The Life and Death of the Public Option

A lot of people seem to have their hands up in arms about the recent Administration positions on the Public Option stemming from the Sunday morning babble. However, like so much of the debate, I think this is a matter of more heat than light.

The story really comes from this NY Times article, as well as this Washington Post report.

The Administration, however, has not really changed position all that much. They have consistently supported the public option, but never said it was a line in the sand. They have said this from the beginning.

However, both Jon Cohn and Ezra Klein point out this has been a point that the Administration has sort of held from the beginning.

Can you fault the Administration for not pushing harder on this? Probably yes. Their messaging has been below par on this, and many other health care reform matters (sadly I think the issue as framed and thought of by everyone does not play to Obama's rhetorical strengths. However, as Nate Silver points out in his posts here and here (both of which are worth reading in full) even though popular with most people, it is not popular with the people who decide all of this, a subgroup of 6 who are a subgroup of 100 people who represent states rather than people.

Yet, here's the concern. It is that the desire for the perfect turn into the enemy of the good. The public option is a good thing. Many liberals really want it. I really want it.

However, what do I want more? I want major reform that would eliminate pre-existing conditions as part of health insurance. I want subsidies for lower income individuals. I want better risk pooling in exchanges. I want some start on the cost control matter, whether through an IMAC.

In other words, even without the public option, we could get a lot of these. And what are the stakes otherwise? Well, for starters the Democrats will have dug their own graves in the midterm election and harmed their own President in a very serious way. They will also help contribute to the status quo, and cause greater problems.

Even without the public option most of the reforms I, the blogs on my reading list, and other policy people have advocated for that are contained in the bills make a major, yet not entirely sufficient step toward fixing our system. That is very important, because, I think it actually builds momentum toward fixing it. If health reform fails over what is really a much smaller aspect of the puzzle than many other matters, it becomes off limits for another generation. That is something we just cannot afford on both a moral and even a fiscal level.