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Lieberman assailed for role in health-care debate

Lieberman scoffs at the theories of his motives. "I listen, but I tell them respectfully that they're as wrong about me as they are in reading my position," he said in an interview. "I was elected as an independent, and I'm going to do what I believe is the most sensible and the best. And as I see it, wherever that puts me, that's where it will be."

Lieberman says the public option is a sop to supporters of full government-run health insurance. He argues that the proposal lacks public support, although polls show a majority favor the concept. He says the government has no place in providing health insurance, despite its role in overseeing Medicare and Medicaid.

Most of all, he insists that a public option would drive the country further into debt. But this argument muddles how the new system will function and is at odds with independent assessments.

Under the Senate and House bills, those without employer-provided coverage would get income-based government subsidies to help buy coverage in a new insurance marketplace. The case for the public option is to reduce the cost of those subsidies by forgoing profits and reimbursing providers at lower rates, and by driving private insurers' rates lower via competition. A strong public option would lower the bill's cost by tens of billions of dollars, the Congressional Budget Office found.

But Lieberman has maintained that the public option alone represents a cost to the government. "He keeps saying over and over that we can't afford the public option, but the question is whether we can afford the subsidies," said John Holahan of the Urban Institute.

Confronted with the cost-saving assessments of a strong public option, Lieberman concedes the point, but he says an aggressive government-run plan would put undue pressures on medical providers and force them to shift costs to private insurers. Put simply, he opposes the public option in any form, regardless of whether it reduces costs. "If they really wanted to do something to deal with my concerns, they would take it out altogether," he said.

That is where the debate is heading. The latest alternative is a collection of private, nonprofit plans overseen by the Office of Personnel Management that would essentially mirror what is already in the proposed new insurance marketplace.

Critics say the new plans' nonprofit status would offer minimal savings -- many insurers today are nonprofit. The plans would have less leverage in holding down provider prices than would a strong public option. The rates for federal employee plans rose almost 9 percent this year. But Lieberman is interested, and in the current debate that is key.

"If it's private, and there's no federal government financial exposure, and the government's not creating an insurance company, that's a long way toward what I've been concerned about," he said.

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