And expect the rest of the conservative Democrats to hold out until pretty much the last minute too because it’s in their interests to do so, both to maximize their leverage and to wait as long as possible to commit themselves, getting as good a sense as they can of which way the political winds are blowing. This was a tightrope walk from the start. But I don’t think the rope any wobblier today than it was yesterday.

I think that’s a pretty good assessment. Marshall goes on to remind readers that much of this bluster may not translate procedurally. Cloture requires 60 votes, but passage only requires 50 votes. In theory (critics will trash this theory as politically naive, but I persist) Joe Lieberman, Blanche Lincoln, Mary Landrieu, Evan Bayh, Ben Nelson, and a handful of others could well argue against the merits of the bill and even vow that they won’t vote for it (in which case it only helps their case to raise the rhetoric now early and often) yet still allow the bill to advance procedurally to an up-or-down vote before voting against.

That’s the path to compromise that I see among Senate Dems right now. Reid only has to get enough votes for cloture, or moving the bill forward, and then he can let his conservatives cover their backsides by voting against the final bill. This in fact may be why Reid says “Joe Lieberman is the least of Harry Reid’s problems.”

This solution gets all parties to where they need to be. Blanche Lincoln could say I don’t like this bill and I don’t think the American people will like this bill, but that’s for the Senate to decide in an open vote. In this way she could explain her advancement of the bill and then vote against it and declare that she voted against a bill that was bad for her constituents. By that time it won’t matter to Reid and the White House, because 50 votes are already got. Republicans will of course make out that Dems who voted for cloture voted for the bill. Practically speaking, that may be true enough to be damaging. Factually speaking, however, those Dems will still have the vote against on the record and will readily bring this up during campaigns.

As if that’s not sad enough, the money quote doesn’t come from Baucus, even, but from San Francisco mayor Gavin Newsom: “We thought Democrats were in control of Congress. If we’re going to capitulate and give up on the public option, only we can be to blame if (reform) fails.”

To be sure, I’m not convinced that the public option is the only way to make headway with health care reform this year, but it certainly would be the most dramatic. And Newsom’s words cut to an interesting point. If Dems scuttled this whole bipartisanship charade and refused to even entertain the likes of Charles Grassley and Mike Enzi, whose ludicrous and insensible demands in the so-called name of bipartisanship are well documented, they really could hold the line and push through a public option. Of course, the right would vilify the party in power, but that’s happening anyway. And a couple of Blue Dogs would take considerable heat in their districts and really face some tough races in upcoming elections.

But then a funny thing would happen: the public option would come on line, and folks would enroll. After a few years–I daresay before Obama completes his second term in office–insurance companies would respond to the effects of a credible competitor with a completely different model. The result would be happier customers, all around. And by that time, Dems would be able to take credit–sole credit, as it were–for the success of health care reform.

Instead, saddled with a plan (Baucus’) that is “still too radical for conservatives and too meek for liberals,” Dems could be forced to take credit for a crappy piece of legislation. Fortunately the Baucus plan is not a stand-alone option. It’ll be reconciled with a whole lot of other paperwork before anything can even be prepared for a vote. Despite efforts to keep the price tag below a trillion and the plan deficit neutral, the White House seems reluctant to get behind Baucus just yet: “White House press secretary Robert Gibbs offered less than a full endorsement Wednesday, calling the Baucus plan ‘an important building block.’”

All of which must only add to Max Baucus’ sense of isolation today.

Lillis argues that single-payer health care should have been Democrats’ starting point in the quest for reform. Not because the single-payer system would have been a viable goal, but because anything else would have appeared moderate in comparison; for example, say, a public option.

Democrats pushing for a government-backed insurance option as part of their health reform strategy are finding out the hard way that, by taking single payer health care off the table early, they have little leverage now to force a strong public plan.

Unlike the Republicans, who adopted the strong conservative position of resisting almost every Democratic reform proposal from the start, Democratic leaders ruled out the liberal single-payer proposal early in the debate. Now in search of a centrist compromise, GOP leaders have plenty of room to maneuver, while Democrats are left facing proposals that either dilute the public option or eliminate it outright.

. . . By choosing the public option — not single payer — as the left-most negotiating point, Democrats left themselves with few places to go but toward more conservative proposals for insurance reform, experts say, including the co-op model and a system of triggering public plans only if private insurers fail to meet certain cost and coverage targets.

This makes appalling sense to me. Lillis goes on to point out that the key in Washington is to “over-ask” and then negotiate to your goal. This is Negotiation 101, right? So has the White House miscalculated in leaving the bulk of the “how” to lawmakers who were too timid to over-ask? Or did the White House expect that, by giving the “no haggle price,” colleagues across the aisle would simply say, “Oh, okay, that sounds like a good deal”?

That seems to be where current evidence is pointing. Single payer is a political nonstarter (today, at any rate), and the White House knows this. But Obama probably could have taken that risk (he wouldn’t be doing any worse now in public opinion polls) and asked a core group of Dems to write single payer into a bunch of drafts that everyone knew would be shredded in committee rooms and on the Sunday shows. But imagine how that would have framed the entire debate over health care as each faction played its proscribed role. Liberals would have squealed and given the president high marks for even mentioning the words. Blue Dogs would have balked, but they’d have seen how the president gave them room to play the good guys in the debate. Conservatives would have been outraged by single payer. They’d have demonstrated in the streets and rallied against big government, socialism, liberal spending sprees, government getting between patients and doctors . . . Who knows what craziness might have emerged? Wingers would have decried government “death panels” as a result of the single-payer system.

And then, from the ruckus of reactionary debate, a moderate voice would have piped up just after the August recess. Maybe it would be the president. Maybe it would be a seasoned congressional leader: A single-payer system, despite the fact that it works well for England, Canada, France, the Netherlands, Japan, Germany, Ireland and many more nations we consider prosperous allies, is not what Americans want or need. The majority of Americans who have insurance are happy with their insurance, and we want you to keep what works. That’s why we’ve decided to unveil a “public option.” This public option will allow you to keep the insurance you are happy with, buy quality affordable insurance if you currently aren’t covered, and it will create competition in the market by introducing a nonprofit model that will force the big, wasteful insurance companies to be more careful with your money if they want to stay in business.

Whew. That would have been sweet. Conservatives would have been up in arms, of course, and all the same rhetoric would have blared from the Republican machine. But we’d have heard it before, and thus the talking points would have lost their edge. Max Baucus, who might still be holding out for some whiff of bipartisan smoke from his finance committee bill, could have looked around the table and said “Okay, single payer is out. We’ll give you that. But the public option is good, it’s sound, it answers calls for compromise. So let’s get to work.”

The Obama administration and congressional Democrats need to push forward with their plan to pass a public option as part of a comprehensive health care overhaul when they return to Washington next month. We don’t see how it works without one.

It is the best way to slow escalating health care costs and expand access to quality care. The country, ultimately, will lose if the public option vanishes because of Democratic efforts to make health care reform a bipartisan effort.

Wow. Emphasis mine, and color me . . . impressed. Bipartisanship requires real effort and real measures on both sides, not simple obstructionism. Not only does the Post go all in on getting health care reform with a public option done, but the paper reminds readers of a relevant fact or two along the way:

A publicly run plan would allow government to administer insurance on a non-profit basis, contracting with hospitals and providers on rates, much as it does with Medicare.

Publicly run insurance would almost certainly spend less on administration than private insurance. A study by the Urban Institute puts Medicare and Medicaid administrative costs at about 5 percent, while private plans spend about 12 percent.

Some critics talk about government-run health care as if it were a great unknown. The truth is, government-run health care already covers about a third of Americans through Medicaid, Medicare, veterans’ care, and the military. These are highly utilized programs, and while not without troubles, have track records of providing good care.

Emphasis mine. Good to see the paper use its voice to drive some key points home.

“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.