Since last Thursday when Sen. Cantwell started calling her “basic health plan” proposal a “public plan,” I have been very troubled. Unfortunately, several media outlets have uncritically repeated her claim that it is a public option.
I don't dislike Cantwell's basic health amendment. In fact, I think it has some merit even if it is far too limited. It allows states to use the power of a large purchasing pool to negotiate better prices from private insurance companies. It could help some low income Americans get private health insurance at a better price, but it is in no way a public option. People would still be insured by private insurance companies. Most writers who focus on health care policy agree that it is not a public option (1,2,3).
Given that the issue of a public plan has become a political flash point, it seemed very strange to me that Cantwell would call her proposal a “public plan.” Calling her “basic health plan” proposal a “public plan” should hurt its chances of becoming law. Conservatives will attack it for being a public plan, and progressives will attack it for being woefully insufficient as a public plan.
Now, thanks to a Chicago Tribune article about Obama lobbying conservative Democrats on the issue of a public option, I think I have an explanation:
When Obama spoke by phone recently with Sen. Maria Cantwell, D-Wash., he made a point of the breadth of support for the public option, the senator said in an interview. Cantwell authored a proposal to let states set up public plans that Democrats added to the Senate Finance Committee bill on Wednesday.
This is very strange. Obama does not need to tell Cantwell that Americans want a public option. Cantwell strongly supports a public option. She voted for both public option amendments in the Senate Finance Committee hearing.
I think the purpose of the call was to ask Cantwell to try to mislead American into thinking her “basic health plan” is a public option. The evidence is that Obama does not plan to fight for a real public option, but only wants some fig leaf so he can tell the base that there is a public option. It sounds like Obama wants to try to use Cantwell's proposal as the newest fig leaf.
Expect to see administration officials soon falsely claim that Cantwell's proposal is a public option. It is the kind of fake “compromise” the health insurance industry is unlikely to really fight. It is not a public health insurance alternative to the private insurance companies. It is only a mechanism to get a better price from private insurance companies. Cantwell's amendment, without a public option, still means the private health insurance companies will get millions of new consumers without competition from a public entity. The idea is completely unacceptable as an alternative to offering people the choice of a real public option.
I strongly hope Sen. Cantwell will stop calling her proposal a public plan. The American people deserve a serious debate about the public option. Actively trying to muddle a honest policy debate is unacceptable regardless of political affiliation. Don't let a decent idea be used as a way to trick the American people.