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Aug 16 2009, 7:13 pm

What The White House's Public Plan "Retreat" Really Means

There's a good argument going on Twitter about what President Obama wanted vis-a-vis the public plan, and what his team actually meant to do today. All I know is that the White House is NOT pushing back against news stories claiming that the "public option" has been essentially taken off the table by the White House.

What this means, however, is up for debate.

Because the President never insisted that a health care bill contain a public plan, he intended to use it as a bargaining chip. It was on the table so it could be consumed, or taken off, whenever  the White House felt it was useful.

No mistake: The President supports a public option. He's said that he won't sign a bill that doesn't include some competitive mechanism in the health care exchange that would cover most of the uninsured, and has said that a government-run program would be the best way to do that.  That's all he's said, though.

That's why Senate Democrats felt free to explore the cooperative option in the first place.

To be honest, I'm not entirely convinced that HHS Sec. Sebelius and Press Secretary Robert Gibbs went on television today in order to say anything about the public plan. Yesterday, Obama himself admitted that the public plan ain't really what the bill is about.

The White House -- and Democrats -- messed this up. Maybe it was inevitable. Somehow, and maybe I'll write this article for a magazine, the idea of the public plan became the sine qua non of meaningful reform for a very vocal portion of the Democratic intellectual elite. House Democrats embraced the idea.  If you equate health care reform with a public option, then, well, health care reform is dead to you.  There are a lot of angry liberals tonight. They are within their rights to feel aggrieved.

The White House DID play up the potential cost-cutting that a public plan might, sometime down the road, produce. Afterall, given the political environment at the time they first started to argue about health care, they had no choice: the public, Democrats in Congress were mouths-agape about the deficit. In polling and focus groups, cost works well. And the public option -- combined with the handy-dandy IMAC price commission proposal -- are curve-benders.

Before the health care debate began in earnest, I can tell you that very senior White House officials believed that some form of public plan was absolutely necessary to ensure that the overall bill would be seen as a cost-cutter.  That opinion changed roundabout three months ago when it became clear that even a public plan with a trigger mechanism -- Rahm Emanuel's preferred option -- just didn't have the votes.

Comments (9)

What do you mean by your last sentence "just didn't have the vote".
It has the votes in the house with the modification the Blue Dogs got.
In the Senate it has 50 votes but not 60. So to say the vote are not there means the "Conservative Democrats" are ready to join the R opposition and filibuster the public option therefore causing their Party to lose the 2010 congressional and senatorial elections and the 2012 presidential elections? I doubt it. But if you mean they are ready to filibuster than they are worst than the R because they enjoy all the perks of being in the majority and then go and stub their own party in the back. The word Democratic Party than means nothing (look at the R how a real party march in steps after they decide where to go!).
Anyway in this case they should do what Carville advises: Just let the real and Quislingian oppositions mount a real filibuster...

"To be honest, I'm not entirely convinced that HHS Sec. Sebelius and Press Secretary Robert Gibbs went on television today in order to say anything about the public plan."

It is not clear what Marc intends to say here. Also over all the post is quite confusing and not clear what the contention is.

Facts are: White House was ready from start to 'trade' the public option. When the heat came, it decided to drop it since simply there are no votes in Senate. Sen. Graham put forward quite a good argument about that on Ezra's blog - Americans already have a larger part of health care with government in the form of Medicare and Medicade (which Sen. Graham supports). With a public option, early year life span of an individual would also come under the preview of Government; essentially making this as a single payer system in the end. Some how the argument that Postal Service can survive with FedEx and UPS does not sound convincing. Republicans claim that a public plan eventually will kill Private Insurance Plans. Or the other possibility that government will land up generously supporting it which will bleed our finances further. The third possibility of Public Plan co-existing with Private Plans without draining our budget seems to be a tricky proposition, so delicately balanced. The point is virtually it seems impossible that such a balance can be achieved. (Unlike USPS with deficits of couple of Billions, we are looking at potentially hundreds of Billions shortfall possibly with the Public Plan.)

Liberals will have to come around the loss of Public Plan. This is the fight which will have to be left for another day if things do not improve. We will have to let 'things play out' by the proposed limits on Insurance Plans in proposed bills.

Even Atul Gawande like folks are not talking about Public Plan. The real core issue is the delivery system - will doctors and hospitals be paid for results or will be paid for the services provided as currently is the practice. Public Plan structured where it pays for service provided regardless of results will not help.

So the real loss of this reform is it does not talk about changing 'delivery system' - fee for results rather than service. It is not clear whether that is going to happen in the proposed reforms. Current signs are not encouraging in that regard.

Public Plan fight is essentially a boggy Liberals unnecessarily glued too.

"To be honest, I'm not entirely convinced that HHS Sec. Sebelius and Press Secretary Robert Gibbs went on television today in order to say anything about the public plan."

It is not clear what Marc intends to say here. Also over all the post is quite confusing and not clear what the contention is.

Facts are: White House was ready from start to 'trade' the public option. When the heat came, it decided to drop it since simply there are no votes in Senate. Sen. Graham put forward quite a good argument about that on Ezra's blog - Americans already have a larger part of health care with government in the form of Medicare and Medicade (which Sen. Graham supports). With a public option, early year life span of an individual would also come under the preview of Government; essentially making this as a single payer system in the end. Some how the argument that Postal Service can survive with FedEx and UPS does not sound convincing. Republicans claim that a public plan eventually will kill Private Insurance Plans. Or the other possibility that government will land up generously supporting it which will bleed our finances further. The third possibility of Public Plan co-existing with Private Plans without draining our budget seems to be a tricky proposition, so delicately balanced. The point is virtually it seems impossible that such a balance can be achieved. (Unlike USPS with deficits of couple of Billions, we are looking at potentially hundreds of Billions shortfall possibly with the Public Plan.)

Liberals will have to come around the loss of Public Plan. This is the fight which will have to be left for another day if things do not improve. We will have to let 'things play out' by the proposed limits on Insurance Plans in proposed bills.

Even Atul Gawande like folks are not talking about Public Plan. The real core issue is the delivery system - will doctors and hospitals be paid for results or will be paid for the services provided as currently is the practice. Public Plan structured where it pays for service provided regardless of results will not help.

So the real loss of this reform is it does not talk about changing 'delivery system' - fee for results rather than service. It is not clear whether that is going to happen in the proposed reforms. Current signs are not encouraging in that regard.

Public Plan fight is essentially a boggy Liberals unnecessarily glued too.

I just got an invitation from OFA NY to attend Eric Massa's Town Hall on Tuesday. My reply was crisp:
"I would only if there will be a public option in the plan".
Let them know that there are many more Blue People
than Blue Dogs!

This is what Pres. Obama said on July 18:

"That’s why any plan I sign must include an insurance exchange: a one-stop shopping marketplace where you can compare the benefits, cost and track records of a variety of plans – including a public option to increase competition and keep insurance companies honest – and choose what’s best for your family."

Re-read this paragraph. "...any plan I sign must include...a public option..." This sounds like a firm position. It sounds to me like he is insisting on a public option. This can be danced around forever, but the truth is that he didn't say a public option was a good idea, but that it had to be in the bill he signed.

Health plans divide people and employers into 'pools' for insurability. The purpose of the public option was to create an insurance option without 'pools' to deny coverage, raise rates and increase illness and injury problems for the next insurer.

Without a public option, abolishing the 'pool' altogether, along with eliminating preexisting conditions, annual and lifetime caps, agreement disclosure 'gotchas' or cancellations other than for nonpayment should make the process worth engaging again for those liberals you mention.

Let's do it!

You mean because Kent Conrad won't vote for it? and likewise, he says it's because it doesnt have the votes. Well that's because he's not voting for it.

movertyperguy

Well now wait a minute.

Unnamed administration officials have clarified the President's intentions for you, Marc, in this post over there where you said nothing has changed. That it was all just a big misunderstanding. That the public option is still not only ON the table, but pivotal in the President's plan.

http://politics.theatlantic.com/2009/08/administration_official_sebelius_misspoke.php

I must have better sources than you do regarding the President's intentions, because The President himself clarified his intentions to me just a couple of days ago.

Barack Obama: "That's why any plan I sign must include an insurance exchange: a one-stop shopping marketplace where you can compare the benefits, cost and track records of a variety of plans - including a public option to increase competition and keep insurance companies honest - and choose what's best for your family."

http://www.whitehouse.gov/the_press_office/Weekly-Address-President-Obama-Says-Health-Care-Reform-Cannot-Wait

That's Barack Obama on his own intentions ... not some alleged administration official.


An illuminating video on Obama's public option intentions:
http://www.gotchamediablog.com/2009/08/obama-on-public-option.html