I am as guilty as anyone of occasionally using some white-hot rhetoric that probably does nothing to convince the undecided or convert opponents. It’s mainly a feature of frustration combined with a feeling that the other side refuses to debate in good faith. I should probably try to be more like E.J. Dionne, who takes the time to lay out the case for the public option in terms the skeptics can understand.
Even if you are the type of conservative who has an ideological belief in the superiority of the ‘market’ to drive economic decision-making, you have to admit that the market needs to have competition to perform it’s magic. If you only have one cable television provider to choose from, that’s not a market economy; it’s a monopoly, and you are a captive customer. Wasn’t that the rationale for breaking up the telephone companies and allowing competition with the Post Office?
The conservative answer to this in the health care debate, so far, has been to change the laws so that health insurance providers can sell their products across state lines. That’s one way to increase competition. But in the situation we have now there are states where people have as few as two companies to choose from when they go to buy health insurance. The health care plans under consideration in Congress would allow for regional exchanges, so that people who are self-employed, for example, can band together across state lines to spread their risk around and get the same benefit in cost savings that people get through their employer-provided health insurance. Putting a public option into the mix of plans on the exchanges would assure that people are not in a captive customer situation.
Whether you are a conservative who wants to limit government spending or you are a centrist Blue Dog Democrat who wants to fix the budget deficit, you have to admit that the Congressional Budget Office says that a public option is the best way to save taxpayer dollars. It might be counterintuitive to believe that a bill that costs $900 billion dollars over ten years will actually improve the government’s bankbook, but the bill is fully paid for by cuts in other parts of the budget. If some of that savings is theoretical and might not fully materialize, it remains true that the government will save more money than it spends on this health care bill, in large part because it contains a public option. Budget hawks should be supporting the public option because it makes the legislation more affordable.
The reason the Republicans oppose heath care reform is partially ideological, but it’s also political. If the public option is popular, the party that created and protects it will also be popular. The Republicans don’t want to lose elections in the future because people see the Democrats as the party most likely to provide them with health insurance.
The reason that centrist Democrats oppose the public option is harder to discern. Polling shows that the public option is popular in most of their districts and especially so among the Democrats and Independents who voted them into office. It is the best way to protect the budget, which is their special concern. So, what’s the problem? It appears the problem is as simple as their desire to get campaign contributions from the health insurance industry and (probably more importantly) deny those contributions to any Republican challengers. I don’t know how to convince them to change their minds about this, but it surely involves making up for the money they’ll lose if they don’t do the insurance industry’s bidding. It’s just that none of us feels like giving them money when they are acting like pawns of the opponents of reform.
