Crunch Time and a Grassroots View of the ‘Robust’ Public Option

By PDA-Chicago Steering Committee: Bill Bianchi, Lorin Klugman, Arlene Gloria Hirsch, Allan Nowakowski, and Jim Rhodes

The PDA-Chicago steering Committee wants to weigh in on the controversy that has arisen over something called a ‘robust’ public option. We all know, the term ‘public option’ has become toxic to many single-payer supporters, and it’s become difficult to discuss this issue calmly.

Many of us at the grassroots are aware that PDA’s allies in Congress, the Congressional Progressive Caucus (CPC), are approaching crunch time when they must either vote for or against the legislation, HR 3200 (billed inaccurately as health care reform), offered by the President and Democratic Party leaders.

The stakes are high. If CPC members support HR 3200 with its anti-progressive, corporate friendly features, they will be accused by grassroots supporters of single-payer of selling out and possibly causing a split in the progressive movement. Plus the bill’s mandates could spark a right wing populist backlash that might result in serious Democratic losses in 2010. On the other hand if they vote against HR 3200 and cause the bill to go down, they will be blamed for any Democratic loses in the 2010 election. Clearly HR 3200 presents the CPC and PDA with perilous choices.

In response to these pressures, the CPC is advancing their ‘robust’ public option’ as a means of showing solidarity with those on the left who oppose HR 3200 and want the CPC to support only the single-payer bill, HR 676 (The National Health Care Act). As a strong ally of the CPC, PDA is naturally feeling the same pressures to shift its position from supporting only HR 676 to the possibility of also supporting something called ‘robust” public option as well.

We acknowledge up front that this whole debate is incredibly complex. Nevertheless, we at the grassroots want to have a voice in any changes that may be taking place. So it’s necessary to lay out our base line thoughts.

The members of PDA-Chicago Steering Committee believe that the current House bill HR 3200 (as we understand it) is defective in many ways and should be defeated. Its primary defects include mandates and subsidies that will force millions to buy private health insurance and require the government to subsidize most of those new policies. And with the government paying the bills, insurers will be able to raise rates at will. As a result, huge amounts of public money will flow directly to the culprits, giving them new billions to lobby the Congress, the media and academics and undo whatever insurance regulations are passed, just as the bankers did with financial regulations. What’s worse, HR 3200’s corporate-friendly features might actually enhance corporate control over the nation’s health care system.

All this contradicts PDA’s founding values, which state: We seek to build a party and government controlled by citizens, not corporate elites — with policies that serve the broad public interest, not just private interests. That prescription cannot be filled under the terms of HR 3200, let alone the Senate version which, as of this writing, contains no public option at all.

The public option that has gained so much attention is in fact only a small part of HR 3200, far too small to correct the strong corporate bias built into the bill or to have any market impact. Plus, the public option is to be marketed in so-called insurance exchanges that will be set up in each state. As a result, many state-based public options will evolve, thereby creating a labyrinth of bureaucratic complexity and confusion, which is exactly what conservatives predict. Yet this public option business has become the focal point of attention while the insidious mandates and subsidies are almost ignored.

As a possible antidote to the corporate bias in HR 3200, the CPC now calls for a “robust” public option –described in detail at the CPC site, see HERE. In truth the description includes some good features that offer the possibility of replacing wholesale corporate control of health care with public influence. One feature in particular is noteworthy, namely that the ‘robust’ public option should, Be available to all individuals and employers across the nation without limitation. That’s definitely a step in the right direction.

While acknowledging the public-friendly features of CPC’s ‘robust’ option, the PDA Chicago Steering Committee still views the CPC ‘robust’ option as deficient in several ways:

• The ‘robust’ plan remains only part of a larger piece of legislation that still enables massive public subsidies for the purchase of private insurance policies. Everyone who supports health care reform recognizes that private health insurance companies are the root cause of this country’s health care crisis. Why then reward those companies with billions of new dollars that will enable them to become even more firmly rooted in our health care system? Money is power. With billions in new revenue, private insurance companies will be able to lobby more effectively against any insurance reforms that may be enacted and to over whelm the public plans. Such ‘market based solutions’ threaten to kill off the common good.

• As far as we can tell, the ‘robust’ plan still allows private insurance companies to play a major role in making health care decisions, such as reviewing and denying claims. They make these decisions on the basis of financial criteria. This is not acceptable. Claim denial can be a life and death decision and should not be subject to balance sheet judgments. For that reason, private insurance companies should be prohibited from making such decisions.

• The CPC’s ‘robust’ plan is still only a wish list on the CPC website. It doesn’t exist in any legislation that we know of.

We recognize that the CPC must engage in the actual political dynamics of the day. However to fulfill the promise of progressive reform, we urge PDA and the CPC to take the following steps:

• Oppose HR 3200 in its current, or likely, final form. With its puny unworkable public option, insurance mandates and mammoth subsidies for private insurers, this legislation would benefit corporate interests while harming those of the American people.

• Insist that the profitability of private insurance companies should play no role in determining the shape of our system for financing health care

• Vote as a block for the Weiner amendment to HR 3200 which substitutes HR 676, the United States National Health Care Act. Then return to your districts and report to your constituents that HR 676 offers true progressive reform including morality, fairness, simplicity, cost effectiveness and the proven track record of Medicare. It’s important that the country hear the benefits of ‘Medicare for All’ from their representatives, particularly those in the CPC. Support without advocacy is an empty gesture.

• If the Weiner amendment (HR 676) fails, then offer the CPC’s improved ‘robust’ plan that includes two additions: 1) an airtight prohibition against subsidizing private insurance. State clearly that public money can be used only to purchase government offered health plans. That is the crux of progressive values. 2) A prohibition against private insurers denying claims.

By voting as a body for the Weiner amendment (HR 676) and then for your new enhanced plan–which states clearly that public money cannot be used to subsidize an industry that contributes nothing to health care–the CPC and its progressives allies will gain national respect and political power. Moreover, they will completely change the national dialogue about the role of government and so-called “market based solutions”. The CPC with PDA’s help will have established for the next generation of Americans that the role of government is not to enable corporate profits but to promote the common good.

Together, the CPC and PDA can take leadership in the struggle for true progressive reform in all areas of American life, if we act now in unison and according to our convictions.

Blogger Ellen Gill states that the definition of “robust public option” has completely broken down so when people use the term there is no general understanding what it means. However, as stated the CPC provides a detailed nine-point definition.