What is a robust public option now?

( – promoted by buhdydharma )

This diary notes a shift in definitions: A “robust public option” used to mean a public option available to all, on the first day of mandates.

What does it mean now?

(crossposted at Orange)  

nyceve sent me an email today.  It said:

Now, I need you to call your member of Congress and reiterate that demand: we need a true public option without co-ops or “triggers.”

So here it’s called a “true public option.”

The letter continues:

It’s still up to us to hold the line with enough votes in the House to make sure the only thing that can pass is a strong public option.

Here it’s a “strong public option.”  Now, at the bottom:

We need you to call your Representatives and say that you only support a public option without co-ops or triggers, and you need them to do the same.

Here, it’s a “public option without co-ops or triggers.”

Now, nyceve’s most recent diary carries a link to a letter to the President by Raul Grijalva and Lynn Woosley.  This letter says, among other things:

We look forward to meeting with you to discuss the importance of your continued support for a robust public option in the final bill.

Keep these wordings firmly in mind.  There will be a quiz at the end of the lecture.


Now, on to HR3200, the bill we want a “public option” in.  John Geyman tells us:

As described in my recent book Do Not Resuscitate: Why the Health Insurance Industry Is Dying, and How We Must Replace It, we have never been able to effectively regulate this industry, which has many ways to game any system by cherry picking the market.

HR 3200 is, like all the other options, not effective regulation either.  The most telling reason why this is so is that HR 3200 does not control costs in any adequate way.  From Geyman’s piece in HuffPo:

…federal payments for subsidies will far exceed any projections that are now being discussed. There are at least 100 million Americans less than 65 years of age with incomes below 400 percent of FPL. If eligibility for federal subsidies is set at that level, the CBO projects that their cost will be about $773 billion between 2013 and 2019. Concerning Medicaid expansion, the CBO has also estimated that extending Medicaid to an additional group of Americans with incomes for a family of four up to $33,000 a year would cost about $500 billion over 10 years.

What will the government’s reaction to this be?  We can only expect the deal to get worse:

We can be sure that the Senate will restrict subsidies below these levels and that any final health care reform bill, if ever enacted, will further exacerbate the problems Americans face in paying for health care.

There may be a cap on the cost of insurance premiums to the individual (what was it, 11% of income?) but there will also doubtless be a cap on costs to the government, when the Blue Dogs start to freak out about the final price tag.  (Here, of course, I am only speculating.  But would anyone here like to bet on it?)  Since government costs are likely to spiral out of control, guess which cap will win?

The real injustice, of course, will be the joke insurance we’ll be asked to buy.  Geyman, again, from HuffPo:

…federal law would mandate them to purchase health insurance, under penalty of fine, and an underinsurance product at that. A working draft of the “actuarial value” of insurance coverage in the Senate Finance Committee last month stated that a policy of “bronze” or “silver” value would cover 65 and 73 percent of total health care costs, respectively — undercoverage by any standard. A family of four with an income at 300 percent of FPL would pay 15 percent of their income on health care. So we would end up with a mandate for inadequate coverage which much of the population, as well as taxpayers, cannot afford.

So what are we calling Congress every day about?  Oh, that’s right, the public option.  What about that?  Geyman:

AHIP and its lobbyists have already succeeded in neutering the public option to a small program without enough potential market share or flexibility to set its own premiums to effectively compete with private insurers.

It’s a robust public option with a poison pill — it’s designed to fail.  So is that the “robust public option” we are supposed to be demanding from Congress today?

Or are we asking for a robust public option which is an AFFORDABLE insurance option available IMMEDIATELY to EVERYONE on DAY ONE of the mandates?

And if we’re looking for that, why has it disappeared from the language of the “progressives” which are supposedly trying to improve HR 3200?  Andrew Coates defines the problem as follows:

Although the Congressional Progressive Caucus’s press release placed the word “robust” before “public option,” they did not define what that term meant to them. Is it not odd for any legislator, much less dozens, to “hinge” their support for an entire (and very important) bill on the inclusion in that bill of an entity they have not defined?


Now, I don’t mean to disparage the work of the good folks at Firedoglake: nyceve, slinkerwink, Jane Hamsher, and so on.  I admire their hard work.  But I do want to know if they are going to defend the “robust public option” I’ve suggested, the affordable “robust public option” that is available to everyone on day one of the mandates, or if they are going to accept the terms of the “public option” laid out now in HR 3200.  But here is Jane Hamsher from FDL, June 23 of this year:

We need to get progressive members of Congress to commit that they will not vote for any bill or conference report that does not have a robust public plan that is:

   * available nationwide

   * available on day one

   * and accountable to Congress and the voters

Do we still want this?

Or are we planning to wait until 2013 to get 5% of it, while the current system vacuums up our earnings with a vengeance while receiving enormous bailouts from the US government?

Here’s a thought.  Give up on the stupid bills, prepare for 2010, defeat the Blue Dogs, and then bring the issue up again in 2011.  We’ll get the bill we want, and millions of dollars won’t go to the insurance vultures.  Meanwhile, try to get single payer passed in the states.


Remember Frederick Douglass?  He told us: “Power concedes nothing without a demand.”  So when we ask for a “robust public option,” what are we demanding?  The option written in HR 2300?  A public option open to EVERYONE on DAY ONE of the mandates?  What are we demanding?

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  1. — if we don’t know what it means?

    • BruceMcF on September 11, 2009 at 11:57 pm

    Robustness is the quality of being able to withstand stresses, pressures, or changes in procedure or circumstance

    (1) Publicly administered

    (2) Available to everyone that the mandate applies to

    (3) Not hobbled or hampered in its ability to provide a cost effective not for profit insurance

    “Available to everyone” – available to everyone that the mandate applies to. That is the “No Taxation Without Representation” principle – no mandatory payment from the citizen if it does not operate under the oversight of the citizen’s representatives. A corporate board is no acceptable “representation”.

    No Public Option = No Mandate means that if the public option is not available to someone, then the mandate cannot apply to them. If the mandate applies to them, the public option must be available to them. “Try the mandate and see how it works” – “Taxation without representation as long as it meets certain guidelines” – is simply illegitimate, and shows how far from being genuinely “Fathers of the Republic” conservative Olympia Snowe truly is.

    “Not hobbled or hampered” … 50 different public insurance plans with 50 different cost pools and 50 different duplicated administrative structures is not robust. Its a fake public option and voting for a mandate with a fake public option will be treated as “Taxation Without Representation”.

    And, further, what about when a natural disaster strikes? What insurance is, is risk pooling. The corporate insurance companies will not be geographically limited – a disaster that strikes one major city in a state will be spread across a much wider risk pool for the corporate insurers – geographic limitation on the public plan is hobbling it as insurance.

  2. …doesn’t work, brings one back to DD.  I’ll go look for it at the citrus.

    • banger on September 12, 2009 at 6:09 pm

    direction of HCR. I see no evidence of reform in favor of those of us who aren’t rich or who believe in rational analysis of problems. The problem wasn’t analyzed, was not discussed using facts, and the current bills are a stupid hodgepodge of junk. I say oppose all of it and don’t work for HCR unless you are sure that the public option is intended to replace the for-profit-system.

  3. Buy survivalist compound in woods

    Pay off all debts and disappear from the electronic control grid

    Get homeopathic remedies before Codex takes effect THIS December.

  4. …is the only public option which will actually work.

    The compromise versions (coops, triggers, etc,) will enrich big Insur/Pharma while being financially untenable, bankrupting the sytem, and continuing to harm “we the people.”


    A public option open to EVERYONE on DAY ONE …

    …is a workable, viable option.

    This healthcare/insurance reform is turning out to be just like TARP and the bank bailouts–Accumulation for the Corps Masters through theft from and dispossession of ‘we the people.’

    I’m now convinced we must say No to the this bill as it continues as a rip off.  

    Say “NO” now and work for Single Payer ASAP.  But to lock us in to this horrible plan is a mistake.  

  5. The Dems are now backing down on public option, see here.

    Please take a minute to view a Greenwald video, with Former Labor Secretary Robert Reich explaining the public option and circulate.

    We are in the worst possible position in re the healthcare issue.  We have been screaming from the position of a “public option, which, as you now see, is being played down each day.  Our bargaining point was not HIGH enough to begin with.  First, we should have been screaming, consistently, right down the line for single-payer healthcare, such as Medicare and/or H.R. 676, and we should start doing that right now. And, we shouldn’t stop — of course, the likelihood is remote (gotta’ let those MF’s who have been screwing us for 75 years and calling the shots with our very health and lives continue to screw us, you), but it would put us in a position of bargaining from a much higher vantage.

    We MUST SAY NO to the bill with the mandate that everyone must have insurance, unless there is a bona fide plan for a “robust” public option.  This public option should be offered to every single American, not just those who can’t afford it, but every single one of those, including those working.  Otherwise, as so many have already pointed out, we will, indeed be rewarding those who have screwed us right down the line.  In turn, this, too, would further marginalize the so-called “middle-class.”


    Thanks for this, cassiodorus!


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