Sources: Expect Disappointed Progressives After Obama's Big Health Care Speech

First, the public option is not free. You pay for it either entirely out of pocket, with a subsidy from your employer if they go into the exchange and with a government subsidy that is not exclusive to the public option. There is no version of universal health care that does not involve subsidizing the people who can't afford it (and charging more to the people who can).

Second, an insurer who faces no competition will likely charge higher prices than if they have to compete. The pubic option is one way to force direct competition. To me the threat, as long as the trigger for it is written into law and not simply at the discretion of whomever happens to be the political appointee of the hour, is probably a cheaper way to do it. But there is also a mechanism through the exchange that can force competition. If the exchange in national then there will always be a range of plans to choose form the way Federal employees have it. If the exchange is too Balkanized such that there is only one plan in the exchange then of course you'd have to have another plan, or the threat of one. You can create competition and reduce insurance overhead with very tight regulation--as they do in Germany, Switz and Netherlands.

Third, the major reasons health care costs are high and growing is not because of the existence of private health insurers. The reason we know that is because Medicare and Medicaid also are experiencing the same kind of inflation, and we know that, under Medicare, some health care providers know how to deliver care less expensively because they do things very differently. Public or private, if you are paying the most efficient care providers you'll be able to pay them considerably less for as good if not better care. Blaming the insurers for all our problems is easy but also misses the point. The government pays for 50% of health care in the US they could use that leverage to transform health care delivery starting to day with or without a public option.

Because we are in a crisis we need to solve our problems in a fundamental way, and pretending that any one provision of reform is either a magic bullet, or the one and only thing we need to do is a massive error.

We already have a public option. It is the Medicare/Medicaid system and is in desperate need of repair.

Why not kill the "public option" in this bill as a way of magnanimous compromise and then immediately reintroduce the idea as Medicare reform, which a plurality of the citizenry support if the idea is to make it more stable?

Too strategic for the tactically-myopic "progressive" standing in the way of progress.

Well, maybe as a *practical* matter you need a car, but there is no law saying you have to buy a car. If there was a law saying that car ownership was mandatory, the analogy would be sound.

I haven't put a lot of thought into it, but it does strike me as unconstitutional. At a minimum, there are constitutional arguments. Certainly you would get challenges based upon Due Process grounds. While not a supporter of Economic Due Process arguments, this one seems pretty compelling to me. You would get first amendment arguments (for example, some people might argue that there religion does not allow them medical care of one sort or the other). There would probably be an argument that it is an unconstitutional tax.

You are being deliberately obtuse. Nothing is free. What I mean, obviously, that the health coverage would be provided without cost to the individual. Just like a park or a public school or the national defense.

I responded earlier to your post in more detail, but it was flagged for approval since it included a few links.

Can't speak for TaraV, but I suspect she was suggesting their are other ways to control health care costs -- "bending the cost curve," as Orszag says -- besides the public option. Fight for the public option, sure. But for Democrats for vote against a bill that includes cost-control measures (and even the Senate Finance Committee bill surely will), moves towards affordable universal coverage, and regulates insurance industry abuses out of existence would be an outrage.

I have no doubt Obama's wranglers, Harry Reid, and Nancy Pelosi are all counting votes in the House and Senate. In the end, they may decide the public option simply can't pass. Rejecting the bill on that basis alone would prove Democrats are just as capable of the sort of narrow, purely-ideological thinking that the Limbaugh party thrives on.

and yet here you, all over this thread

her you are arguing for subsidies to the insurance companies.

as long as their costs dont' rise above inflation! Forget all that other stuff we said about costs all ready being out of control.

Here you are, the champion

for giving tax dollars to insurance companies, and then bleeding other families who do not qualify for subsidies.

Wow, someone tries to use logic and reality in their argument and you call them names. And he's on your side! Can't imagine what you call folks on the other side.

Couldn't agree more. Democrats that believe there are other methods to achieving meaningful, lasting health care reform without a public option are on your side.

By all means, fight for a public option. Democrats who really care about the public option are justified in threatening to kill reform if there's no public option, in hopes of getting the provision included.

In the end though, I don't think it's unreasonable to expect every single Democrat to vote in favor of a bill that introduces much needed new health care regulation, provides generous subsidies for the unemployed/underemployed/self-employed to purchase insurance, and includes once-in-a-generation cost-saving measures, even without a public option.