Matthew Yglesias says the folks pushing the public option need to calm down. Without the public option,
It wouldn’t be an ideal health plan or the best bill you can imagine. But it’s no exaggeration to say that it would be the greatest progressive legislative accomplishment in four decades, and that’s nothing to sneer at.
In the middle of a fight where the other side is screaming that Obama wants to create death panels, it’s a little weird to argue liberals shouldn’t go ballistic over hints Obama is going to drop the public option. As Matt Taibbi said, “time to consider what good stuff might be in a public-option-less bill is after you’ve lost that battle, not before.”
But Yglesias’ argument also highlights a problem with traditional economic models. Yglesias says the current bills have a lot to offer:
most notably a set of consumer protections that would cap out-of-pocket health costs, guarantee access to preventive care, and prevent insurers from treating people well as long as they’re healthy only to start monkeying around when they get sick.. [The bills] force insurers to offer a defined set of benefits to all comers at a fixed price—no discrimination based on gender, health status, whatever. ..those of us who do have insurance would be spared the insurance-related anxiety that’s endemic in contemporary American life.
Let’s assume that such a bill gets passed and that insurance companies don’t manage to bury within the 1000 page bill loopholes that neuter the bill. The day after the bill passes, the insurance companies, will start working nonstop to create as many innovative ways around it as possible. They’d be fools not to — tweak the rules back in their favor and they win serious $$$.
What are the odds that liberals & progressives will be able to mobilize again and again to stop them?
Well, look at what happened with Wall Street. First they gutted the rules restraining their behavior while our side wasn’t really paying attention (some folks on our side saw it was happening but we didn’t do much about it). Eventually the new freedom they gained blew up the system and we had to bail them out, which really pissed off a lot of taxpayers. Despite this public anger, they’ve managed to skate virtually scot free. Why? Because there are no institutions that either act as a political check on them or help to mobilize resistance.
In contrast, look at Medicare. Sure, health care lobbyists have gotten all kinds of goodies for themselves into it (e.g., banning Medicare from negotiating lower drug prices). But when it comes to coverage? It’s so untouchable we’ve got right-wing folks at town hall meetings saying, ” Keep your government hands off my Medicare.”
That’s why the public option matters. It isn’t simply that it’ll create competition. Once created, it’ll act as a foci for organizing. Every time insurance companies try to mess with it – and they will, over and over – they’ll face a much, much tougher battle than they would otherwise have.
Traditional economic theories don’t handle these kind of economy-politics interactions very well. It’s one more reason we need a new way of thinking and talking about the economy.
