Wednesday, June 24, 2009

RIP: Health care's public option

If you support the inclusion of a public option in the impending health care reform bill and you want to feel depressed, try this analysis, by Nate Silver, of the likely impact of PAC contributions on the votes of currently "undecided" Senators. Silver concludes that a bill that includes a public option has scarcely a chance of coming out of the Senate.

Of course, it doesn't help at all that Senate Majority Leader Harry Reid is second from the top on the list of those likely to be influenced by PAC money, and hence not likely at all to take any sort of leadership role on behalf of passing the bill the president seems to want.

I say "seems to want" because I'm not really clear on his level of commitment. He's been making the right noises in public, but is he twisting any arms behind the scenes? It's just that Obama's standard operating procedure seems to be making all the right noises in public, then backing off when public attention is diverted elsewhere. We've seen it with government transparency, Guantanamo, and other issues that nobody outside the civil liberties crowd is paying attention to anymore.

Yes, a substantial majority of the public wants a public option, and Obama is invariably responsive to public opinion -- in public. He's also aware that with or without the public option, he gets to be "the president who gave us (nearly) universal health insurance." Is it truly in his self-interest to push for a plan that actually could work -- by bringing down the cost of health care? Maybe. But probably not.

This is America, where substance always is secondary to appearance. So what if we get "health care reform" that consists entirely of forcing individuals and business owners, subsidized by taxpayers, to shovel even more money into the coffers of the HMOs and big pharma? Who cares? Obama?

We'll see. According to Silver, the public option needs eleven more votes in the Senate. How many senators will sign on? A lot of that depends on how hard the president is willing to work for those votes.

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