Columnist: Health care by a new name

Published 12:41 pm Monday, July 13, 2009

Washington Democrats appear to falling back on an old reliable answer to the “public option” dispute in their health care plans: When you can’t change the issue, change what you call it.
“The only debate on that is what it will be called: a patient option, public option,” said House Speaker Nancy Pilosi in a Thursday news conference. “Write in your suggestions.”
Suggestions? How about “banana?”
After all, new administrations often rename things. This one is no exception. Team Obama has already renamed the “global war on terror” to the less ambitious “overseas contingency operations.”
Treasury Secretary Tim Geithner has transformed the oxymoronic “toxic assets” into the much more enticing and sturdy-sounding “legacy assets.”
Obama lashes “lobbyists” until he invites them to participate in fact-finding or negotiations as “stakeholders.”
But would a “public option” by any other name offer as many benefits?
That’s become the focus of this summer’s big health care debate. A “public option” would simply be this: a government-run insurance plan to compete with private insurers. Think Medicare, but offered as a choice you could choose instead of your present private health insurance, if you have any.
You don’t have to take it, if you can find something better. But if you can’t, it’s like a good friend – always available even if he occasionally needs to sleep on your couch.
Obama likes the public option, as do a majority of other Americans, depending on how you ask the polling question. A Quinnipiac poll a few days ago, for example, showed 69 percent support for a public/government-run option, but only 28 percent said they would opt into it. I would like to think that gap in responses indicates high hopes for their current insurance plans coupled with a desire to have more choices and competition to hold down costs.
Reducing costs is one of three “bedrock requirements for real health care reform” that Obama gave to Congress to fill in the details. The other two were to ensure “quality and affordable” care and guarantee choice, “the freedom of every American to choose their own plan and doctor – including the choice of a public insurance option.”
But Chief of Staff Rahm Emanuel seemed to sing a slightly different tune early last week. He said a health bill without a public option might be acceptable as long as there is “a mechanism to keep the private insurers honest. … The goal is non-negotiable; the path is.”
Say what? Progressives erupted in howls of protest. Obama paused in his Moscow trip to say once again that he strongly supports the public option, even if he does not want to draw a line in the sand on it. That’s just as well, for this is Washington. The less firm the language and conditions for negotiation, the more likely an idea like a public option can survive the inevitable assaults by the private health insurance companies.
So they can change the name, but to what? Republicans and other conservatives already call it “socialism,” but the S-word has lost some of its energy through overuse. Some of us are old enough to have heard the same howls of protest against Medicare in the 1960s and more recently against expanding SCHIP, the federal health insurance program for kids. Each has become one of the government’s most popular programs.
As insurance companies have charged more for less coverage – and millions more people have lost private coverage entirely – calling a public insurance option “socialism” only makes socialism sound good.
No wonder the private health insurance companies and their Capitol Hill allies fear a public option. They say the public won’t like it, but their bigger fear is that we the public will like it better than what the private market is providing us now.
A compromise may well center on another euphemism: “coop.” That’s short for a nonprofit medical cooperative plan that some top Democrats and Republican moderates see as a possible substitute for a government-run insurance option. Still, hard-line conservatives oppose the offering of any public money to help states set up their co-ops.
Many on the right also sniff at a suggested “trigger,” in which a government-run plan would only be employed if certain targets, like cutting costs, are not met by the private market. Stealth socialism, in their eyes. It’s hard to please some people. But, without a public insurance option of some sort, any Obama insurance compromise is going to ring like a hollow victory, no matter what name he calls it.

E-mail Clarence Page at cpage(at), or write to him c/o Tribune Media Services, 2225 Kenmore Ave., Suite 114, Buffalo, NY 14207.