Public Option Is Not Dead Yet

The headlines are encouraging: The AP reports, “White House appears ready to drop ‘public option’.” Politico reads, “White House backs away from public health care option.” And the front page of USA Today says, “Obama may drop public option in health care.” These headers all stem from Health and Human Services Secretary Kathleen Sebelius’ comment on CNN Sunday Morning that the public option “is not the essential element” of President Barack Obama’s health care plan. But by Sunday night the White House was already walking back Sebelius’ statement.

An anonymous administration official told The Atlantic that Sebelius “misspoke” and White House health reform communications director Linda Douglass released a statement explaining: “Nothing has changed. The president has always said that what is essential is that health-insurance reform must lower costs, ensure that there are affordable options for all Americans and it must increase choice and competition in the health-insurance market. He believes the public option is the best way to achieve those goals.”

Obama’s allies on the left are equally emphatic about the non-death of the public option. Democracy for America head Howard Dean told the Washington Post, “I don’t think this bill is worth passing without a public option.” And Rep. Eddie Bernice Johnson (D-Texas), a member of the Congressional Progressive Caucus, told CNN, “It would be very, very difficult [to pass Obama's plan] without the public option.” But Democrats in the Senate are singing a slightly different story. Sen. Kent Conrad (D-ND) told Fox News Sunday that “there never have been” enough votes for a public option in the Senate, and that continuing to fight for it would be “just a wasted effort.”

But that does not mean that Americans fighting against government-run health care are out of the woods yet. Conrad insists that the Senate could pass health reform that includes health insurance co-operatives. Co-operatives do have a long and proud tradition in many sectors of the U.S. economy, but details matter. Conrad says these health co-ops will not be “government-run and government-controlled” but instead “membership-run and membership controlled.” But others in Conrad’s caucus have a starkly different co-op goal. Sen. Chuck Schumer (D-NY) is pushing a vision of co-ops that are: 1) run by the government, preferably the federal government; 2) funded or subsidized by the government; or 3) includes plans chosen by the government.

If the language that comes out of the Senate looks anything like what Schumer is proposing, then there is no real difference between co-ops and the public plan. If, on the other hand, the Senate produces something that; 1) is not funded by the federal government 2) is not “government-run and government-controlled”; but instead 3) is “membership-run and membership controlled” then co-ops would be acceptable.

Of course, the public plan is just one of the more objectionable parts of Obama’s health care plan. The individual and employer mandates, the expansion and federalization of Medicaid, the creation of a new health czar, not to mention the trillion dollar cost of the new plan, are all still intact. If, as Sebelius insists, the White House wants health reform to increase “choice and competition” than there are a number of conservative alternatives in the House and Senate that do just that by pursuing health reform through a “patient-centered” approach. The White House’s rhetoric is rapidly moving away from an expert/government-centered approach to health care and towards a more market/consumer model. Let’s hope their actions start matching their words.