About those revolting liberals
So what do I think of the liberals who are threatening to vote against health care reform if there is no public option ?
I think it is very very clear (as noted by Ezra Klein with whom I mostly agree) that it is not about the public option and not even entirely about health care reform.
Here the key point is that the big battle has already ended in liberal surrender. The appeal of the public option back in 2008 when it was proposed by the Edwardses was that it would amount to stealth single payer, but, it was assumed, that Republicans would be too embarrassed to explain why. Public health insurance is much much more efficient than private health insurance. We know this, because private companies can't compete with the medicare administration without huge gigantic immense subsidies.
Therefore, if a public option were allowed to compete on a level playing field with private insurers, they would wither away. Clever. Turns out that Republicans (and Ben Nelson) are not easily embarrassed and have made exactly this argument. Of course they claim that they are concerned that the playing field might not be level, but they can't come up with any way to make it level with a slope level enough to make it possible for private health insurance companies to compete.
The compromise which would preserve endangered health insurance companies from
unfair competition is to restrict the public option to individuals and small firms buying health insurance on the exchanges. Obama declared his determination to avoid stealth single payer exactly in the announcement which raised false hopes among those who hope for stealth single payer. He said the exchanges must include a public option. That means he agrees that large firms be required to buy health insurance from private companies which means that they'll do fine.
Game over.
Revolting liberals have decided to ignore Klein's explanation that they have lost already and threaten to vote against health care reform over the not so important sliver of a public option which hasn't been ruled out already.
Why ?
Atrios *and* Paul Krugman have made it absolutely clear that this is no longer about health care reform. Reform without a public option is not unacceptable to revolting liberals because it will increase the profits of parasitic insurance companies. Reform with a public option only on the exchanges would do that too. Reform without a public option is unacceptable to many, because it is exactly what AHIP, the insurance industry lobby, proposed. Karen Ignani's very first offer would be accepted by the US government. The shame of liberal defeat would not even be covered by a fig leaf (hmmm current in the running option is more like an olive tree leaf).
The question is do powerful interest groups get exactly what they propose ? My answer is that if they propose universal health insurance with extensive regulatory reform then sure.
The revolting liberals are, to put it as rudely as possible, like blue dogs. They say no and require a last minute compromise to win their votes just to show that they can say no. The blue dogs accepted very minor changes and went back to their districts to brag about how they had held up health care reform. Then the revolting liberals demanded even more tiny changes so that they could prove that attention had to be paid to them too.
That's what it's about now.
