Wednesday, September 09, 2009

On the public option

I haven't really gotten Kevin's idea that it would be ok to drop the public option as long as other things are done. I think that argument just misses the larger issue. Any health reform fails without a public option because the public option is the first step to fundamentally changing our health care system from the free market, monopolized morass of the status quo to a single payer, Canada style system. Absent the public option, we basically have tinkering on our way to unaffordability. Or, to put more clearly, offering the subsidy and no public option is acceptance of the status quo - an admission that things aren't that bad and that we just need to massage the monopolized system to fix its ills.

A mandate and subsidies don't freak out the GOP because they know that these are minor repairs that they can fight against and whittle away. What the GOP fears is that Obama will actually get angry and use his rhetorical power to actually do some monopoly busting. That's why they say death panels and all that other nonsense. They fear the long term, psychological changes that will be brought on by a well functioning, easy to use public option.

Perhaps people who have not lived in a universal health care system can't truly grasp this concept but it is the ease of use that wins the day for single payer. You walk into the hospital, you get service, you pay nothing. No special cards, no long forms, no hassle, no foul looks when you say you don't have insurance. If you think about the nightmare of private insurance, where most people don't even understand what is covered, what to do in case of an emergency, or how much they'll be paying in situation X, Y, and Z and you compare that fear to how the same person feels in a public health insurance system, the status quo loses every time. No one, given the choice between a monopolistic or hybrid system and a public option, single payer system would chose the former. That's why the GOP is freaked. And that's why we need to hold out for the public option. It's not even about getting those 45 million insurance (although that will happen and it's a great necessity). It's about fundamentally altering health care in America and putting us on the road to a Canada style system. That won't happen with the subsidies mess.

(Aside: It's never been about cost. The USFG can spend whatever it wants. That's why we just pissed a trillion or two down the drain fighting wars that didn't need to be fought. It's about values. Do we value American lives more than we do filling corporate coffers and defense contractors pockets? Other countries have made clear that they value their citizen's lives first. Somehow, anytime someone suggests that we might value our citizen's lives, the Right screams bloody murder about budget deficits. Notice they don't blink twice when asked to spend a trillion dollars developing a weapon system that doesn't work or to invade a foreign country.)

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