Where to start with this piece below in the WSJ? 

What the public option is about is people not wanting to pay private insurance companies' advertising and market segmentation strategy implementation costs, and for a degree of administrative complexity Kafka would have had a field day writing about.

I guess the author doesn't get that or doesn't want to get it. 

To characterize the goal of "liberals" on health insurance as only about universal coverage, and not also cost control, is false and a straw man argument.  The more taxpayer money gets spent on subsidies so businesses can provide private health insurance and the insurance lobby will actively support the bill, the less cost control we get, and the less likely it is that the public option can work. 

So it's really about the ability of the health insurance and big pharma (which is being bought off via the prohibition on the government using its bargaining power to negotiate less expensive drug prices for consumers), and the political party that is entirely (as opposed to the one that is partially) owned by corporate America , all playing by the current rules of the game, to block the changes we really need when the party more sympathetic to reform has as much control over the Executive and Legislative branches of the federal government as it has had in at least 40 years.   

The result is, under the current rules of the game, a) either these two lobbies in particular need to be bought off to get the universal coverage part done, at the cost of a tilting of the playing field to the point where the public option may not be able to serve as a robust enough alternative to private insurance to rein in costs over time, or b) no bill.   

What health care policy in our country is really about is how ordinary people are screwed and our economy damaged by our predominantly for-profit health care non-system and the power of the vested interests to block common-sense reform.    

I for one am finding it difficult to get clear enough bearings to know whether or not I should advocate that my senators support some version(s) of what eventually comes out of the process.  My efforts over the coming weeks are particularly focused on trying to figure out whether the public option as it stands is likely to be effective, or whether the opposition has succeeded in rendering it ineffective for what it is supposed to do, with little or no prospect of fixing the problems any time soon.

If the former, then, all the unnecessary cost notwithstanding, passing it and trying to fix the problems later on might be the least bad way to go and I'd hold my nose and urge my senators to hold their noses and vote yes. 

If any of you who have resolved similar concerns one way or the other would like to share with me how you're thinking about the situation at this time I'd appreciate it. 

Because in a struggle in which the forces of ignorance, irrationality, moral corruption, and taxpayer  stickups know clearly what alternatives they can accept, whereas the rest of us ordinary Janes and Joes just looking for a better health care deal are trying to sort that out, the odds are against anything good coming out of this.  And time's a ticking...

Wall Street Journal

August 11, 2009

CAPITAL JOURNAL: Health Debate Isn't About Health

By Gerald F. Seib

The health debate, which now has moved beyond the Beltway and into raucous town halls across the land, is so intense in part because it's not really about health care at all.

On a deeper level, it's about the role of government in America's economy. And that is a raw and unresolved topic, only made more so by months of exceptional government intervention amid a deep recession.

The trigger for this deeper debate has become the question of whether to include a "public option." The idea has become so heated that it's now making both sides lose their bearings a bit -- which is ironic, because the public option wasn't previously the focus of the health debate and is a question on which some obvious compromises already are on the table.

Like all political arguments, this one doesn't occur in a vacuum. In fact, in this case, the prelude is particularly important.

Beginning a year ago, before President Barack Obama took office, the federal government began taking a series of unprecedented actions designed to stabilize whole pieces of the economy -- first the financial sector, then the housing industry, and finally the auto makers. The result, of course, was the federal government owning controlling interest in an insurer (American International Group) and a car company (Chrysler), and big chunks of another car company (General Motors) and a big investment house (Citigroup).

The good news is that the financial sector avoided a meltdown, and the economy appears to stabilizing. But the maneuvering had one other effect: It has left the public a bit stunned to see its government dive so directly into the country's economic mainstream.

From there, Washington moved immediately into debating an overhaul of the nation's giant health-care system. Moving straight from wrenching economic crisis to wrenching health debate was a calculated gamble by the White House. It thought the economic shock might actually ease the way for a broad revamp because Americans would be ready to accept the idea of big changes and also would accept the argument that full recovery couldn't occur until runaway health costs were corralled.

But the timing has had another effect: It has meant the health debate is unfolding just as Americans are pondering what the shape and size of the government's role in the economy ought to be.

As a result, the flash point in the debate has become the question of whether a health overhaul should include a public option, in which the federal government offers its own health-insurance plan to compete with private insurers. Democrats want one, and Mr. Obama says it would provide choice and keep private insurers "honest." More important, the party's liberal wing has decided that a public option is essential.

In another environment, that might have been the fodder for a wonky policy debate about whether a public option would improve or distort the insurance market and whether it would really save or cost the government a lot of money. Instead, in this environment, the public option has raised the fear that a government already running AIG and GM would soon be gunning for Aetna as well. Everything else that has happened in the past year makes it easier for some people to believe that's what the health debate is all about.

So Republicans, who never liked the public-option idea anyway, have made it the centerpiece of the argument, portraying it as a Trojan horse designed to carry into the marketplace a wholly government-run health system. As the accompanying graphic illustrates, the Wall Street Journal/NBC News poll shows that the two parties have divided so deeply on the question that they are mirror images of each other.

In the heat of the moment, both ends of the spectrum are losing their way a bit. Liberals have forgotten that their initial goal in health reform wasn't a government-insurance program but universal coverage for all Americans. To further the irony, the public option was never a centerpiece of Mr. Obama's campaign platform on health care last year; indeed, it was hardly discussed.

Republicans, meanwhile, have forgotten that they accepted a version of a public option just a few years ago, when they approved the Bush administration's plan to provide a prescription-drug benefit for Medicare recipients. That plan includes a fallback option for the federal government to organize drug plans for seniors if private insurers don't offer enough choices. The option isn't a precise parallel, and it has never been used, but it's there.

The real point is that there are ways out of this box. One would be to make a public-insurance plan merely a fallback, to be exercised only if private insurers aren't offering enough options in all markets. The other would be to take the suggestion of Senate moderates and replace the public option with nonprofit insurance cooperatives as an alternative that doesn't require the government to be directly in the business. In an environment less charged with arguments about government's proper role in the economy, both might be easier for each side to accept.