one of the selling points was that it could or would lead to a single-payer system and also provide competition for the private insurance. The CBO now estimates that 10 million people will be enrolled in the public plan in 2019, Howard Dean has put the number lower at 5-10 million.
We are told that the proposed plans will not lead to single-payer by Secretary Sebelius and that the competition will be mild at best, nothing like the original talking points.
:(
This article is from June...
A pseudo-public option ... guess we'll find out
http://www.democraticunderground.com/discuss/duboard.php?az=show_mesg&forum=389&topic_id=5878900&mesg_id=5878900http://pnhp.org/blog/2009/06/17/sebelius-flat-out-never-single-payer/"...The proposal to provide a government-run Medicare-like program as an option for purchase within an insurance exchange of private health plans is vehemently opposed by the insurance industry, the U.S. Chamber of Commerce, the AMA, all Republicans, a large bloc of conservative Democrats, and many others. No amount of negotiation can resuscitate a Medicare-like option. It’s dead.
To avoid losing the support of the progressives and many of the moderates in Congress, efforts are being made to create a new private program that has distinguishing features, primarily cosmetic, that will allow them to mislabel it as a public option. The fear of opponents is that this pseudo-public option could later be transformed into a government-run program. Thus it is imperative that the design of the option would lock it up as a private sector model with no possibility of transformation. Without that assurance, the pseudo-public option will have to be eliminated during markup in order to salvage other reform policies. The opponents will never ever sign on to single-payer-in-waiting.
Those in the progressive community who abandoned single payer to support a public Medicare-like option, believing that this was the politically feasible strategy for success, simply haven’t been paying attention if they still really believe that a government-run public option can survive..."-------
Interviewer: What’s been the hardest thing for you to explain?
HHS Secretary Kathleen Sebelius: I think that the whole idea of the public option has been difficult, in part because I think some of the opposition has described it as a potential for a draconian scenario that was never part of the discussion in the first place. So disabusing people of what is not going to happen is often difficult because there is no tangible way to do that.
Interviewer: Can you say flat out it’s just never going to be single-payer health insurance, and we’re going to try to write it, if we can, so that it won’t ever be?
Secretary Sebelius: Oh I think that’s very much the case, and, again, if you want anybody to convince people of that, talk to the single-payer proponents who are furious that the single-payer idea is not part of the discussion..."
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THE HISTORY OF THE PUBLIC OPTION.
http://www.prospect.org/csnc/blogs/tapped_archive?month=08&year=2009&base_name=the_history_of_the_public_opti"...The rest is history. Following Edwards' lead, Barack Obama and Hillary Clinton picked up on the public option compromise. So what we have is Jacob Hacker's policy idea, but largely Hickey and Health Care for America Now's political strategy. It was a real high-wire act -- to convince the single-payer advocates, who were the only engaged health care constituency on the left, that they could live with the public option as a kind of stealth single-payer, thus transferring their energy and enthusiasm to this alternative. It had a very positive political effect: It got all the candidates except Kucinich onto basically the same health reform structure, unlike in 1992, when every Democrat had his or her own gimmick. And the public option/insurance exchange structure was ambitious.
But the downside is that the political process turns out to be as resistant to stealth single-payer as it is to plain-old single-payer. If there is a public plan, it certainly won't be the kind of deal that could "become the dominant player." So now this energetic, well-funded group of progressives is fired up to defend something fairly complex and not necessarily essential to health reform. (Or, put another way, there are plenty of bad versions of a public plan.) The symbolic intensity is hard for others to understand. But the intensity is understandable if you recognize that this is what they gave up single-payer for, so they want to win at least that much.
The alternative history question would be: What if they had pushed for single-payer all along? Could the political process then have sold them out and compromised by supporting the public option we now look likely to lose?"