelihoods at stake.

What we may see is a brief scaling back on the deadline, which should still leave enough time to report a bill out of both houses in September and reconcile them by October. But the fights ahead for health care appear to be playing out over cost and who pays. The public option is in the bill, as long as it gets dragged over the line.