Public option? Who cares?

Okay, the Senate Finance Committee has turned down the "public option" in its health care bill — to which I say, "So what?" If people actually were paying attention, they'd know that any real public option — to wit, one that actually could lower the cost of health care — never even was considered by either the Senate or the House.

The alleged public option was always nothing more than a choice for individuals forced to buy their insurance via local or regional "exchanges." It never was an option for employers, and employer funded health insurance is where the money is.

So, some paranoid Republicans possibly think such tiny and limited public options might be a "first step" towards SOCIALIZED MEDICINE (gasp, wheeze, urinate fresh white tennis trousers) and some not especially bright liberal Democrats think public options can successfully compete with private plans even under enormous constraints. Nothing ever has prevented the American Public from electing individuals who are enormously stupid.

If there's no public option for employers to buy into, there is no real competition. The so-called public option now under consideration is just a straw horse, set up so as to be knocked down — or not — but it doesn't matter to any real extent. It serves only to differentiate "liberal" Democrats, "moderate" Democrats, and Republicans — and if that's all that matters, we may as well roll over and go back to sleep.

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.