Robert Reich’s new column makes me want to take a flying leap. He’s right, of course, about the Senate version of the public option.
But in a broader context, and since the teabaggery of August, momentum has shifted in the direction of Medicare for All. For a while there, it looked like there wouldn’t be any public option, and such an omission would’ve likely doomed healthcare reform (the House would’ve spiked the bill).
Now, it looks like we’ll have a public option — a seed to help grow a Medicare for All program. We won’t get there with this bill. But there’s no question that we’ll eventually get there. Arguing to expand the public option isn’t nearly the massive endeavor that arguing for the entirety of reform has been. It’s just going to have to be an ongoing process. And it certainly won’t be as difficult as pushing for Medicare for All without any public option in th law. Congress, for all of its nincompoopery, is giving us an opening here — a clear path to single-payer — and we’d be insane not to exploit it.
The arguments are simple and American — competition, affordability, choice, etc.
So if we look at the current public option as standalone policy, it’s depressing. But if we look at it as something to be nurtured into Medicare for All, it doesn’t look so awful. It’s just going to take some work. Here are the immediate goals now, and/or once it passes:
1) Push the launch date earlier than 2013. Social Security was changed shortly after it passed in order to get benefits out prior to the original launch date. There’s precedent for making it happen.
2) Block the opt-out. Make sure some of the red state legislatures don’t screw their people.
3) Block the fail. In order for the public option to survive, enrollment needs to be significantly expanded (a Wyden bill to increase choice), premiums need to remain affordable (make sure it doesn’t become a dumping ground for the sick) and rates need to be moved closer to Medicare (kill the level playing field).
From there, the public option will flourish and evolve into a serious national health insurance program. But if we give up on it, Medicare for All will remain nothing more than a clever frame for single-payer. At least for the duration of our lifetimes.