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The Heart of the Matter

Progressives want, as President Obama does, something to keep the insurance industry honest. If not a public option, what will accomplish that?
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The DC establishment is in full attack mode, as usual with mostly anonymous quotes, trying to defeat a central part of the President's health care plan, the public option. These inside-the-Beltway conventional wisdom worshipers of both parties don't like the idea of big change or taking on scary powerful special interests, and they hope they can intimidate people pushing for real change. As one of the left-of-the-leftists (is that what LOL stands for?) being attacked, let me cut to the chase and go to the heart of the matter, because there are apparently some folks in the government with great insurance plans who are still puzzled why the whole "keeping the insurance companies honest" part of President Obama's plan matters.

The tens of thousands of organizational staffers, bloggers, and grassroots activists who are fighting our hearts out on behalf of the President's plan got into this fight because of the dysfunction of the insurance industry in terms of our lives. Like President Obama, we have seen family members having to fight with insurance companies while they are sick and dying. Personally, I have a friend with diabetes die because he couldn't get insurance coverage, and didn't have the money to take care of himself the way a diabetic should. I have family members with pre-existing conditions stuck in jobs they don't like for fear of not being able to get insurance should they switch. As a diabetic myself, there isn't a month that goes by where I'm not hassling with an insurance company bureaucrat over something, and as a small businessperson, I feel the financial pain of insurers raising my rates through the roof.

When the President talks about needing to keep the insurance companies honest, we know he is right because we see it, up close and personal, in our own lives. When the President and other Democrats take on the insurance industry, we cheer them on because we know of what they speak. This is what drives us. We are not putting everything we have into this fight because of our thrill at the possibility that the deficit might go down, or that doctors might order fewer test results patients don't need. That's all good, but it's not what is making us give money to Organizing for America, Health Care for America Now, Democracy for America, and the other groups fighting this fight, it's not what is motivating us to show up in bigger numbers than the right-wingers at town halls; it's not what is getting unions, MoveOn, DFA, USAction, nurses and so many other groups to organize lobbying visits to keep the President's plan alive; it's not what caused so many of us to give $160,000 in 24 hours to reward those members of congress who say they are going to hold the line on the public option.

This isn't symbolic for us, something we are doing just because the right-wing attacked the public option. We want real accountability, real competition, a real check on the insurance industry. So to all you insiders who find yourselves utterly mystified about why we care about a public plan, this is it: we want a check on insurance industry power, pure and simple. We want, as President Obama does, something to keep them honest. Tell us, if not a public option, what will accomplish that? How are you going to make that promise happen?

I can think of some ways that would help. Rate regulation, for one, as Bob Creamer and I suggested the other day. Repealing McCarran-Ferguson, the law exempting insurance companies from anti-trust laws, would help. Making it easier and faster to file class-action consumer lawsuits against insurance companies, that would also be a powerful check on insurers.

But you know what the funny thing is: these insiders panicking because they don't currently have the votes in the Senate, and attacking the very people who have kept the President's plan in the game all these months, they aren't talking about any ideas that would actually accomplish the President's goal of keeping the insurance companies honest. Maybe I would feel a little better about the co-op proposal if I'd seen any actual details on it, but not even the leading advocate for it in the Senate, Kent Conrad, has spelled out anything that would make analysts think it could remotely provide the check we are looking for on the insurance industry.

So Mr. President, us left-of-the-leftists have your back. We share your goal, so essential to health care reform, of providing something to keep the insurance companies honest. If the people attacking us for supporting your plan (some of them anonymous staffers in your own White House) want to show us an alternative that actually accomplishes your goal, we will listen respectfully. In the meantime, we will keep fighting our hearts out for your plan regardless of who attacks us.