Misdirected Activism

Am I the only one who didn't really see a line in the sand from the President in yesterday's health care YouTube address?

That’s why any plan I sign must include an insurance exchange: a one-stop shopping marketplace where you can compare the benefits, cost and track records of a variety of plans – including a public option to increase competition and keep insurance companies honest – and choose what’s best for your family. And that’s why we’ll put an end to the worst practices of the insurance industry: no more yearly caps or lifetime caps; no more denying people care because of pre-existing conditions; and no more dropping people from a plan when they get too sick. No longer will you be without health insurance, even if you lose your job or change jobs.

The emphasis of the must is on the insurance exchange, which is actually a very important policy to break regional monopolies in the insurance market. The public option is wedged in there, but mostly Obama demands an insurance exchange so that individuals and small businesses have the ability to choose from a wide variety of plans.

But what this shows to me is that the public option is yesterday's debate. I think we'll get it, if we get a bill. But it's not holding up the process any more. It's too popular to kill the bill over. There are other elements that can sink the bill, most of them to do with cost. The DNC push against recalcitrant House and Senate Democrats just references some horror stories from citizens and states "it's time" for health care reform. No policy is forwarded, certainly not the public option.

The groups pushing back against reform aren't simply opposed to the public option, they're opposed to reform in general. And they see the cost controls and how to pay for the bill as the best way to attack it. Unfortunately, not a lot of people on the progressive side are defending wealth surtaxes or increasing the authority of MedPAC, for example.