The Necessity of a Public Option

With DailyKos and others taking a big swipe at Dennis Kucinich (and reportedly getting him to change his vote), and with everyone on the progressive left going on and on about our shared disappointment in the Health Care bill, I am left revisiting thoughts I had last summer. Specifically, why is a public option so important? Don't get me wrong, I see the merits of a public option (especially if there is an insurance mandate)--and quite honestly, I'm with Kucinich and others in preferring a model that would include single-payer, but is it a deal-breaker (a la Tina Fey) if the bill doesn't include one? It shouldn't be.

Single-payer would be the most equitable and efficient system, and I'm disappointed that the (supposedly) Democratic leaders in Congress and the White House never seriously considered trying for it. A public option almost certainly would be better than nothing in that, if we aren't going to supplant for-profit health care, we can at least give it a dose of competition.

Still, I believe that the same objectives we seek in a public option could be met by using a tool which Democrats have been running away from since the 90s: Regulation. With a strong system of regulation, such as price-controls and eligibility requirements, we could achieve just about everything promised with a public option. Mind you, this system still falls far short of where single-payer would get us, but I think that relative to the public option, its a wash. It may even be better. If we are to merely rely on a public option to work its invisible hand in the "marketplace" that is human health, who really knows where it would lead. Certainly in an economy like the current one, I can envision a time when certain forces might work to undermine the publicly provided option financially. Many or most people would not be inclined to stand up for the public option in this scenario, because they wouldn't be a part of it in the first place. Where would we be then without any other regulatory force that we all depend on, and thus have an interest in protecting?

Why then, isn't regulation the emphasis of progressives and the left? Because since the Clinton era, the left has been so eager to prove its pro-market credentials that we've forgotten what we stand for. So, yes, the Public Option could be a tool to shame private insurance into more reasonable territory. But, short of single-payer, our aims should be on identifying the structural problems with our current health care system and creating legislation that fixes those problems. I think many aspects of the current bill do this--or at least get us closer to this type of an environment, and it should be supported on that basis.

TR and Health Care in the Early 20th Century

Basically I'm posting this because in spite of all the military involvement in the Philippines--and Cuba!--and Panama!--TR was still a pretty cool President. Besides, how cool is this?:

State of the Health Care Bill

Ta-Nahesi Coates (a daily read of mine) posted his discussion with Ezra Klein about the status of the Health Care bill now that Kennedy's Senate seat has been lost. Klein does an excellent job of explaining why the (Senate version of the) bill was (and still is) worth supporting. While Klein describes it as "intellectually honest" for progressives to admit that we truly wish for a single-payer system and that the current bill isn't really what we'd dreamed of, he rightly insists that the potential improvements to our present system included in the bill are too great for us to pass up.

Although my own insurance situation will not be affected either way (bill or no bill), I can't shake the feeling that we are missing a historic opportunity to accomplish something momentous in terms of social justice and economic fairness.
Perhaps most frustrating is the thought that the Democrats are on the verge of dropping this completely simply because their huge majority in the Senate was diminished by just one seat. One f'n seat! They still have 59 seats in their caucus. Maybe I'm overestimating the discipline of the congressional GOP, but I'm pretty confident that if they had a 59 seat majority in the Senate, with an insane majority in the House, not to mention a doctrinaire Republican in the White House, and that if they were then on the verge of passing legislation that was pretty much a pillar of their party's agenda for a generation or two (say tax code reform, for example), they would not hesitate to ram it through. They would succeed. Sure, some Senate Democrats would threaten to filibuster, but in the end, they would pass their bill, the President would sign it, and they would all celebrate together at parties with their mistresses, while drinking bourbon, and joking about how easy it all was.
Why can't the Democrats accomplish things the same way? Is it a matter of will? Are they just a bunch of cowards? Or is it just that a significant proportion of elected Democrats aren't committed to social democratic or progressive ideals to begin with? If so, what the eff are they doing in our party?