Subject: [big campaign] New Huff Post on Need for Public Health Insurance Option from Creamer
From: [email-masked]
To: [email-masked]
Date: Tue, 16 Jun 2009 08:42:37 EDT
List-Id: <bigcampaign.googlegroups.com>

Four Reasons  Why Giving Consumers The Choice of a Public Health Insurance 
Plan is Great  Politics for Democrats 

The private health insurance industry and its voices in Congress have  
begun to spin the narrative that offering consumers a choice of a public health  
insurance plan is: 
a). Never going to pass Congress; 
b). A fringe proposal by the Democratic Party’s  “left wing;” 
c). Is generally bad politics for Democrats. 
This narrative is flat  wrong.  In fact, offering  consumers the choice of 
a public health insurance plan as part of health care  reform is great 
politics for Democrats of all stripes, and is absolutely capable  of passing 
Congress.   Here are  four reasons why: 
1). It is very popular. In a  poll taken earlier this year by Lake 
Research, 73% of respondents favored a  health plan that gives them the choice 
between a private plan or a public health  insurance plan.  Only 15% preferred  
to  have only the choice of a  private plan.  And the preference for a choice 
between public and  private health insurance plans extends across all 
demographic and partisan  groups, including Democrats (77%), Independents (79%) 
and Republicans  (63%). 
In fact, this is  one of the most popular parts of President Obama’s health 
care reform proposal –  which a Diageo/Hot Line poll found last week had 
overall support of 62% of the  voters.   
What’s more, private  health insurance companies are very unpopular.  Only 
7% of Americans say they trust  private health insurance companies. 
Democrats have the  high political ground on the issue of health care 
reform in general, and the  choice of a public health care plan in particular – 
with support from the  Democratic base, crucial independent voters – and even 
Republican voters.  In the coming debate, we need to act  like it. 
2). Democrats Need the Choice of a Public  Plan to mobilize the base to 
fight for reform.  The prospect of escaping from the  tyranny of private health 
insurance firms is enormously motivational to core  Democratic voters.   
In order for Democrats  to maintain a motivated, united front in defense of 
health care reform, the  health care proposal must include the choice of a 
public health insurance  plan.  If it does not, elements of  the base will 
oppose the plan and much of the balance will be tepid in their  support. 
We desperately need  that united base of progressive organizations and 
voters to do battle with the  massive number of special interests that will do 
everything in their power to  oppose, disrupt and cripple a serious health 
reform proposal, as they did in  1993.   
The fact is that any  health care reform that actually controls cost will 
gore the oxen of many of the  health industry’s special interests; they will 
be very motivated.  In order for us to be successful in the  face of that 
motivation, we must mobilize a unified, equally-motivated group of  voters to 
demand change.  
We not only need the broad base of support  – which we have – we will also 
need intensity to carry the  day. 
The presence of a  public health insurance option in the plan is critical 
to maintain that unity  and motivation.  
3). A proposal containing a provision that  gives consumers the choice of a 
public health insurance plan can pass  Congress.  The rules contained  in 
the budget resolution that passed Congress protect health care reform from a  
filibuster in the Senate.  That  means it can pass with just 50 votes.  We 
will have 50 votes in the Senate to pass a provision giving us a  choice of 
a public health insurance plan.  
The talking heads keep intoning:  “But we won’t have any Republican votes.”
  We don’t need Republican votes to pass the Senate.  In fact we could 
loose all Republicans  and 10 Democrats and still pass a bill. It would be great 
to pass a bill with  bi-partisan Congressional support, but the choice of a 
public option already has  massive bi-partisan support among the voters.  
Once it’s passed, the special interests  won’t have any more luck taking it 
away than they had privatizing Social  Security or eliminating Medicare.   
In fact, there is a  real question whether a bill that does not contain the 
choice of a public plan  can pass Congress.  Eighty House  Democrats have 
signed a letter saying they won’t vote for a bill without a  public option.   
There is simply no appetite  among most Democrats in Congress to pass a new 
version of the disastrous  “Medicare Part D” that provided some 
pharmaceutical coverage to those on  Medicare.  It has huge gaps in  coverage (a “
donut hole”), it gives private health insurers a monopoly on  providing 
coverage, and it prohibits the government from negotiating with  pharmaceutical 
companies to get cheaper prices. It would have been simple and  elegant for 
Congress to extend traditional Medicare coverage to include drugs,  but the 
Republicans that then controlled Congress and the White House – and the  health 
care and pharmaceutical firms -- would have none of it.  Their goal was not 
to provide a  critical, needed service to consumers.  It was to make lots of 
money.  The result is a much more expensive approach than coverage through  
Medicare.   
Yesterday in his  speech to the AMA, President Obama was dead on when he 
said, "But what I refuse  to do is simply create a system where insurance 
companies suddenly have a whole  bunch more customers on Uncle Sam's dime but 
still fail to meet their  responsibilities." That brings us to point  four. 
4). The choice of a public option is  critical to assure that health care 
reform actually delivers universal coverage  and controls costs.  
That is why  President Obama says he has included it in his proposal for 
health care  reform. 
Those who argue that a  public option is not necessary ignore both history 
and everything we know about  structuring incentives for human behavior.  
For middle class  Americans who don’t qualify for Medicare, we have just 
lived through a  private-health-insurance-only world.  It has been a disaster. 
 Why  do we spend 50% more per person than any other country on earth for 
health care,  yet are 37th in health care outcomes?  The only thing that 
completely  differentiates America from every other industrial  country on earth 
is that we are the only country whose health care system is  dominated by 
private health insurance companies.   
This is not a  speculative question.  The jury is  in. They had their shot 
and blew it.  And it is no wonder.  Do you  think any insurance executive 
spends a minute trying to figure out how to assure  universal insurance 
coverage and control system-wide costs?  They spend all of their time  figuring 
out how to maximize their market share, their profit  margins and executive 
salaries. That’s why they want to insure healthy people,  not sick people.  It’
s why they  employ armies of people to decline claims, and why they waste 
tens of millions  on advertising.  It’s why companies  like Cigna spend $26 
million on their CEO’s salary. It’s why the amount they  spend on marketing 
and administrative cost is so much greater as a percentage of  the total 
spent on health care than it is under  Medicare. 
They don’t do these things  because they are bad people.  They  do them 
because those are the rules of the game in the private insurance  market.  That’
s how their success  and failure are measured.  That will not change unless 
they are forced  to compete with a plan that has different incentives – one 
that is in  business to assure universal coverage and to control health 
care  costs. 
The bottom line for Democrats is that when  it comes to health care reform, 
it’s not just the sizzle, it’s the  steak.  Democrats are going to  get 
one shot at reforming health care, and that reform has to actually work to  
provide universal coverage and control costs.  Congress may be able to live 
off of the  optics of a plan that won’t work for a while, but it won’t be 
long before it  will be obvious that the plan either worked as advertised or 
not.   
We can’t afford to screw  this one up.  Democrats need to pass  a health 
care reform bill this year, and we need to be sure that it will really  work.  
Giving people the choice of a public health  insurance plan will do more to 
assure that the system works as advertised than  anything else we can do.   
Robert Creamer is a long-time  political organizer and strategist, and 
author of the recent book: “Stand Up  Straight: How Progressives Can Win,” 
available on _amazon.com_ 
(http://www.amazon.com/Listen-Your-Mother-Straight-Progressives/dp/0979585295/ref=pd_bbs_sr_1?ie=UTF8&s=books&qid=1206567141&sr=8-1
) . 

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