Wednesday, December 16, 2009

The Public Wants its Option

Now the polls are out on the public-optionless Senate bill. They ain't pretty:

The NBC/Wall Street Journal poll coming out later today will show opposition to the health care bill growing -- mainly from disappointed liberals, who are very much disappointed to see the public option getting thrown out.

The poll has 47% saying the Obama health care plan is a bad idea, to only 32% who say it's a good idea.

Chuck Todd writes on Twitter: "Most of the movement on the 'bad idea' comes from some of the president's core support groups, folks upset about lost public option." He also writes: "Still, large majorities of the president's core support groups believe his plan is a 'good idea,' but the margins have shrunk."

In addition, 44% now say it's better to not pass this bill -- seemingly a large bloc of conservatives, plus some liberals -- to 41% who say it's better that something pass: "First time NBC-WSJ poll had that upside down."
This is with medicare buy-in. With that removed, expect opposition to spike dramatically.

I'd expect it to stick, too. With the public-option or medicare-buy-in versions of the bill, at the very least there was something positive to point to, and something that could be expanded to keep progressives on board and defray the negative reaction to the mandates among the general public.

As it is, the only people defending the "force you to buy private health care for Joe Lieberman's sake" Act of 2009 are Democratic team cheerleaders. They aren't going to get that much traction. Not with this nonsense.

Edit: Jed Lewison brings up something that I've been concerned about, too:

he central argument made by proponents of the Lieberman-wrecked health care reform bill is that it would expand coverage to 30 million Americans who would otherwise be uninsured. It would accomplish this, they say, through subsidies, subsidies that comprise the bulk of the bill's $800+ billion price tag.

Given the centrality of those subsidies to the expansion of coverage, one of the biggest questions about this reform effort is whether the subsidies are politically sustainable. Unfortunately, history suggests they may not be. While Medicare and Social Security have broad-based support because everybody benefits from them regardless of income, means-tested welfare programs -- including Medicaid and even health insurance for children -- are constantly at risk of being cut, entirely dependent on the prevailing political winds.

The important point here is that because the mechanism for making coverage affordable is subsidies for low-income Americans rather than systemic reform that would apply across the board, the subsidies will constantly be on the chopping block -- and the expanded coverage that is the goal of this bill will always be at risk.

Moreover, because subsidies don't kick in until 2014, it's possible that in a nightmare scenario, they could be dramatically cut or even eliminated before seeing the light of day. In the absence of any systemic reform, then, we face the unpleasant possibility that with a realignment of power in Washington, DC, we could end up with a mandate -- and fewer, or even no, subsidies.
This is why the political and policy arguments against this crap are inextricable. If the Dems lose seats because of this bill in 2010 or 2012, and if the job market and deficit situations remain moribund, the health care subsidies are going to look like a more and more tempting target for Republican or ConservaDem cuts. Poor people don't vote for Republicans, after all. They disproportionately don't vote at all. So why not screw them?

This is just about the only place in which the interests of the health insurance companies and the poor intersect. The corps will want to keep the subsidies flowing, because it will line their own pockets. That might keep the more corporatist Dems on board, but the crazy teabagger Republican party that is poised to seize control may have to sacrifice the corps' support to keep their base happy.

(Republicans, you see, have to do that. I know it may be confusing to Democrats and their apologists. "Strong" and "base" are not words that usually go together in the Democratic mind. But Republicans are different.)

Then again, maybe the corps have nothing to worry about. All that money is going to buy a LOT of lobbyists. If you think Pharma and the health insurance corps are bad now, just wait until they gets funneling those big mandate dollars into lobbying firms and "pro-market think tanks".

America will be lucky if the Lincoln memorial isn't "brought to you by GlaxoSmithKline and Wellpoint" by 2015.

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