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The Public Option – Doomed From the Start


The Public Option – Doomed From the Start

RoseAnn DeMoro

With the collapse of the dismal Republican healthcare bill, some Democrats are reviving talk of a public option as the cure for the holes in the Affordable Care Act that opened the door for the GOP attack.


Protecting the sacred private enterprise model at all costs–financial, human, whatever. Got to keep the profits rolling in, capitalism is the only economic system God has directly blessed and watches over. For pity’s sake. To the point of irrationality and outright idiocy, people cling to that delusion.


“Health care reform must preserve insurance industry profits” - B. Obama, September 9, 2009

Insurance is a financial product, not a health care product.


RoseAnn gives a clear reason for why pursuing a public option now as opposed to an all-out push for universal single payer (states or federal - whoever gets there first) is a poor strategy. What I want to know is why was a public option (Medicare like choice for someone under 65 while many others under 65 are covered through private insurance) ever considered? It sounds like a stupid idea for all the reasons given here - obviously someone who can get cheaper health insurance (because they are young and not sick) is going to get some bare bones policy and thus their money is not going to shore up the public version which will be filled with mostly high cost enrollees. Every time I heard someone (e.g. Kucinich who I mostly like) talk about the public option as something useful during the ACA discussion, I cringed.


In 2009 “the public option”, a contrived distraction, succeeded in distracting most Murkins from the devil in the details that Max Baucus, Liz Fowler, Billy Tauzin, and other ACA architects were inserting in the ACA, while doctors and nurses requesting a seat at the table were being hauled off in handcuffs


While I don’t think the public option has any chance of becoming law because the Republicans see it as a sneaky way to get single-payer, even if were to become law and failed I think there are enough single-payer systems in other countries to bolster the case for single-payer. The big problem with single payer is that it involves the government and Republicans will oppose it. Many Republicans have taken a pledge not to raise taxes for any purpose. The Republican Party would have to shift back toward the center for single-payer to become law. However, as far as I can tell the Republican Party is still moving right and some Republicans have now reached the area of white nationalism.


A public option was considered an option because when Obama’s boys and girls were constructing the ACA, he offered a "public option’ together with options that would have enriched the insurance and pharma combo options. Remember what happened? One of his henchman, Rahm Emanuel torpedoed the public option. Emanuel was/is a crook - both as when was an Obama advisor and as mayor of Chicago. I believed one of the proponents of the public option, holdout Dennis Kucinich, had been threatened to be thrown out of Air-force One if he didn’t giive up on his resistance. It would be crazy to go through this crap again. There is only valid public option, Medicare for all. Nothing less. This comment is in no means meant to critique RoseAnn DeMORO.


The Republicans have as much power as they do because the Democrats are as horrible as they are. They have been utterly wiped out, have refused to change leadership, or their policies, and have chosen to take direct corporate bribes. Now, it looks like the DCCC’s strategy is to focus on right wing Democrats to win in 2018. The Republicans win because the Democratic Party is rotten and polls show this. If there were a decent opposition party offering popular and progressive policies, the Republicans would be wiped out, and the Republicans are already a minority party with deeply unpopular policies. If I were a Republican, I would fully support the DCCC, the DNC and the Clintonites in that party. They’d be toast without them.

Another great article, by the way, from RoseAnn DeMoro. When I have more dough, I will donate to Commondreams.


AMEN!!  IMHO, the RePooplicans should formally declare Dirty Debbie Duhby-Ass (aka Debt-Trap Debbie / D.I.N.O. Debbie) a member of their party, and canonize her for the role she played in the DNC’s blocking of Bernie last year.  She could be their candidate for President in 2020, with Scott Walker as her running mate.  Perfect!!


That’s what happened. PNHP http://www.pnhp.org/ were hauled out of Congress in handcuffs. The public option (sold as a stepping stone to single-payer) was the Obama compromise for letting universal, single-payer go. However, all three were off the table in the negotiations over the gift to the insurance industry aka ACA. After the ACA was passed insurance stock skyrocketed, remember that.


“I happen to be a proponent of a single payer universal health care program…I see no reason why the United States of America, the wealthiest country in the history of the world, spending 14 percent of its Gross National Product on health care cannot provide basic health insurance to everybody. And that’s what Jim is talking about when he says everybody in, nobody out. A single payer health care plan, a universal health care plan. And that’s what I’d like to see. But as all of you know, we may not get there immediately. Because first we have to take back the White House, we have to take back the Senate, and we have to take back the House.” – Barack Obama, 2003"

In 2006, I spent a day with Obama in the U.S. Senate, and he said he supports a “debate” on single-payer, but that he also had started to have his doubts, now that he was in the Senate:

I asked him to give me some specific examples of what he meant. Is a proposal to convert America’s healthcare system to one in which the government is the single payer for all services revolutionary or reformist? “Anything that Canada does can’t be entirely revolutionary-it’s Canada,” Obama joked. “When I drive through Toronto, it doesn’t look like a bunch of Maoists.” Even so, Obama said that although he “would not shy away from a debate about single-payer,” right now he is “not convinced that it is the best way to achieve universal healthcare.”

By last week, it became clear that Obama and his allies in Congress will use their legislative leverage to prevent even a debate about single payer. Here’s the Associated Press: “Baucus and many others, including President Barack Obama, say single-payer is not practical or politically feasible.”

“Everything is on the table with the single exception of single-payer,” Baucus said."


I don’t understand why you think the public option is doomed from the start. If it has lower overhead, it would be less expensive for everyone. Therefore it would not only attract the elderly and sick, it would attract everyone. Also, private insurance could still be required to cover the elderly and sick at the same price as everyone else. With the public option the cheapest option, it would probably become insurance for all. I think you’re being overly pessimistic.


It’s interesting to hear the view the public option isn’t a good idea. We’re used to thinking of a spectrum, with no public healthcare on the ‘bad’ side, then targeted groups like veterans and Americans over 65, then the ACA, with the public option being the next good policy better than that, before single-payer. I don’t have the expertise really to evaluate the public option regarding this article’s argument quickly but it’s good to hear the case made to consider. Of course we want single-payer, but many would compromise on the public option in the meantime. This is a suggestion to not compromise.


Sell that to the Democrats.


It’s bad enough that Republicans want their base to have no idea what a risk pool means, but come on Democrats, stop lying, a public option doesn’t work.


What part of the different risk pool argument are you not buying? Reducing overhead (which a public option could achieve) is going to help significantly, but not more than 20-30% - after that any savings have to come from paying less (doctors will get less as some of them should and pharmaceutical companies would get less as most of them should) BUT that doesn’t really work if you aren’t the ‘single’ payer - I don’t think the public option can do much for cost control on the supply side. So if people were randomly assigned to public option vs barebones insurance, then I agree people with the bare bones insurance will go “this sucks, I’d rather be in the public option”. But if the public option is loaded with high risk and the bare bones with low risk - than that 20-30% is going to be immediately swamped with higher costs just because you have sicker patients.

It was always broken, and I’m embarrassed/pissed off at any politicians who wasted their time on such a concept (which got discarded anyway).


Aside from the serious cost problems detailed in the article and by other commenters, the public option is poor strategy politically because it doesn’t include everyone.

Social Security is the ‘third rail’ of American politics because everyone is entitled to it. When everyone is in, it’s darned difficult to pit one group against an ‘undeserving’ other the way they do with Medicaid, AFDC, food stamps, affirmative action, and every other program when they want to slash it to bits.

A public option that was mainly for the sick, elderly and low-to-middle income would live a politically precarious life even if (especially if) it was moderately successful.

We need to fight for policies that include everyone - because then everyone has a reason to fight for them.


The staunch corporate governance advocate chimes in once again to argue against single payer. DLC-redo No Labels will be ejaculating such propaganda as well.

Corporate Democrats for a time pretended to be for a public option in the MSM. In reality, they knew of course that Obama had already killed the public option in meetings with the Big Insurers and Big Pharma.

Such corporate Democrats are aligned with Republicans representing their clientele of corporations and wealthy individuals. It is that whole oligarchy thing you know.


It’s all about money, to be extorted from the poor folks that need coverage, that drives the profit making industry. The problem is that many folks still face financial ruin if they become ill especially if it’s a major illness such as cancer. The gift that keeps on giving, to the insurance industry, is Obama’s legacy. Granted a portion of the poor and un-insureable got covered but the inherent problems remain in high rates and high co-pays. These is no will in Congress to solve these issues as their rich sponsors grease the wheels of the keepers of the profit generating system known as Congress. I find it intriguing that there’s always plenty of funds to destroy nations on a continuous basis but never enough for the folks that live here. Oh, and it’s getting worse every day.


One of the best extortion rackets on the planet; the Mafia could never dream of this success.


It blows my mind that any “progressive” could be snookered once again by a so-called “public option”.

This time it is being used to dilute support for single payer.

Anyone who doesn’t realize this is being taken for a fool by corporate servicing Democrats who had Wellpoint write most of the ACA legislation, and who are hell bent on killing any advancing of an expanded Medicare as single payer.

Some on this forum will dishonestly construe this comment as support for Republicans.

Here is a preemptive “go cluck yourself”.