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Medicare Part 'E'

It's a bit late in the game to start armchair-quarterbacking framing decisions, but I like Mark Kleiman's idea of calling the public option "Medicare Part E." The "E" is particularly clever, as it follows Medicare Part D (the drug program) and stands for "everyone."

That said, the problem for the public option has not been insufficient popularity. It's been the opposition of powerful interests, and through that, the opposition of crucial congressional votes.

By Ezra Klein  |  September 25, 2009; 11:48 AM ET
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Given that the Finance Committee has jurisdiction over Medicare and Medicaid, why aren't a whole lot more true blue, big state Democrats on the committee?

Posted by: bcbulger | September 25, 2009 12:19 PM | Report abuse

And Logic and Common sense.

If it weren't for those meddling realities I would have gotten away with it.

Posted by: fallsmeadjc | September 25, 2009 12:20 PM | Report abuse

"E" could stand for "Elite". A few posts ago, you mentioned some CBO estimates that (correctly) show a "savings" due to the infliction of a public option on unsuspecting Americans. These "savings" result in part from the fact that many providers will simply not perform certain services for the prices stipulated by such an Elite Option, making the subsidy unusable to many citizens and forcing these citizens to pay both tax and service fees while "saving the Government" tons of money due to unutilized (more properly, redirected) subsidies.

The good news is that if the Senate even tries to push through a public option all other legislation this term will be under extreme scrutiny and will face enough public opposition sufficient to stall any other monarchist initiatives. So, a public option (which could be easily amended in future terms) might actually be a long-term win for patriotic American constitutionalists.

Posted by: rmgregory | September 25, 2009 12:27 PM | Report abuse


Because the Democrats don't like to win, that's why. The Dems are scared of their base, while the GOP cannot get enough of theirs. I think it mirrors the interests of DC, and it's reflected in everything from Dem Senate procedures, to a "debate" w/ the Southern Party over a small cost-reducing, widely popular, competition-increasing program to provide public health insurance.

Posted by: Chris_ | September 25, 2009 12:31 PM | Report abuse

"the problem for the public option has not been insufficient popularity. It's been the opposition of powerful interests, and through that, the opposition of crucial congressional votes."

When you phrase it like this, Ezra, the implication is that any measure, no matter how popular, will lose if powerful economic interests are opposed.

We both know that beating those interests is almost always an uphill battle, but they can be beaten.

The problem with the public option IS insufficient popularity in the sense that while it polls well, that support is largely pretty shallow. People like the idea to the extent that they understand it, but people haven't been SOLD on it; hell, most people aren't really sure what it IS.

Calling it Medicare Part E wouldn't be a magic bullet, but it would lift the public option out of the overall clutter of the health care debate, which would be a good first step towards selling people on it.

And that's what you need to beat powerful economic interests: not just broad support in a poll, but a fairly large subset of people to whom the issue matters, and matters a great deal.

Anytime nobody's paying attention, the interests will win. But if people are clearly paying attention, and are clearly going to be pissed if their Congresscritter votes the other way, then you've got a decent chance to beat the interests.

That's what we don't have here with respect to the public option: any reason for Congresscritters to believe the voters will stick it to them if they vote against it.

Posted by: rt42 | September 25, 2009 1:18 PM | Report abuse

The public option is even popular with a majority of GOPers per the CBS poll this am. It IS a matter of packaging.

If we had started with Medicare for All (or at least letting people buy in starting at age 50 with a basic plan for everyone else with subsidies and the Medicaid boost) and the cost-cutting measures in the Baucus Bill we could be done with it by now and it would have been a real improvement while bending the curve downward.

Obama couldn't think big enough and Baucus/Conrad couldn't buck their insurance co patrons. Too bad for all of us.

Posted by: Mimikatz | September 25, 2009 1:20 PM | Report abuse

Or to put it another way:

Instead of Medicare-for-All, let's try Medicare-for-Anyone.

Posted by: jshafham | September 25, 2009 3:48 PM | Report abuse

I like Kleiman's proposal a lot, but I think I have actually seen it bandied about in comments some time ago on this very blog. It is a great frame which is why I think this administration will avoid it.

Here is a link from 2007:

Posted by: Nat_51 | September 25, 2009 10:49 PM | Report abuse

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