Colorado Progressive

Last night I spoke with a Democrat named Marla, a mother of a friend. She told me that she writes to the president once a week, and that she’s been writing to Sens. Bennet and Udall as well recently in strong favor of a public option. That’s great, I told her. She went on.

“I told the president that if he dumps the public option, we’ll dump him!”

That’s where I asked for clarification. Marla’s argument is that if the president caves on the public option, then there’s really nothing left to call reform. Her views are pretty consistent with the liberal rallying cry these days, and I think that’s unfortunate. Matt Yglesias (who heavily favors a public option and a single-payer system) makes the point that reform without a public option can still include the following:

(a) subjects insurance companies to tough new restrictions,
(b) taxes employers who don’t provide decent health insurance to their employees,
(c) creates a new regulated marketplace in which individuals and small business employees can buy quality health insurance,
(d) expands Medicaid eligibility, and
(e) offers subsidies to ensure the affordability of insurance for middle class families

That’s all pretty exciting. If the president and lawmakers can reach middle ground, then at the end of the day I think we’ll see a bill that, for example, makes it illegal for insurance companies to dump patients who get sick. That alone would qualify as reform. Or how about Yglesias’ item (c)? In a new regulated marketplace where individuals can buy “quality health insurance,” insurers would not be allowed to discriminate based on preexisting conditions (keyword here is “quality”). Had cancer? Great, we’ll still insure you. Heart disease? No problem. Diabetes? Come on in.

Of course, there’s still the issue of 47 million uninsured Americans. But by holding insurers to their coverage commitments and by expanding Medicare access and overall insurance affordability, that number will come down. Item (b) will help to cut down on the number of underinsured Americans, as well, which will improve the overall public health environment. Finally, Yglesias makes the case that Congress can always come back to tinker and add to a passed reform bill in the future. If liberals get hung up on the public option today and don’t allow the Democratic leadership a little bit of room to maneuver, then there’s a chance we really will end up with an extremely weak bill that only comes together to save face for the White House.

For the record I have good health insurance and I support a public option. Of course, I think the country would be better served by a single-payer system, so the public option makes excellent sense to me. The truth of the matter is that health care in this country does not have to be for profit. Period. (Imagine if your public safety services were all privately run.) But that’s the system we have, and as we see today that’s a tough system to change. That doesn’t mean its impossible. If liberals lose sight, however, of which parts of the president’s plan actually stand to create measurable improvements in American’s lives, and if we treat reform as an all-or-nothing scenario with no room for incremental gains, then we’ll do ourselves a disservice in the long run.

By all means, write to the president (and your senators and representatives) this week and tell him you support a public option. But also tell him that you will be happy when your parent/child/spouse/sibling/partner/friend will be guaranteed coverage no matter what illnesses arise. Or that you will sleep easier at night when you know that losing your job does not mean losing your affordable health care coverage. That’s where reform can get a lot of good work done, even without a public option.