What Little is Left of the Public Option Would do More Harm Than Good

Actually, we probably DON'T want the public option, because the particular "public option" that is being discussed at this stage is not the "public option" that was originally envisioned by Jacob Hacker, who invented it. Hacker wanted roughly 100 million Americans on the public option, whereas even if the "public option" such as it exists now (in the House bills) is passed now, it will be lucky to ever attract 10 million. And who knows how long it would take to even get up to 10 million?

Furthermore, many economists believe that the public option up for grabs now would be like the Hindenburg, doomed to self destruct due to a ruinous combination of being swamped by the sick and being shunned by providers. As a word of advice, if the public option is passed, unless you are totally desperate and absolutely must have health insurance with a 5-10% discount, you should probably steer clear of actually signing up for it.

Whereas, at least 30 million and probably more than that would be needed for non-negligible cost reduction.

What the current public option would be would be a way for Obama to "thread the needle," a way in other words for him to get both centrist and slightly left of center progressive Democrats at the one extreme and right wing "Blue Dog" Democrats and a smattering of Republicans at the other extreme to sign on to the same final bill.

Public option or no public option, the biggest component of the final bill will be the mandate. Public option or no public option, the second biggest component of the final bill will be how many low income people are allowed to get Medicaid. Public option or no public option, the third biggest component of the final bill will be whether new taxation on businesses thwarts what little job creation they might be able to do if they didn’t have to pay new health taxes. Public option or no public option, the fourth biggest component of the final bill will be exactly what the subsidies will be for low income individuals who still do not qualify for Medicaid, but who now supposedly have to buy insurance.

You can quibble if you want about my importance ordering, but that the public option is far less important than the four items I mentioned is indisputable.

The original public option had real cost control and even underlying health care cost reduction connected with it. The public option hanging in the balance now does not have any substantial cost effect at all. So the public option hanging in the balance as of this writing is nothing more than rearranging deck chairs on the Titanic.

Nothing at all (or just getting the insurance companies to stop acting criminally via recessions etc.) would at least keep the ball alive with respect to single payer state by state or national single payer within the next decade or so. Passing the weak, fake public option would all but close the door on single payer for an unknown but substantial number of decades. It would possibly close the door on single payer forever.