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Going public

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"If, as advocates argue at other times, the point is to insure sick people whom private companies, despite all regulatory efforts, find ways to shun, the public plan could offer a valuable safety net. But that wouldn't save money."

Now other analysts make the opposite case: that without the competition provided by an alternative, insurance companies will cling to their bad habits and costs won't come down. That the public option will attract a limited clientele and won't cripple the industry. That Medicare works pretty well, so why wouldn't this plan also be more efficient than profit-making giants?

I don't pretend to be able to resolve these arguments, but I do sense that a half-baked public option, if it passes, won't be able to live up to the hype.

"Mr. Reid's decision, made after two weeks of deliberations and under intense pressure by his party's liberals, assures that a public insurance option will be included in bills brought to the floor in both houses of Congress," says the New York Times.

"It is not clear that Mr. Reid has the 60 votes he would need just to bring the bill to the Senate floor if it includes the public insurance plan. Senate aides said Monday that Mr. Reid was several votes short of that goal."

"His decision does not settle the debate roiling Democratic ranks over how to create a government plan that would give consumers who don't get coverage through their employers an alternative to plans offered by commercial insurers," says the L.A. Times.

Washington Times: "Senate Majority Leader Harry Reid on Monday sought to assuage the left wing of his Democratic Party by deciding to include a government-run insurance plan in his health care reform bill, bypassing the lone Republican who supported the effort and ensuring a bruising political battle in pursuit of President Obama's top legislative priority."

Reaction on the right, from Allahpundit:

"I'm not sure what we're supposed to react to here, aside from the left's success in getting something with a public plan to the floor which (a) may not even have 60 votes behind it and (b) is almost guaranteed to lose The One's very small fig leaf of bipartisan support as Olympia Snowe walks away. Politically, I don't see how he had any choice except to cave to progressives. His reelection bid's already in trouble; if he'd stiffed them on their public-option fetish, he'd be finished. So here's his attempt at a compromise to save his own ass, featuring a P.O. watered down with a state opt-out clause to try to draw Blue Dogs but with enough tweaks to the tax threshold for 'Cadillac plans' to get big labor to stop grumbling about how this bill isn't 'robust' enough."

Josh Marshall does the math: "It's certainly a problem that a substantial number of Americans -- probably in red states -- would lack the public option. But by making it an opt-out rather than an opt-in, you start with a truly national program. That's the key. The default is everyone is in. Even if you had 1/3 or even, conceivably half the states (or half the total national population in however many states) opt out, you'd still have enough heft to make it have the desired effect."

Firedoglake's Jane Hamsher: "The only reason the public option stayed alive after every DC pundit said it was dead was because 68 members of the House said 'no public option, no bill.' It gave the Senate the nerve to go as far as they have."

HuffPost's Miles Mogulescu says that "Democratic leaders in Congress don't want to be the fall-guys in the murder of the public option. Too many of their constituents have become attached to it. The public option has in effect become a symbolic proxy for the activist base of the Democratic Party on whether Democrats are fulfilling their campaign promises or selling out to special interests. . . . Without it, all we're left with is Health Reform in Name Only."


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