The Good, the Bad, and the Stupid in Yesterday's Public Option Debate

Yesterday was public option day in the Senate Finance Committee mark-up, as amendments by Sens. Rockefeller and Schumer that would have created public health insurance options for the Baucus bill were debated for hours before going down to defeat. Outlets like Huffington Post and the Politico promised everything short of actual bloodshed in a Democrat vs. Democrat battle royale. But that didn’t even remotely happen. Instead, we got an honest-to-God debate. But senators will be senators, and there was some inanity to be had as well.

These were weighty issues, and they got the consideration they deserved. From Sen. Rockefeller’s impassioned arguments that private insurance companies have treated the American people so badly that they need and deserve the security of a public option; to Sen. Grassley’s stern admonishment against introducing a player into the marketplace who could come to dominate it; to Sen. Schumer being the first politician I’ve heard yet make the argument that those already with insurance would see lower costs due to the competition from a public option, there was much matter here.

For a sampling, check out Sen. Rockefeller’s argument and questions for the Senate Finance Committee policy staff:

Good stuff! Tough questions! And no willful ignorance in sight. Sadly, the whole day did not match this level of erudition. Also demonstrated during the proceedings is that some of our senators aren’t quite masters of reading comprehension.

Sen. Kent Conrad had to go and ruin the erudition when, once again, he held up France as an example of universal health care that works even though it’s not government-run. Conrad seems to have preposterously newly gotten this observation from T.R. Reid’s new book, which he read just a few weeks ago. To which I say, Senator, please stop skimming! (Regular readers of this blog will remember that French citizens are covered for public hospitals and most doctors through the government-run program Sécurité Sociale, which the supplement with complimentary private insurance on top).  Weirdly, this complete misreading of the French system served as the basis for Conrad voting against both public option amendments, even when his initial complaint of too-low Medicare rates for the Rockefeller version was sated by the Schumer version.

Similar, opponents of the public option constantly cited a study that suggested that millions -- no, tens of millions -- no, hundreds of millions would sign up for a public option, leading to the crumbling of private insurance. Of course, this was not the projection of the Congressional Budget Office, the authoritative estimated numbers which Sen. Kyl later referred half-jokingly as “our holy grail.” The CBO projects only 10, maybe 15 million people would sign up for a public option, were it offered alongside equivalent private insurance plans in the Health Exchange for individuals and small businesses.

No Sens. Grassley et al. were quoting the Lewin Group’s analysis of a public option, which dramatically estimated 103.4 million people would enroll in it, with 83.4 million leaving private insurance to do so. There’s a huge problem here -- well, two, really. That Lewin Group model presumes the public option would be available to everyone, but it’s not. Only small businesses and individuals can sign up for it. It also presumes that the public option pay providers based on Medicare rates -- something the Rockefeller version would do for two years only, and the Schumer version would never do. In short, the entire model does not apply to what they’re talking about. You won’t hear Grassley or Hatch or Ensign or anyone else quote the other set of numbers from the Lewin Group -- the ones that more accurately model the proposal in the amendments and conclude 78% of people in private insurance now would stay right where they are, with a modest 33.6 million enrolling for the public option. This despite the fact that it’s in the exact same report!

Oh, and by the way, I’ve made this plea before, so I may as well copy it verbatim: “please, please, for the love of God, please find someone else to crunch your numbers. The Lewin Group is a wholly-owned subsidiary of Ingenix, the database company that provides information on provider rates for most of the major insurance companies, and is itself a division of UnitedHealth, the nation’s largest insurer.”

Yesterday’s Senate Finance Committee showed several members at their best. It also showed several members flunking basic reading comprehension.

So let me ask you -- how nervous should we be that the latter group of senators were the ones who successfully voted down the public option amendments?