Time for Liberals to Give Up on the Public Option

It's time for liberals like me, who favor the public option or its functional equivalent, to give up on the idea and move forward to enact an historic, landmark national health insurance legislation. And to do so now -- not next week or next month.

Without the public option, the votes are there, with at least some Republican support, to do what Democrats have been trying to do since Harry Truman all the way through President and Hillary Clinton's heroic but unsuccessful efforts in 1994. We can pass national health care legislation that would accomplish the two goals that have always been the Democratic Party's priority for more than 60 years: First, virtually universal health insurance, including those who are too wealthy to qualify for Medicaid but too poor to afford health insurance; and second, mandatory coverage for all -- meaning insurance companies must insure everyone and are barred from declining due to the status, age, or pre-conditions of anyone. (Both go hand-and-hand, since insurance would not be affordable unless there is a broad mix of healthy younger people with less healthy older people in the customer mix).

In short, the dream of progressive Democrats for a national health insurance system that guarantees that matters of life or death should not be a function of wealth can finally come true; but only, in my view -- to be realistic -- if liberal Democratic members of Congress supporting the public option put it aside now. I have four reasons.

First, it is a pragmatic judgment: It is only a matter of time before they will reach the conclusion there are not 60 votes in the Senate to allow a vote on any health care bill that includes the public option.

Second, I fear if pro-public option Senators and House members wait too long, the polarization between the parties as well as within the Democratic Party will get geometrically worse -- thus threatening the enactment of any bill this year, or perhaps for a very long time. Already we have seen liberal organizations, bloggers and strident hosts and guests on the liberal cable network evening shows making vicious attacks on those in Congress whose consciences and/or constituents will not allow them to support a public option.

This has already happened. Senator Joseph Lieberman was recently accused of "whoring for the insurance companies" by one of the liberal cable network's leading hosts because Senator Lieberman has suggested he might vote to stop the filibuster of a bill containing the public option. I strongly disagree with Senator Lieberman's position, since I not only support the public option but believe there should be an up-or-down vote in the Senate. But I also, as always, greatly respect Senator Lieberman's integrity and his sincerity. It is too bad, but not surprising, that critics cannot disagree and debate Senator Lieberman's position on the merits without attacking his motives or using scurrilous personal epithets.

Third, the public option is not as important as the other two reforms that are long overdue -- universal insurance and universal coverage.

I have heard certain liberals claim they would rather have no bill at all than a bill without a public option. I would bet that everyone of them already have health care insurance. Or to put it another way, I'll bet that there isn't a single uninsured person who can't afford health insurance, or who faces bankruptcy because of a health care emergency, or who is forced to rely on hospital emergency rooms for basic health care for their families, who would agree that if there is no public option, then there should be no bill at all that would have provided them with basic health insurance, perhaps for the first time in their lives.

And fourth, the public option as it is presently provided for in the Democratic House bill and the Senate Health Committee bill actually only allows a small percentage of people to purchase it. It seems this is a well-kept secret. It is a fact, rarely mentioned by liberals supporting the public option that the pro-public option Democratic bills would prevent over 150 million people -- i.e., all employees who currently are provided health insurance by their employers -- from purchasing the public option. This is apparently because both business and labor don't want their employer or union-controlled (or both) plans disturbed.

That leaves about 25 million or less that would have access to a public option -- i.e., the uninsured, small businesses not mandated under the bills, and self-employed individuals. That's still a big number, but it is still a small fraction of the population.

Second, if the public option is intended to create competition to "keep the private insurance companies honest," there is a private-market alternative. It was, in part at least, proposed by progressive Democratic Senator Ron Wyden of Oregon and conservative Republican Robert Bennett of Utah and many other liberal Democrats and conservative Republicans.

In the Wyden-Bennett approach (included in their "Healthy Americans Act," which, for reasons I have never understood, the Senate and the House [in a counter-part version] never seriously considered or debated), all state insurance exchanges would be required to include as one option the Blue Cross health insurance plans that all members of Congress and federal employees currently have -- or its actuarial equivalent.

Since the Blue Cross plan is heavily regulated by the states and even receives tax subsidies from the federal government, it walks, talks and looks like the public option -- but is still a private sector-run program. And with such a requirement, private insurance companies would have an incentive to sharpen their pencils and chase our business -- or else we can buy the same lower cost insurance policy that members of Congress now can buy on the public insurance exchanges.

Whatever the final outcome, clearly there are more than 60 votes in the Senate, and substantial majorities in the House, ready to vote on a national health insurance plan that has universal coverage, individual mandates and mandatory coverage -- but with no public option. We can always come back in several years to re-look at the need for a public option if private insurance companies haven't felt the pressures of competition on the public exchanges -- the so-called "trigger" proposal that Maine Republican Senator Olympia Snowe said she could support.

The perfect is the enemy of the good.

Fellow Democrats, fellow liberals: Let's reach out to Republicans and independents in the country, show them we are willing to compromise and give up the public option, and let's get a national health insurance bill passed that provides virtual universal and guaranteed health insurance coverage ... at long last.

Yes we can.


Lanny J. Davis, a Washington lawyer and former special counsel to President Clinton, served as a member of President George W. Bush's Privacy and Civil Liberties Oversight Board. He is the author of "Scandal: How 'Gotcha' Politics is Destroying America."

This piece appeared in Mr. Davis's weekly column, "Purple Nation," in the Washington Times, today Monday, November 2nd. It also is published at http://pundits.thehill.com/author/lanny-davis.

Mr. Davis regularly appears on Sirius/XM's POTUS/Press Pool with Joe Mathieu on Monday usually some time between 1-2 pm to discuss his column for that week.