The Public Option As Scapegoat

The Hill’s Jeffrey Young is reporting that in light of the Democrats’ decision to drop the public option and the Medicare buy-in provision from the Senate health bill, SEIU is backing away from their support of the legislation:

The SEIU had planned to participate in a Capitol Hill press conference along with the AARP, the liberal advocacy group Families USA, Consumers Union and the American Cancer Society Action Network. As recently as Tuesday morning, the organizations distributed an advisory to the news media that included the SEIU. But the move by Senate Majority Leader Harry Reid (D-Nev.) to excise provisions of the healthcare reform bill to create a government-run public option health insurance program and to allow people between 55 and 64 years old to buy into Medicare gave the labor union pause, spokeswoman Lori Lodes said.

This explanation is a bit hokey. Initially, the public option would only be available to individuals, small businesses and the self-employed. Union members would presumably remain in their generous employer-sponsored plans — far from the public option or any other health insurance program offered in the exchange. Thus, their reaction to the latest developments is either just a misunderstanding of the policy — which I highly doubt — or a back door way of opposing the 40% excise tax on so-called Cadillac health care plans. The indexing of the excise tax may be problematic, but overall the the excise tax would exempt most union members from the fee, help slow the rate of health care cost and reduce the deficit.

I’ll leave that policy debate for another day and simply point out that the so-called compromise debacle has provided progressive critics of health care reform with cover to register their discontent with other parts of the Senate health care bill. The reality is, most progressives rated the chances of a public option passing the senate as highly unlikely at best. Sen. Reid’s decision to include an opt-out extended the public option dream, if only briefly, but it didn’t change the fundamental political reality. Without converting conservative Democratic senators to the progressive cause, the policy was still a no-go.

For this reason, among others (including the plan’s narrow reach), the heart of health care reform was never about the public plan. The real game was in improving affordability standards, enhancing the exchanges, and figuring out the payment reform. At this juncture, to pretend that health care reform is synonymous with the public plan is a bit opportunistic and disingenuous.

Update:

This post wasn’t intended as a hit against the SEIU, but in making the larger point that progressives are overreacting to the loss of the public option, I unintentionally mischaracterized the motives of the organization.

Regrettably, I failed to mention that the SEIU is a membership-driven organization that polls its members before supporting legislation and actually includes many members who are in jobs that don’t offer benefits and would have benefited from the public option.