Weekly Pulse: The Push for the Public Plan

Lindsay E. Beyerstein

This week, the AMA warned Obama that a public plan could restrict patient choice. But for millions of Americans, getting a choice between healthcare and no healthcare would represent a 100% increase in their healthcare options.

Healthcare reform is back in the news, as legislators and interest
groups spar over the promised public component of Obama’s healthcare
plan.

In very simple terms, this is a fight between groups with a vested
interest in expensive healthcare and everyone else. This week, the
American Medical Association warned Obama that a public plan could
restrict patient choice. But for millions of Americans, getting a
choice between healthcare and no healthcare would represent a 100%
increase in their healthcare options. Obama’s public plan would also
give people the choice of keeping their private health insurance. The
public plan is an additional option, not a diminution of options.

The AMA is a powerful interest group, but it doesn’t speak for all
physicians. Several prominent groups representing doctors and medical
students, including the American Association of Family Physicians, co-signed a declaration supporting Obama’s push for a public plan this week.

Expect the health insurance lobby to fight the public option tooth and nail, says economist Dean Baker in AlterNet.
It’s smart business from their perspective. Platitudes about the free
market aside, no real capitalist welcomes competition. As Baker points
out, a public plan represents competition to health insurance
companies. For every dollar Medicare pays to providers, it spends two
cents on administration. Whereas private insurers spend about fifteen
cents on the dollar in administrative costs. Baker estimates that if a
public plan were available, insurance profits would drop by 20-30%, all
things being equal.

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Former president Bill Clinton invited about 20 progressive bloggers
to his Harlem office on Monday for a seminar-style discussion about the
work of the Clinton Foundation. Several staff from Media Consortium
member organizations were in attendance, including yours truly.
Healthcare was a major topic of conversation. Emily Douglas of Rewire, who also attended the meeting, writes:

The former President observed that the
country, emerging from a "post-9/11 emotional straitjacket" has become
"more communitarian" – and that President Obama has fewer budget
issues, and less Republican opposition, to content with when attempting
reform.  But, most importantly, "everything is worse now" – health care
spending has doubled, more are uninsured, and disposable income,
adjusted for inflation, is down.

Clinton said that he’s optimistic about the prospects for healthcare
reform this year, but he encouraged Obama to drive a hard bargain with
congressional Republicans. All things considered, the former president
said, it would be better to pass healthcare with 60 votes for the sake
of the Obama administration’s long-term relations with congress. The
alternative would be to pass healthcare through budget reconciliation,
which would require only 51 votes, but which would incur a lot of
ill-will among Republicans. However, Clinton cautioned against writing
a weak bill to avoid reconciliation. In Clinton’s opinion, if we don’t
contain healthcare costs by moving to outcomes-based medicine and
making our healthcare delivery systems more efficient, the system will
be unsustainably expensive.

James Ridgeway of Mother Jones
has also been mulling the challenge of writing a bill that’s acceptable
to enough Republicans to avoid a budget reconciliation fight. Ridgeway
fears that sweeping structural reform will take a back seat to
political expediency. He fears that by trying to please everyone, Obama
could end up pleasing no one:

One disturbing possibility is that
health care could become a replay of the credit card legislation. The
pattern goes something like this: First, we get a propaganda blitz
heralding sweeping changes. But although the final legislation corrects
some of the most egregious abuses, it doesn’t change the system’s
underlying flaws. So, for example, insurance companies may be required
to cover people with preexisting conditions-a need Obama illustrated
vividly in his AMA speech with moving references to his mother’s battle
with cancer. We might see what the president called "more efficient
purchasing of prescription drugs," which presumably means faster
approval of generics and giving the government greater power to haggle
with Big Pharma over drug costs. We will likely see incentives for
health care providers to offer more cost-effective-and, hopefully,
better-treatment. These things are not meaningless, and they will
provide a modicum of relief to some struggling Americans. But they do
virtually nothing to strike at the deeper problems of the for-profit
health care system. And they offer only a fraction of the savings that
a single-payer system would provide.

If the healthcare debate sounds vague and abstract, that’s because
it is. There are several competing bills coalescing, but at this point,
there’s no overall vision for reform. Everything is up for grabs. Never
afraid to think big, Sen. Bernie Sanders (I-VT) is circulating a
petition for single-payer healthcare, with an assist from Chelsea Green.

Surely the weirdest healthcare story of the week comes from Tracy Clark-Flory of Salon: An
anti-choice blogger who claimed to be carrying a non-viable pregnancy
to term out of pro-life principle was exposed as a hoaxster when an
alert reader identified her "dead baby" as a doll. It’s not clear why
the 26-year-old social worker perpetrated the hoax. Jessica Valenti of Feministing injects a note of compassion for the perpetrator, "Though as angry as this makes me, I’m with Sadie at Jezebel
on this: ‘It’s tempting of course to use this as a chance to take an
easy bash at anti-choice, and revel in anything that makes them look
foolish, but frankly, I’m just sad for this woman.’ As am I."

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