Fixing Health Care Does Not Require a "Bi-Partisan" Bill -- It <i>Does</i> Require a Public Health Insurance Option

While a public health insurance option may not have bi-partisan support in Congress, it has big time bi-partisan support among the voters.
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The private insurance industry and its spokespeople in Congress are frantically making the argument that for health care reform to last and have the support of the American people, Congress must pass a "bi-partisan" health care reform plan.

Of course you never heard a word about "bi-partisanship" from the insurance industry or Republicans when they passed the notorious "Medicare Part D" prescription drug plan in 2003. Back then, they froze Democrats out of all negotiations, and passed the bill on a 220 to 215 vote in the House (with only 16 Democrats voting yes). In fact, Medicare Part D would be their idea of a "good" health care "reform": taxpayer subsidies for private insurers with no competition from a public plan. And if we went that route, the results of health care reform would look pretty much like the results of Part D as well - no cost control, giant gaps in coverage, and confusing options for consumers.

Now that the political tide has turned, and last year's economic collapse has given voters a fresh lesson in the consequences of turning public policy over to corporate CEOs and insurance giants like AIG, the Republicans and insurance companies have had an eleventh-hour conversion to the benefits of "bipartisanship" when it comes to health care reform.

It's no surprise then that in the current debate, the advocates of this position have made it clear that, to them, "bi-partisanship" means one thing: Americans should be denied the choice of a public health insurance option like Medicare. Their problem is that while a public health insurance option may not have bi-partisan support in Congress, it has big time bi-partisan support among the voters.

In fact, of course, it won't matter one whit to average Americans whether the bill passed by Congress is "bi-partisan." What will matter is that:

  • Something gets passed.

  • It provides health care for everyone.
  • It puts the brakes on skyrocketing health care costs.
  • In the current context, there is no way to provide these things without also providing us with the choice of a public health insurance plan that would compete with private insurance companies, and keep them honest.

    Average Americans know that they have been at the mercy of private health insurers for too long. After the health care mess that they have created, insurance companies can hardly expect everyday voters would be real keen about handing them the exclusive right to provide health insurance to everyone in America who is ineligible for Medicare, Medicaid or Veteran's benefits.

    A poll conducted earlier this year by the highly respected Lake Research Partners found that voters overwhelmingly want everyone to have a choice of private health insurance or a public health insurance plan (73%), while just 15% prefer everyone having private health insurance.

    And the preference for a choice between public and private health insurance plans extends across all demographic and partisan groups, including Democrats (77%), Independents (79%) and Republicans (63%). So in fact, President Obama's proposal that creates a choice of a public health insurance option is a bi-partisan plan - whether is has "bi-partisan" support in Congress or not.

    Because of the budget rules passed by Congress, Obama doesn't actually need any Republicans to pass a health care reform bill. The rules allow passage without a filibuster, by a simple majority - which in the Senate means 50 votes and a vice-presidential tie breaker. That would allow passage of a truly effective health care reform plan even while losing all Republicans and 10 Democratic Senators.

    Of course in this political environment that won't happen. They may squeal on their way to the vote, but in the end most Democrats and some Republicans will almost certainly feel the heat of public opinion and vote for health care reform when the chips are down.

    The president's principles - which were outlined in a letter to the Senate last week - have broad support among most Democrats in both houses, notwithstanding adamant insurance industry opposition to a public health insurance plan.

    The few isolated Democratic opponents in both Houses have never advanced solid policy arguments in opposition to giving Americans the choice of a public health insurance plan. The closest they've come is a frail argument that many private insurers couldn't compete. That line of argument ignores two facts:

    • The point of health reform is to provide health care to all Americans, and to cut costs - not to benefit wasteful, inefficient private insurance companies that have become fat by gouging consumers and denying claims.
  • If private insurers can't compete with an efficient public health insurance plan, they have no business being in the market place. After all, they would be the first to argue that the "private sector" is always more "efficient" than government.
  • What they're really worried about is that in order to compete they would have to cut massive CEO salaries like the $26 million Cigna paid last year to its CEO - a figure that is 65 times higher than the salary paid to the CEO of the Federal Government - President Obama. Insurance companies are worried that they would have to become more efficient and cut their profit margins in order to compete. Of course from the point of view of the taxpayer, that is one of the major goals of health care reform: to control skyrocketing costs and incentivize efficiency instead of waste.

    The other argument advanced by the few Democrats who oppose a public health insurance option is the fallacious notion that it is not popular in their districts. In fact, Republicans and Independent voters are almost as sick of being at the mercy of private insurance companies as Democrats. The idea of providing consumers with a choice of a public health insurance option is popular in Arkansas and Kansas - as it's popular in Illinois and New York. It's popular in rural areas and urban areas.

    The Obama plan for health care reform has massive bi-partisan support throughout the United States. Let's get busy making sure that it becomes the law of the land whether the insurance companies and the Republicans in Congress support it or not.

    Robert Creamer is a long-time political organizer and strategist, and author of the recent book: "Stand Up Straight: How Progressives Can Win," available on

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