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The many lives of the public option

PH2009102800254.jpg

Nate Silver marvels that the public option isn't dead yet, and lists the five surprises that have brought us to this point. I'm a bit less confident than he is that the option isn't, for all intensive purposes, dead. There's been one surprise, I think, and that's been the effectiveness of the activist left at convincing the elected center-left that they'll face real anger if they appear to be abandoning the public option. But we haven't yet cleared the hurdle that led so many people to write the proposal's eulogy months ago.

Skeptics of the public option's political chances held that Olympia Snowe, Ben Nelson, Evan Bayh, Mary Landrieu, Blanche Lincoln, and one or two others would force a deal that killed the public option in all but name (the "trigger" falls into this category, as, arguably, does Carper's original idea to allow states to build their own public options). Harry Reid, for his part, did the thing you'd want to do whether or not the public option is going to pass: Put it to a vote before the Senate. If the moderates mean to kill it, they have to do so publicly. Reid, I think, realized something important: It's one thing for the left to be defeated on its top priority. It's another thing for it to be screwed. What Reid has done is ensure that it's not screwed.

In doing so, however, he also did the thing you'd want to do if you want the option to pass: He opened the moderates to tremendous pressure, and arguably isolated them. We're likely to see a vote in which 55 or more Senate Democrats vote for the public option, as do almost all House Democrats. You could imagine the provision being stripped from the Senate bill in order to clear the filibuster, but then what happens in conference, when the Senate has to reach some minimally acceptable compromise with the House?

When health-care reform is finished, there are going to be two books worth writing. The first is the book about the public option, which is also the book about the health-care reform fight that most of us watched. The second is the book about everything else, which, in part because of the consuming controversy around the public option, happened quietly and largely behind closed doors.

Photo credit: AP Photo/Susan Walsh.

By Ezra Klein  |  October 30, 2009; 11:31 AM ET
Categories:  Health Reform  
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Comments

"for all intensive purposes"
Have you been hanging out with Yglesias again?

Posted by: _SP_ | October 30, 2009 11:49 AM | Report abuse

That's "intents and purposes."

Posted by: LADemocrat | October 30, 2009 11:49 AM | Report abuse

Intensive purposes?

I hope that was a joke.

Posted by: josephanzalone | October 30, 2009 11:51 AM | Report abuse

Ezra is starting to sound like Kent Conrad regarding co-ops.

He wasn't able to get his Wyden-Bennett style increased exchanges to get any traction through his blog.

So now he just concern trolls about the public option and seems to hope for it's eventual demise.

Getting pretty boring.

Posted by: PorkBelly | October 30, 2009 11:57 AM | Report abuse

Exactly, when Senate meets House in Conference; Senate vote block with no Republicans is absolutely not going to have any spine to withstand House pressure in undertaking wrong bill: wrongly financed, with no iMAC and with generous PO. That is what Harry Reid has done - essentially wipe out any capacity of Senate in Conference to negotiate for moderation. With no GOP vote at risk to loose in Senate, House is going to get a free run in Conference.

Posted by: umesh409 | October 30, 2009 12:02 PM | Report abuse

Actually, there's a third book to write, namely, how the conventional media simply ignored the numbers (Dem. v. GOP in Congress) and simply wrote off the Public Option.

Then when reality set in and the Public Option came sprinting back, they had to explain it as some form of resurrection.

The truth is, the only place the PO was ailing was in the minds of the MSM which routinely discounts progressive policy initiatives, choosing instead to inhabit a world where possibilities are defined by the likes of Joe Lieberman and Chuck Grassley.

Anyway, that's the book I'd like to see get written.

Posted by: leoklein | October 30, 2009 12:28 PM | Report abuse

if the house was so in favor of the public option they would have gotten medicare +5. They're not. And the watering down will continue.

they'd be better with a trigger to a robust public option.

Posted by: visionbrkr | October 30, 2009 12:32 PM | Report abuse

Ezra: I hope you write the book about everything else. The public option has received waaay to much attention.

Posted by: BillKramer1 | October 30, 2009 12:40 PM | Report abuse

Apart from the "Obama's playing 11-dimensional chess" argument, nothing makes me madder than the "public option has received waaay to much attention" argument.

The public option is health care reform. In the history of the world there has NEVER been a system that controlled health care costs without government-administered payment rates. That's because there is no competitive market in health care--and there never will be.

The fact that this public option has been crippled to the point where it is meaningless, says nothing about the validity of the underlying idea.

The problem is we don't have leadership in today's Democratic party that is willing to stand up for good policy. Here is the money quote from Politico regarding the disagreement between Schumer and Emanuel over the public option:

“neither one could care less which public option mechanism is used”

Posted by: bmull | October 30, 2009 1:33 PM | Report abuse

Bmull - although "government administered payment rates" doesn't mean the same thing as the public option. Plenty of countries don't have a public plan - Switzerland, etc. - they just ban private insurers from making a profit.

PorkBelly - oddly, Ezra hasn't blogged about the fact that the House bill's version of the Exchange, while not as open as the Wyden version, is open to much larger employers.

Posted by: StevenAttewell | October 30, 2009 1:46 PM | Report abuse

Come on! The public option is no more alive than it was several weeks ago. PO trigger is the best the Senate will get. For all her talk, Pelosi was quick to abandon a public option tied to Medicare and Senate won't even get that far.

If i thought Reid and Pelosi were this capable i'd believe that their continued focus on the PO is designed to distract Republicans from other aspects of the bills and to create the impression that the PO is the only hurdle to overcome.

Posted by: mbp3 | October 30, 2009 2:43 PM | Report abuse

Come on! The public option is no more alive than it was several weeks ago. PO trigger is the best the Senate will get. For all her talk, Pelosi was quick to abandon a public option tied to Medicare and Senate won't even get that far.

If i thought Reid and Pelosi were this capable i'd believe that their continued focus on the PO is designed to distract Republicans from other aspects of the bills and to create the impression that the PO is the only hurdle to overcome.

Posted by: mbp3 | October 30, 2009 2:44 PM | Report abuse

The Left's main priority is a single-payer system. The public option was their compromise. They planned for it to be the next big step towards their main priority. That approach is failing largely because pipe dream ideas don't stand up very well to the light of day. The left's ideas for the healthcare industry are stupid. They would make everything worse. It's time to look at better ideas.

Posted by: fallsmeadjc | October 30, 2009 4:12 PM | Report abuse

"in part because of the consuming controversy around the public option"

This is beneath you Ezra. Deals were made behind closed doors because that's what politicians and special interests do, and our media is nearly worthless. There could be no public option and that would still be true. Indeed, since you admit the media thought the public option was so dead it wasn't even worth talking about, it's hard to see how you blame liberals for the media's failure to cover other deals.

Posted by: Hopeful9 | October 30, 2009 4:52 PM | Report abuse

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