From Erza Klein:
Howard Dean: Health-care reform 'worthless' without the public option
Dylan Matthews beats me to the punch with some well-deserved shots at Howard Dean's contention that absent the public option, "this bill is worthless and should be defeated."
No, it isn't, and it shouldn't.
Organizer friends have patiently explained to me that the public option only has a chance if its supporters take a hard line on its inclusion. That may be right, but the problem is that that strategy relies on people such as Dean actually convincing their base that the public option is central to health-care reform's success and desirability.
That's not true. Indeed, it's not even clear how it could be true. The strongest public option on the table -- the House's version -- would serve a couple million folks and cost a bit more than private insurance. It's worth having, for reasons I've argued over and over again. But a lot of things are worth having. It isn't decisive, or even obviously relevant, to the bill's success or failure. If the bill is "worthless," then it's worthless in the presence of the public option. And if it's not worthless, it's not worthless in the absence of the public option.
Which leaves us arguing over the meaning of the word "worthless," I guess. This is a bill that cuts premiums costs. That extends insurance coverage to more than 30 million Americans. That cuts the deficit. That establishes an expectation for near-universal health-care coverage. That really digs into delivery-system reforms. That takes the first, halting steps away from the fee-for-service system. That makes better insurance cheaper for the poorest Americans. If passed, it will be, without doubt or competition, the largest piece of progressive social policy since Lyndon Johnson established Medicare and Medicaid. If this isn't worthwhile, then progressives should pack up and go home, because nothing Congress passes in the foreseeable future will even come close.
I'm not among those who think the public option should be dropped. The bill would be better for the public option's presence, and all the arguments against its centrality also apply to those demanding its removal. If the bill's managers have to compromise on it, then they better get something serious in return for their concession. But it should be kept in perspective, and people shouldn't be misled about its importance, or about the worth of the underlying bill.
It's too bad that you can't see the stuff I boldfaced on FB, but you can on Fort McHenry.
UPDATE: 5:25pm Pacific:
Might as well show you what Dylan Matthews said in the American Prospect:
First, as TAP founder Paul Starr noted in the New York Times the other day, less than 2 percent of the population will likely be enrolled in a public option in the form in which it is currently being proposed. It will also likely have higher premiums than private plans, meaning that it will not be able to pressure private insurance prices downward, as was the proposal's original intention. Why providing this very weak public option to a very small slice of the public is a make-or-break aspect of the health-care bill for Dean is beyond me.
More important, here Dean is actively undermining some of the most positive aspects of the health-care bill. This statement effectively argues that the 25 percent cut in the cost of individual health insurance for families that would result from the bill is "worthless." So too are its community rating and guaranteed issue provisions, which will finally prevent insurers from discriminating against patients based on pre-existing conditions. And, of course, providing insurance to 31 million more people is "worthless" to Dean as well.
Promoting the public option is all well and good, but the other components of the House and Senate bills will have a far greater impact in reducing the cost and increasing the accessibility of health insurance. It is insulting to those who have worked for these reforms for decades for Dean to minimize these reforms as a means of promoting another.
