Reviving An Option

Our View: The Need To Ensure The Availability Of Affordable Health Care Insurance Is Too Great To Declare The Public Option Dead On Arrival, Despite The Senate's Misgivings

October 04, 2009

As discouraging as it was to watch certain members of the Senate Finance Committee treat the concept of affordable health insurance coverage as America's own Bolshevik Revolution last week, hope for a modicum of common sense in the U.S. Congress springs eternal. The battle over the public option isn't over yet, as there is at least one more card to play.

As House Speaker Nancy Pelosi has already promised, no matter what comes out of the full Senate, the health care reform bill approved by the House of Representatives will contain the public option. What happens in the inevitable conference committee is anyone's guess.

But how in the world could Senate Democrats get to the point where the concept of the public option - some quasi-government insurer offering a basic health insurance plan financed by premiums (not tax dollars) in order to keep private insurers from gouging consumers - is even particularly controversial?

What does that make Social Security or Medicare? America's embrace of Marxism? Good thing Franklin Roosevelt wasn't stuck with a U.S. Senate full of statesmen like Max Baucus and Kent Conrad. Instead of Social Security, the nation's elderly would be struggling today to figure out what their local "co-op" might be offering in the way of retirement pensions.

But that's not even a fair comparison. Social Security was a big step in 1935. The public option is something that state governments now offer routinely. Take, for instance, the 37-year-old Maryland Automobile Insurance Fund. It is essentially the public option for mandatory auto insurance, making sure that an affordable policy is available to drivers without taking the place of private companies like Allstate or GEICO.

This is a complex issue, and Republicans and other demagogues have had a field day twisting the facts and misrepresenting the proposed solutions. In such a hostile and confused climate, people attending town hall meetings are booing Medicare. Medicare! As if providing health care for the nation's elderly was something for which we should all be ashamed.

Make no mistake, the public option is no solution by itself. It's merely one way to ensure that if people are going to be required to purchase health coverage, insurance companies don't take advantage. As the nonpartisan Congressional Budget Office noted, it would probably be the choice of a small percentage of people whose employers don't offer heath insurance.

The criticism of it has gotten so confused and over the top, however, that opponents have argued that it's both too good and too bad - a predatory competitor and inevitably incompetent. How it can simultaneously be both is, well, just part of Bizarro World on the Potomac.

Still, the cost-saving public option may be on life support, but it's not dead yet. One encouraging sign is that the compromise floated last month by Republican Sen. Olympia J. Snowe of Maine - to have the public option be available only if private insurers fail to provide sufficient alternatives - was never offered to the committee and therefore neither endorsed nor rejected.

That opens the possibility that the so-called "trigger" amendment will be added instead at conference, a strategy that might give it the momentum, and votes, it needs to get through the Senate. Assuming the proposal sets a realistic minimum standard, we think that could be just what the doctor ordered.

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