Time To Let Go Of The Public Option

by Conor Clarke

I have decently warm feelings about a public option, but I don't think it's a good site for an all-consuming pitched battle over the fate of American health-care reform. So it's nice to see that some members of the Obama administration think this, too, and my heart goes out to the White House staffer who said the following to the Washington Post:

"I don't understand why the left of the left has decided that this is their Waterloo," said a senior White House adviser, who spoke on the condition of anonymity. "We've gotten to this point where health care on the left is determined by the breadth of the public option. I don't understand how that has become the measure of whether what we achieve is health-care reform."

Amen. The public option is neither a necessary nor a sufficient condition for successful health-care reform (defined as expanded coverage that is more cost effective). I understand the argument, made by Paul Krugman and many Democrats, that the public option might be an important "signal "of whether Obama is really the progressive [that] activists thought they were backing." But I am not convinced, for at least two reasons.

First, the "signal" argument is not a substantive point. I think there is a decent chance the public option will reduce costs in the 10-year window, although it depends on the details and the CBO report on this subject seemed rather speculative. But the "signal" argument doesn't hinge on those details. It hinges only on the intensity of support for the abstract proposition that the government should get more involved in the insurance industry.

Second, the health-care bills that are working their way through committee seem uniquely ill-suited for a litmus test. If you check out the congressional summary of America's Affordable Health Choices Act of 2009, you'll find about 20 important provisions that have nothing to do with the public option and have received little or no attention in the public debate. Health exchanges? A prohibition on premium variance? These things have been swept under the rug. But if we get over the public option, perhaps we can get back to the rest of health-care reform.