The Public Option: Popular Everywhere But the U.S. Senate

Many sound notes of exasperation that the public option continues to be the focal point of the health care fight, both on the right and the left. But at this point, their exasperation is itself becoming exasperating. At its core, we’re talking about a policy point that, despite eight months of pummeling, remains popular except in the halls of the United States Senate and the corridors of the headquarters of the insurance companies. It is the latest incarnation of the people vs. the powerful -– and I’d say folks have a right to be angry that the people seem to be losing.

Two bits of news today reinforce the unmistakable trends of continues popularity and support. Washington Post-ABC News released their latest poll, finding support for health care reform in general is split right down the middle. But giving people the choice of private insurance or the ability to voluntarily buy into a high-quality, government-administered public health insurance plan, similar to Medicare, scores better at 55%. But that’s the tip of the iceberg! When actually described correctly as being an option available only to those who don’t already have insurance, support jumps to 76%. It’s like the August of our discontent never happened.

One of the canards about the public option is that physicians won’t support it because they’ll refuse its presumably lower negotiated payment rates. But today’s New England Journal of Medicine should put the lie to that once and for all. A survey by email and phone of 2,130 physicians (well above the 800-1,000 sampling of most polls) finds tremendous support among doctors for the public option -– 63% of doctors support health reform that incorporates a choice between public and private coverage, whereas only 27% prefer reform where private insurance is the only option. Even surgeons, slightly more conservative and skeptical of reform by nature, come in at 59%.

Oh, and tomorrow the AFL-CIO is set to endorse a public option formally, after their incoming president has warned darkly about primary challenges for Democrats who vote against it.

Now I should note that popularity does not always correlate to the right policy, particularly on something as complex as health care. But let’s review. All three major Democratic nominees for president endorsed a public option two years ago.  This year, so did the leadership in the House and the Senate, as did all but one committee chair with jurisdiction over health care. The last committee chair released a blueprint with a public option months ago, before changing his mind. 100 members of the House are threatening to vote against a health care bill that doesn’t contain it. The Senate Majority Leader is for it, as are the number two (Durbin) and the number three (Schumer) Democrats in the Senate. A still-popular President of the United States devotes a significant portion of his health care stump speech to it. Progressives are for it. Labor is for it. Doctors are for it. The American people are for it.

What’s on the other side? Entrenched Republican resistance that has already said jettisoning the public option isn’t enough for them to vote for the bill. And an insurance industry that’s dishing to Business Week about their ability to influence centrist senators like Baucus and Conrad and Blue Dog congressman like Ross.

It’s one thing to year in and year out lost to the lobbyists and special interests whose money and influence control the levers of power. It’s quite another to have our noses rubbed in it.

(Photo credit:  The White House, via Sen. Max Baucus' web site.)