Al From: Democrats Don't Need the Public Option - Transformational reforms have always passed with bipartisan majorities

Democrats Don't Need the Public Option. By AL FROM
Transformational reforms have always passed with bipartisan majorities.
WSJ, Oct 16, 2009

Now that the Senate Finance Committee has voted for a health-care bill that does not include a government-run plan, it would be a mistake for Democrats to insist on adding the public option to reform legislation this year.

By insisting on the public option, liberal Democrats will allow the Republicans, who have no ideas of their own, to cloud the prospects for reform. If this happens, Republicans will be able to divert attention away from reforms most Americans want and instead focus on what Americans disagree on—whether we need a new government-run health plan.

As President Barack Obama has made clear, we need to reform. Right now, health insurance is too costly and the health-insurance market is not competitive enough. Too many people lack insurance or the chance to choose a plan that best suits their needs. Too many people are denied coverage because of pre-existing conditions or lose their coverage when they become sick. And our most successful public program—Medicare—is on the road to going broke. Doing nothing is not acceptable.

With control of the White House and Congress, the American people will rightly hold Democrats accountable for the outcome of the health debate. At the same time, the focus on the public option and level of discord it has generated is already taking a toll on the president's approval ratings and hurting the party more generally. In January, Democrats enjoyed a double digit lead on the "generic ballot"—a measure of support for a party. Last week, a Gallup poll showed that Democrats are now essentially in a dead heat with Republicans on the generic ballot. Particularly significant, the poll showed a nearly 20-point drop in Democratic support since the last election among independents, the key to our victories in 2006 and 2008. Insisting on the public option could cost many Blue Dogs in the House and a number of red-state moderates in the Senate their seats.

Now is the time for Mr. Obama to lead the way to historic health-care reform. He's the only one who can. I'd suggest he do so by taking these three steps:

• First, say unequivocally that he wants a plan that jettisons the public option and contains real reforms to cut health-care costs. As the Senate Finance Committee bill shows, a public option is unnecessary to expand coverage. Dropping it should win support of most centrist Democrats.
• Second, make clear that he does not want Congress to use parliamentary maneuvers, like the budget reconciliation process, to ram through a bill that can't command 60 votes in the Senate. Health-care reform needs broad support; it is too important and too controversial for Congress to pass by resorting to legislative chicanery or short-circuiting the legislative process.
• And finally, make one more effort to bring moderate Republicans along. Transformational reforms, such as civil rights legislation and Medicare in the 1960s, have always been passed with bipartisan majorities. Health-care reform should be no exception. The president promised a post-partisan politics. What better place to forge it than on his most important initiative?

If Mr. Obama takes these steps, I'm convinced Congress would pass a bill that requires every American to buy insurance, offers consumers a choice of plans through a new health exchange like the successful Commonwealth Connector in Massachusetts, provides subsidies that assure everyone can afford a basic plan, and prevents insurance companies from denying coverage to people with pre-existing conditions or dropping coverage for people who become sick. All of these are reforms most American can agree on.

I'd personally like to see health-care reform include fees (as the president proposed) on Cadillac health-care plans, incentives to replace fee-for-service payments with more cost-effective models (the best way to bring down health-care costs over the long haul), and measures to limit abuses in malpractice suits (which Republicans have long called for).

Such a plan would meet the objectives the president has already outlined—expanding coverage, lowering costs, and improving quality—without adding to the federal deficit. With centrist Democrats signed on, such a plan should garner the 60 votes necessary to pass the Senate. Even without a public option, it would achieve most of what liberals have long fought for. Open-minded Republicans might even find it hard to resist.

Mr. From, the principal of The From Company LLC, is the founder of the Democratic Leadership Council.