Robert Reich: Harry Reid, and What Happened to the Public Option
Tom Davos
Thursday, November 19, 2009
Harry Reid, and What Happened to the Public Option
First there was Medicare for all 300 million of us. But that was a
non-starter because private insurers and Big Pharma wouldn't hear of
it, and Republicans and "centrists" thought it was too much like what
they have up in Canada -- which, by the way, cost Canadians only 10
percent of their GDP and covers every Canadian. (Our current system of
private for-profit insurers costs 16 percent of GDP and leaves out 45
million people.)
So the compromise was to give all Americans the option of buying into
a "Medicare-like plan" that competed with private insurers. Who could
be against freedom of choice? Fully 70 percent of Americans polled
supported the idea. Open to all Americans, such a plan would have the
scale and authority to negotiate low prices with drug companies and
other providers, and force private insurers to provide better service
at lower costs. But private insurers and Big Pharma wouldn't hear of
it, and Republicans and "centrists" thought it would end up too much
like what they have up in Canada.
So the compromise was to give the public option only to Americans who
wouldn't be covered either by their employers or by Medicaid. And give
them coverage pegged to Medicare rates. But private insurers and ...
you know the rest.
So the compromise that ended up in the House bill is to have a mere
public option, open only to the 6 million Americans not otherwise
covered. The Congressional Budget Office warns this shrunken public
option will have no real bargaining leverage and would attract mainly
people who need lots of medical care to begin with. So it will
actually cost more than it saves.
But even the House's shrunken and costly little public option is too
much for private insurers, Big Pharma, Republicans, and "centrists" in
the Senate. So Harry Reid has proposed an even tinier public option,
which states can decide not to offer their citizens. According to the
CBO, it would attract no more than 4 million Americans.
It's a token public option, an ersatz public option, a fleeting
gesture toward the idea of a public option, so small and desiccated as
to be barely worth mentioning except for the fact that it still (gasp)
contains the word "public."
And yet Joe Lieberman and Ben Nelson mumble darkly that they may not
even vote to allow debate on the floor of the Senate about the bill if
it contains this paltry public option. And Republicans predict a "holy
war."
But what more can possibly be compromised? Take away the word
"public?" Make it available to only twelve people?
Our private, for-profit health insurance system, designed to fatten
the profits of private health insurers and Big Pharma, is about to be
turned over to ... our private, for-profit health care system. Except
that now private health insurers and Big Pharma will be getting some
30 million additional customers, paid for by the rest of us.
Upbeat policy wonks and political spinners who tend to see only
portions of cups that are full will point out some good things: no
pre-existing conditions, insurance exchanges, 30 million more
Americans covered. But in reality, the cup is 90 percent empty. Most
of us will remain stuck with little or no choice -- dependent on
private insurers who care only about the bottom line, who deny our
claims, who charge us more and more for co-payments and deductibles,
who bury us in forms, who don't take our calls.
I'm still not giving up. I want every Senator who's not in the pocket
of the private insurers or Big Pharma to introduce and vote for a "Ted
Kennedy Medicare for All" amendment to whatever bill Reid takes to the
floor. And if this fails, a "Ted Kennedy Real Public Option for All"
amendment. Let every Senate Democratic who doesn't have the guts to
vote for either of them be known and counted.