POLITICS: Is the Public Option Really Dead?
Howard Dean, former chairman of the Democratic Party, has bluntly stated that no health care bill is better than the health care bill proposed by the Senate. His reasoning is that the Senate bill is complicated, therefore, making it a target for Republicans.
Dean’s opinion is that the House and Senate should scrap the bill and start over so that they can simplify the bill and get the reform they set out to achieve in the first place, specifically either a public option or expanding Medicare. While I absolutely agree with Dean that the bill needs a public option or something similar to it to put the insurance industry in serious check, I disagree with him that we should just kill the bill and start over. I disagree for a few reasons.
Democrats are not going to have such a large majority forever. The 2010 elections are coming sooner than we think and Democrats are bound to lose at least a few seats. It has taken them nearly a year to get this far and trying it all over again would put any form of health care reform at risk. The public is getting more anxious all the time and the more the debate goes on, the more the public gets tired of it. According to Gallup polls, support is slumping for health care reform the longer it goes on. Support was above 50% in September and it has now waned to the high 40’s. The lag in support could be due to the tiring debate or lack of a public option, but either way the overall support has dropped.
While the health care bill lacks what I and many others would prefer, a public option, it still has plenty to offer. No more getting denied health care because of a pre-existing condition. That change is long overdue, especially because some insurance companies have listed things like domestic violence as an uninsurable pre-existing condition. Patients will also be protected from being dropped by insurance companies. People with incomes of up to 400 percent of the poverty level would be eligible for subsidies to help them buy insurance, while families with an income of less than 133 percent of the poverty level would be covered under Medicaid (insuring an additional 14 million people). Small businesses will receive tax breaks to help them ensure their employees. The nonpartisan Congressional Budget Office projects about $1 trillion in savings over 20 years if the bill passes. Any of these measures by themselves are worthy of passage, just as was expanding health care for children through SCHIP earlier this year. In sum, they form a very strong bill.
It is important to remember that there is still a lot up in the air about what the final bill will look like. Rep. John Conyers (D-Mich.) and Sen. Russ Feingold (D-Wisc.) have been very vocal about continuing to fight for more competition, specifically the public option. Conyers said the following:
“My message to the these Senators is this: Just as it took compromise to pass your bill last night, so now will it require additional compromise to successfully reconcile your legislation with the House.”
Fiengold added:
“I will be urging members of the House and Senate who draft the final bill to make sure this essential provision [the public option] is included.”
However, Feingold also said that if the public option does not make it into the final bill, it still offers “meaningful reform.” There are plenty of legislators that are sure to do all they can to get some form of a public option in the final bill. Yet, even if a government-run option does not come out of the bill, it is still a great step forward — with room for even more progress in the future. As Sen. Al Franken (D-Minn.) said, “It’s something we can build on. Social Security passage was [originally] just widows and orphans.” What happened with the expansion of Social Security could very well happen with health care in the future.
There are still questions about how the House and Senate bills will merge, but even if the public option does not make the final bill, it is still a great bill. Supporters of health care reform, especially Democrats, should not let one missing provision overshadow how much this bill will accomplish and the doors it will open for people.
Randal Serr is a liberal political columnist for Rhombus. He is currently pursuing a graduate degree in public policy at the University of Utah.


I think I would actually agree with Howard Dean, this is a huge deal for our country. Why rush it just because we can? Shouldn’t health care reform take longer to make sure we iron out as many wrinkles as we can? It seems those who want to get it passed ASAP are more concerned with the “winning” of getting it passed than actually providing the best health care for the nation.
I also don’t think we would want health care to do the same thing that Social Security has. Maybe I have my facts wrong, but it seems people are afraid of not having any SS because it’s drying up.
We’ve already spent a long time on this. It’s been almost eight months of formal negotiations. Congress NEVER spends this long on anything and I’m glad they did on this. This is a good bill, not a great bill. It’s imperfect, but it makes a lot of important steps in the right direction. This is an historic bill for our nation and its people. I’m glad it passed.
And I think you missed the point on Social Security, Jon. The point is that Social Security was only targeted at a select few when it originally passed and subsequently expanded to cover everyone. It wasn’t about Social Security itself, but rather it’s expansion. While this bill doesn’t do everything progressives want it to do right now because of political necessity, it could easily be expanded on in the future, just like Social Security was. It’s just important to pass the original bill and start moving in the right direction.