Netroots Blast Senate Health Deal

Jane Hamsher, at Firedoglake, sends out a confused, and rather petulant email opposing the Senate health deal.

At the outset, let’s get a few things straight. The bill does not do enough to control costs, and certainly fails with respect to consumer choice — most of us who don’t like our insurer are completely out of luck. And I think the public option as originally conceived would have been a provision worth fighting for until the bitter end. But that proposal is an ancient, barely recognizable ancestor of the “public plan” included in both the House and Senate bills.

The House public option would have been required to negotiate payment rates like private insurers and only been available to a tiny sliver of the public. The Senate version would have been open to even fewer people due to its opt-out provision. With that said, let’s take apart what Hamsher said.

“The Senate is cutting a deal to kill the public option by giving the President the ‘trigger’ that his Chief of Staff, Rahm Emanuel, has been fighting for since he took office.

Shoveling taxpayer dollars into “too big to fail” insurance companies is not the change I voted for. The failure to establish a public option to control medical costs and increase competition is President Obama’s failure alone.”

Rahm Emanuel has not been pushing a trigger “ever since he took office.” This was Olympia Snowe’s idea, and Emanuel saw it as the most politically viable option. You can disagree with him, or be angry with him, but the trigger is not part of his long-planned secret plot help the insurance industry. It’s just not.

No one ever said insurance companies were “too big to fail.” No one. This phrase is irrelevant to the health care debate.

And in my view, the failure to pass a public option is not Obama’s. It’s arithmetic. They don’t have the votes. Joe Lieberman was going to filibuster a bill with a public plan. Lieberman gave Ben Nelson, Mary Landrieu, and Blanche Lincoln political cover to join in the obstruction. His reasons were illogical, disingenuous, and maybe even vengeful. But this was Lieberman’s doing. Not Obama’s.

Hamsher says the public option would have “controlled medical costs.” Neither the House or Senate version of the public option would have controlled costs. See above. They lacked the necessary market share to achieve meaningful cost control and were constrained by the requirement that they use negotiated reimbursement rates.

The Senate deal provides for national, strictly regulated non-profit plans in the exchanges. Is this significantly inferior to a “public plan” that negotiated rates? Here’s the kicker — Hamsher has fiercely advocated a public option that uses Medicare rates. Well, the deal provides for an expanded program that uses Medicare rates. It’s called Medicare. As in, the Medicare buy-in.

“This plan includes a deal between the White House and PhRMA that guarantees there will be no negotiation for Medicare prescription drug prices.”

I agree. Our government ought to negotiate drug prices. Still, I don’t think this is a reason to defeat health care reform.

She concludes:

“The Senate’s triggered public option is a failure of Barack Obama….Obama is the only one who can save the public option and make these statements more than mere campaign promises. The fight isn’t over, and we need to let Obama know that a failed public option will be his fault.”

Honestly, I think health care reform is the most important domestic issue facing the country today. Nothing is more important. And it deserves a tone that is far more serious than the one she’s employed here.

There are still real battles left to wage on health care reform legislation — namely the effort to open the exchanges so that we might have some leverage with our insurers. There will be a dispute over how generous the subsidies ought to be to help people obtain insurance. There will be efforts to both weaken and strengthen new regulations on insurers. These battles need to be joined — and they are all more consequential for those in need than an argument over a public option that had become almost entirely symbolic.