Go all out for the public option

By all accounts and appearances, President Barack Obama is plunging into national healthcare reform with a rear-view mirror affixed to his shoulder. In it, he sees Bill and Hillary Clinton attempting to ram a round single-payer healthcare bill through a square hole in Congress as lawmakers listen carefully to noisy, noncompliant lobbyists.

How else to explain why, as Obama touts the benefits of creating a public insurance plan to compete with private insurers, his top advisor, David Axelrod, is telling David Gregory on Meet the Press that the administration isn’t going to push the public plan too hard.

While Obama watches the Clintons crash and burn in the mirror, he’s perhaps also hearing the voice of Frank Luntz in his head. Luntz is the slimy Republican political consultant who creates scary catchphrases in order to kill genuine attempts at policy reform. Luntz recently sent a 28-page memo to Republican lawmakers that tells them how to frighten the public about a government “takeover” of healthcare. Luntz stresses to his pupils that the public wants reform and trusts Democrats more than Republicans to do it. It’s necessary to erode that trust, he says, by convincing people that the Democrats want to put “bureaucrats” between them and their doctors, which will “delay” treatment. “Delayed care is denied care,” he instructs them to say.

The irony, of course, is that the nightmarish picture Luntz recommends painting already exists—it’s just that it’s being perpetrated by the private insurance industry rather than the federal government. Denial of care is the modus operandi of insurers whose ultimate goal is profit, not medicine; the more they can deny treatment, the more money they make for shareholders. So, the burden is on patients to fight for care.

Regular CityBeat readers know that we favor a national healthcare system that eliminates for-profit insurance—yes, Mr. Luntz, a true government takeover. But we also understand that conservatives and moderate Democrats aren’t even close to letting that happen and that Obama favors incremental changes over sudden, wild policy swings.

But he must keep the pressure on for a competitive public plan, which is, by its very nature, a necessary incremental change; without it, in our view, there’s little point to reform at all. It’s the way to cover the 50 million Americans who currently have no access to care, and it’s the appropriate response to the trend of employers either chipping away at covered treatments or requiring employees to pay a larger premium—or both.

Obama must hammer home the idea that introducing a government option is right in line with conservative, free-market thinking. Conservatives love competition and choice as paths to lowered costs and better service. Offering a public plan provides another choice and creates more competition. But, perhaps more importantly, if done right, it would serve as a model for how things could be without the pressure to profit.

That, we think, is why there’s a backlash against the public option; the private insurers don’t want us to know there’s another way. And they, along with other stakeholders in the healthcare sector (doctors, insurers, drug makers, etc.), have been shelling out big bucks to make sure their interests are served in whatever emerges from the debate. In the two-year 2008 election cycle alone, the healthcare sector contributed more than $167 million to national political candidates, according to the Center for Responsive Politics (CRP), and $18.8 million of that went to Obama alone. Additionally, these industries spent $484.4 million in lobbying in 2008, almost $40 million more than was spent in 2007, CRP reports. More to the point, insurers have targeted moderate “Blue Dog” Democrats with larger contributions, and those lawmakers responded by urging Democratic leaders to shelve the public option.

Given the perils of politics, Obama is right to proceed cautiously, but not so cautiously that he undermines reform altogether. And he’s right to learn lessons from the Clinton debacle. But that was 16 years ago, and things have changed. The public has lost a considerable amount of faith in Corporate America and wants a public option by a wide margin.

The president must use the free-market benefits of introducing a government health plan to expose opponents as nothing more than protectors of the status quo and defenders of a system everyone knows has failed.

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