Lower Your Sights
Paul Starr tells us all to give up on the public option. Paul may be very smart and right on the merits, but he fails to understand the political contours of the debate.
Because the public option has stood no realistic chance of being enacted in the form it was conceived, its main value all along this year has been as a bargaining chip. The proposal will now have served a valuable political purpose if, by sacrificing it, the White House is able to provide enough cover to Democratic senators from red states to get a bill out of the Senate Finance Committee, through the upper chamber, and into conference with the House.
The Republicans have focused their opposition on the bugaboo of "government-run health care." By jettisoning the public plan, swing Democratic senators can tell their constituents that they prevented a government takeover. This argument will not sway die-hard right-wing voters, but it may suffice for many others and thereby help give those senators confidence they can vote for the bill.
Some liberal members of Congress are still insisting the public option must be part of health reform. They should continue to say so -- their protests may make the ultimate concession all the more valuable. But if any of them actually do vote against the final bill and prevent it from passing because it fails to offer a public option, they will help to ruin the best chance in years to put health care on a path toward reform. And they will do severe damage to the presidency of Barack Obama.
Um, it hasn't swung one Republican, who keep talking about "Trojan horses." This is why the leadership has now resorted to talking about splitting the bill.
Furthermore, this idea that liberals are pawns in Paul Starr's Great Game just will not sit will with the only people out there fighting for this bill. As we saw in polling yesterday, support for reform collapses without a public option. That's the reality of the situation, folks, and to try and decouple the public option now will just remove all the energy from the fight, all the support, leaving the White House in the unenviable position of trying to pass something without any public engagement on their side. The legislation is shaky enough as it is, before cutting all the public support off at the knees. That would be suicide for the bill.
Max Baucus has been saying that the public option is a bargaining chip to get insurers to embrace other reforms since March. There's no question that he and the White House saw it that way. But we're now in August, and support is collapsing, and the only thing holding this bill together are progressives, who don't really want to be humiliated anymore. Especially when we know that offering an individual mandate without a viable public insurance option would be political suicide.
Keeping in mind that this anonymously sourced report could be total bunk, it's worth pointing out that axeing the public option and requiring individuals to purchase coverage under a private health insurance plan would be a horrible political miscalculation. If you think we're having problems selling health care reform now, just wait until we try to explain why all adults under 65 will be required to purchase health insurance from the private sector with no public option.
Oh, you're not interested in making that argument? I didn't think so.
When coupled with a public option (or the sort of rigorous regulatory regime which isn't under consideration), a mandate achieves universal coverage and cures the free-rider problem. But without the public option, the private sector will have a monopoly on a product the public is required to buy, and over the long-run you'll almost certainly see premiums skyrocket and quality of care plummet.
Progressives don't support a public option because they're four year-olds and they reflexively support anything conservatives oppose. They support it because they want to see an end to the private insurance monopoly that's put the squeeze on them for decades. And no, the bill as designed currently wouldn't do that to the degree it must to reverse incentives, because it firewalls out those who get coverage from their employers; but these kinds of things have the tendency to evolve over time, and it's crucial that it's put into place now. Without doing so, Democrats are once again putting themselves at risk with losing a generation.
But on a political level, the left has been betrayed over and over again on the things that matter to us the most. The village is pleased, I'm sure. But the Democratic party only needs to look back eight short years to see just how destructive it is to constantly tell their left flank to go fuck themselves.
In 2000, I recall standing in line to see Al Gore speak here in LA and I was inundated by a bunch of young, impressionable lefties, inspired by the globalisation movement and Ralph Nader's message. We sparred for some time, me telling them how third parties don't work, and them having none of it. They had no political experience except what they saw as a betrayal of liberalism and they found Nader's analysis of the two parties as being in bed with corporate interests extremely convincing. And it was very hard to argue that point, although I did try valiently, knowing as I did that while both parties were corporate whores, the Republican Party, being insane, wanted to actually kill large numbers of people in foreign countries, put the church in everyone's bedroom and give everybody's money directly to the wealthiest people in the nation. But I didn't convince any of them. And we know the result.
At the time nobody believed that an incumbent Vice President in a roaring economy would have a race so close that the Republicans could steal it. But we know differently now don't we? And you would think that the Democratic establishment would also know that because of that, it may not be a good idea to alienate the left to the point where they become apathetic or even well... you know. It can happen. It did happen. Why the Democrats persist in believing that it can't happen again is beyond me. Perhaps they internalized all the villager CW about Al Gore being a bad candidate, but the fact remains that if a slice of the left hadn't been so disgusted by the New Democratic, mushy centrism of the Clinton years, he would have won.
Obama mobilized a whole lot of young people who have great expectations and disappointing them could lead to all sorts of unpleasant results. Success is about more than simply buying off some congressional liberals or pleasing the village. It's worth remembering that a third party run from the left is what created the conditions for eight long years of Republican governance that pretty much wrecked this country.
And that's where we're at right now. Obama can pretend Chuck Grassley is acting in good faith and renounce the public option in the name of bipartisanship (that's a really brilliant move by Grassley, by the way, he's playing in the big leagues), or he can support the people who elected him and believed in his message of change. I think those 60-odd million are more important than Sen. Grassley's feelings, but what do I know, I don't live in Washington.
I do know this: alienating your key supporters right when they're needed the most is a recipe for disaster.