SALON

Monday, Aug 17, 2009 5:18 PM UTC

The public option’s last stand

We'll have no one to blame but ourselves if healthcare reform doesn't include a public option

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Topics: Healthcare Reform

The public option's last stand

I would have preferred a single-payer system like Medicare, but became convinced earlier this year that a public, Medicare-like optional plan was just about as much as was politically possible. Now the White House is stepping back even from the public option, with the president saying it’s “not the entirety of healthcare reform,” the White House spokesman saying the president could be “satisfied” without it, and Health and Human Services Secretary Kathleen Sebelius saying that a public insurance plan is “not the essential element.”

Without a public, Medicare-like option, healthcare reform is a bandaid for a system in critical condition. There’s no way to push private insurers to become more efficient and provide better value to Americans without being forced to compete with a public option. And there’s no way to get overall healthcare costs down without a public option that has the authority and scale to negotiate lower costs with pharmaceutical companies, doctors, hospitals, and other providers — thereby opening the way for private insurers to do the same.

It’s been clear from the start that the private insurers and other parts of the medical-industrial complex have hated the idea of the public option, for precisely these reasons. A public option would cut deeply into their current profits. That’s why they’ve been willing to spend a fortune on lobbyists, threaten and intimidate legislators and ordinary Americans, and even rattle Obama’s cage to the point where the administration is about to give up on it.

The White House wonders why there hasn’t been more support for universal healthcare coming from progressives, grass-roots Democrats, and Independents. I’ll tell you why. It’s because the White House has never made an explicit commitment to a public option.

Sen. Kent Conrad’s ersatz public option — his regional “cooperatives” — won’t have the scale or authority to do what a public option would do. That’s why some Republicans say they could buy it. What’s Conrad’s response? “The fact of the matter is there are not the votes in the United States Senate for a public option. There never have been,” he tells “Fox News Sunday.” Conrad is wrong. If Obama tells Senate Democrats he will not sign a healthcare reform bill without a public option, there will be enough votes in the United States Senate for a public option.

I urge you to make it absolutely clear to everyone you know, everyone who cares about universal healthcare and what it will mean to our country, that the bill must contain a real public option. Tell that to your representatives in Congress. Tell that to the White House. If you are receiving piles of e-mails from the Obama e-mail system asking you to click in favor of healthcare, do not do so unless or until you know it has a clear public option. Do not send money unless or until the White House makes clear its support for a public option.

This isn’t just Obama’s test. It’s our test.

Robert Reich, one of the nation’s leading experts on work and the economy, is Chancellor’s Professor of Public Policy at the Goldman School of Public Policy at the University of California at Berkeley. He has served in three national administrations, most recently as secretary of labor under President Bill Clinton. Time Magazine has named him one of the ten most effective cabinet secretaries of the last century. He has written 13 books, including his latest best-seller, “Aftershock: The Next Economy and America’s Future;” “The Work of Nations,” which has been translated into 22 languages; and his newest, an e-book, “Beyond Outrage.” His syndicated columns, television appearances, and public radio commentaries reach millions of people each week. He is also a founding editor of the American Prospect magazine, and Chairman of the citizen’s group Common Cause. His widely-read blog can be found at www.robertreich.org. More Robert Reich.

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On March 21, 2010, the House voted to approve a healthcare bill intended to overhaul the system and guarantee Americans access to health insurance. The vote was 219 to 213. Problem solved? Hardly.

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