Public Option's Winding Road to Spotlight

Government-Funded Health Insurance for All went from Think Tank Idea to National Political Controversy

(CBS/ AP)  It started out with a couple of liberal policy wonks. One on each coast.

Along the way, Elizabeth Edwards - sensitized by her own experiences as a cancer patient - helped propel it into presidential politics during her husband's campaign.

The idea of a government medical plan to compete with private insurance might have been just a footnote in an academic paper. Instead it has followed an unlikely path to center stage in the national health care debate. Many Democrats insist any legislation must include a public option, while nearly all Republicans are against it. President Barack Obama seems uncomfortably stuck in the middle.

Into one bill would go reforms on which there is bipartisan agreement, such as making insurance portable and requiring companies to take customers despite pre-existing conditions, reports CBS News chief White House correspondent Bill Plante.

The second bill, which Democrats could pass with a simple majority and no Republican votes, would include more expensive, and controversial changes, such as the public insurance option - which many Democrats consider non-negotiable, Plante reports.

More coverage of Health Care Reform

A look at the roots of the idea shows that the policy experts who proposed early versions believed the government plan would become one of the largest insurers in the country. But Mr. Obama and other candidates saw it as a compromise between rival Democratic factions. One side wants Medicare-for-all, while the other prefers to subsidize coverage through private insurance plans - as Massachusetts has done. The debate within the party still rages, with Mr. Obama in the crossfire.

Former North Carolina Sen. John Edwards was the first Democratic presidential candidate to propose a public option as part of his health care plan, unveiled in 2007. Behind the scenes, his wife, Elizabeth, was a strong advocate of his decision.

In an interview, Elizabeth Edwards said that as the daughter of a Navy captain, she grew up with government health care and found it dependable. Later in life, her sojourn in the medical world as a breast cancer patient opened her eyes to the travails of people who had no insurance, or whose coverage turned out to be unreliable.

"I met people who were constantly coming up against one problem or another," Edwards said. "Even people like me, who have health care, know someone who has been through some misery because they couldn't afford the health care they needed."

Read more about the health care fight over the public option:

Obama takes Health Care Fight to Talk Radio
Obama, Congressional Dems Near Clash
White House Blurs Stance on Public Option


Before the 2008 presidential campaign, chances were slim that lawmakers one day would consider government coverage for middle-class workers and their families. Liberals had talked for years about expanding Medicare to cover not just seniors, but all Americans. That's all it seemed to be - talk.

Then in 2001, political scientist Jacob Hacker proposed a plan he called "Medicare Plus." Employers could choose either to offer private insurance or pay a payroll tax to finance coverage for their employees through a health plan modeled on Medicare. Hacker, now at Yale University, retooled his proposal early in 2007 as the presidential campaign geared up. It caught on with core Democratic constituencies.

"The unions fell in love with Jacob's idea," said health economist Len Nichols of the New America Foundation.

Hacker said he wanted to bridge the gap between Democrats who supported a single payer plan like Medicare-for-all and those who wanted to preserve the employer coverage that has served most Americans for a half century.

"I tried to provide a case for seeing common ground between those two positions," Hacker said. "There's certainly a strong political argument that single payer is not feasible. Threatening (employer) coverage is a political nonstarter, and moving all health care spending onto the public budget is virtually impossible in the current fiscal climate."

Nonetheless, he said estimates showed his public plan would end up covering about half of workers and their families - gaining a powerful position in the market.

On the other side of the country, a Berkeley health policy professor had come up with the idea of a head-to-head competition between a government plan and private plans. Helen Halpin proposed such a scheme in 2002 for California, a state with a history of failed attempts to remake its health care system. The following year, she retooled the plan as a national proposal.

Called the CHOICE Option, Halpin's plan would let people decide whether they wanted government coverage or a private plan.

"May the best model win," Halpin said. "Depending on the preferences of the population, the system could evolve to single payer, but it would be a totally voluntary transition." Her bet: The government plan wins.

Edwards' health care adviser, Peter Harbage, said he was familiar with both Halpin's idea and Hacker's proposal, and they were discussed in the campaign's deliberations.

"What Helen had here was the idea of choice, and choice as an option," said Harbage, now at the Center for American Progress. "The catch phrases people are using today were part of her paper."

Edwards decided on his health care plan after the campaign set up a private teleconference debate that featured two independent policy experts. One argued for a government-run system, while the other defended a market-based approach like Massachusetts has.

"We were both walking around with phones," said Elizabeth Edwards. "I was listening in." After the debate, her husband decided to go for the market-based approach - with a public option added.

Later on, Mr. Obama and Hillary Rodham Clinton adopted the public plan. The idea remains popular with the public: a Kaiser Family Foundation poll this week found 59 percent of Americans support it.

[nottellin1]

91% of the American people feel healthcare needs reform".

This is my favorite quote. I think both Reps & Dems can agree that reform is needed. We have to be careful not to let our pols pass reform just for reforms sake. Seems to me that is exactly what Obama and the Dems want is any bill so that they can claim a victory. The Obama presidency scares the sh out of me. Comments about how we need to screw the rich as if all are guilty of extreme greed instead of some bad apples. Even better is the desire to support the lazy and illegal as if that is what America is about. Contributing to those less fortunate is a wonderful thing but not of much moral value if it is manditory. The 'give me' mentality in th US right now is truly frightening.

[trapbreaking]

MORE DISAPPROVE THAN APPROVE OF OBAMA ON HEALTHCARE

Forty-nine percent of Americans currently say they disapprove of President Barack Obama's handling of healthcare policy, while 43% say they approve, similar to views expressed in mid-July.

.Gallup

Don't like Gallup? Here is Rasmussen:

SUPPORT FOR CONGRESSIONAL HEALTH CARE REFORM FALLS TO NEW LOW

Health Care Reform plan proposed by President Obama and congressional Democrats has fallen to a new low as just 42% of U.S. voters now favor the plan. That?s down five points from two weeks ago and down eight points from six weeks ago.
A new Rasmussen Reports national telephone survey shows that opposition to the plan has increased to 53%, up nine points since late June.

Another one:

54% SAY PASSING NO HEALTHCARE REFORM BETTER THAN PASSING CONGRESSIONAL PLAN

Thirty-five percent (35%) of American voters say passage of the bill currently working its way through Congress would be better than not passing any health care reform legislation this year. However, a new Rasmussen Reports national telephone survey finds that most voters (54%) say no health care reform passed by Congress this year would be the better option. 

.
Yet Another one, this one from NBC out today:

A plurality believes Obamas health plan would worsen the quality of health care, a result that is virtually unchanged from last months NBC/Wall Street Journal poll. What is more, only four in 10 approve of the presidents handling of the issue, which also is unchanged from July.

And a majority 54 percent is more concerned that the government will go too far in reforming the nations health care system, while 41 percent is more worried that the reform will not do enough to lower costs and cover the uninsured.

[jschmidt27]

With the employer provided insurance the employee is not the customer of the insurance industry. The employer is. The employer searches the best deal for them not the insured. So all employers should pay into a fund the employees can access for insurance. That would force insurers to be competitive to their customers. The govt should reduce overlapping regulation between state and Fed govt. The public option would bypass state regulations giving them an unfair advantage. The drug approvals are costly and take many years. That process needs to be studied and improved. Govt paperwork adds a huge amount of cost to insurance. The medical records need to be computerized across doctors, hospitals. Govt can provide incentives for that. Insurers should not be allowed to drop subscribers but should be allowed to charge a small fixed percentage for increased risk of insuring higher risk individuals. Individuals should not be uninsurable for pre-existing conditions. And of course last what Congress doesn't want to hear, tort reform. If we have such upstanding Congressmen as Dodd, and Frank,designing legislation, we'll get something that is more important to lobbyists than to voters as we did with the credit card legislation. Unfortunately Democrats thought they had unlimited power but they were elected because they were not Bush and Obama was an unknown to most except those who were wise enough to know a Chicago politician couldn;t be good.They thought all Americans would welcome their intrusion into every aspect of our lives because Democrats know what is best for us, better than we know. They know best how to spend our money, how to regulate our lives and how to give us the best healthcare. But that attitude has backfired and they found out the hardway just how independent Americans are.

[winstrv]

As much as it pains me to say this, I have to admit it - my Democrat friends were right !

They told me if I voted for McCain , the nation's hope would deteriorate, and sure enough there has been a 20 point drop in the Consumer Confidence Index since the election, reaching a lower point than any time during the Bush administration .

They told me if I voted for McCain, the US would become more deeply embroiled in the Middle East , and now, tens of thousands of additional troops are scheduled to be deployed into Afghanistan .

My Democrat Party friends told me if I voted for McCain, that the economy would get worse and sure enough unemployment is at 9.4% and the new stimulus packages implemented recently have sent the stock market lower than at any time since the Islamic Terrorists attacks of 9-11.

They told me if I voted for McCain, we would see more "crooks" in high ranking positions in Federal government and sure enough, several recent cabinet nominees and Senate appointments revealed resumes of scandal, bribery and tax fraud.

They told me if I voted for McCain, we would see more "Pork at the trough" in Federal government and sure enough, 17,500 "Pork Bills" showed up in Congress since January 2009 .

I was also told by my Democrat friends that if I voted for McCain, we would see more deficit spending in Washington D...C. ,and sure enough, Obama has spent more in just 60 days than all other Presidents together - in the entire history of the good ole USA !!


Well I voted for McCain in November and my Democrat friends were right... all of their predictions have come true!

[ramos1129]

If the Exchange plan is based on the Federal Employee Health Plan, then it is really the best way to go.

I am a retired federal employee and have had the FEHP for years. Under this plan, insurance providers compete each November for my business. These include national, regional and local providers. There are over 20 such providers. I sit down and study each plan's offerings and then chose whichever plan I want. Government involvement is sponsorship and monotoring of the plan and thus is very little.

I am 71; have diabetics; overweight despite exercise and diet and have high blood pressure. If I did not have the FEHP, my carrier would have canceled my insurance long ago or priced it out of sight as would have the others.

The key to the FEHP is that the insurance companys have to compete for my business which is not really the case in the public market for whatever reason.

So, the Exchange idea seems to be the best way to go.

[ubrew12]

A recent EKOS poll indicated 87% of Canadians believe their health-care system is better than the U.S. model. Why? First, it's universal. Everyone is entitled to treatment and they get the same level of care as a multi-millionaire. By contrast, in the U.S. the rich can buy top care and jump to the head of the waiting line, while the poor are uninsured and die from lack of insurance. Second, visit the doctor and there's no fee. Americans pay through the nose at every step of their care and in fact, pay twice as much as Canadians per person. No Canadian winds up bankrupt because he or she had to pay for health care, which happens in the U.S., where private insurers often reject people with serious illnesses seeking coverage. Third, Canada's quality of care is unparalleled. Indeed, polls have consistently shown that more than 90% of Canadians are pleased with their level of care. In America, that number could NEVER be higher than 85%, since 15% of the population is uninsured, and aren't receiving ANY care at all. Top surgeons at Toronto-area hospitals are as good as any in the U.S., and they treat patients based on need, not the size of their bank accounts. Nurses and other health professionals are well-trained, too, with standards often exceeding those in the U.S. Fourth, many of Canada's medical outcomes top those in the U.S. Canadians live longer, their infant mortality rates are lower, their cancer and heart disease levels and the rate of low-birth weight babies, are better. Fifth, they often wait only several weeks to see a specialist. Wait times for many procedures, such as hip replacements, are dropping dramatically now that more money and attention have been focused on the problem. Sixth, Canadians know that part of their health dollars aren't going to line the pockets of fat-cat private health insurers, whose profits in the U.S. have equalled the total amount of money that Canada spends annually on health care for all its citizens.

[AK-47_Justice]

by Marc1986
"What we need to do is give them incentive to pick private insurance back up, or fix private insurance, not create a WHOLE NEW PUBLIC SYSTEM. Look at Medicare and SS for crying out loud. THEY ARE BROKE."
*************************************



Appears you are posting more foxnewsus propagandus, so that statement you made about listening to multiple 'news' sources is bull.

First off, neither SS or Medicare is broke!

While it's true that both trust funds have been stolen from since 1969, to pay for numerous military/industrial complex fanatical conflicts, SS is still producing a $250 Billion surplus each year -- down from the $300+ Billion surplus during bushworld. SS is hardly broke, and is now estimated to be fine until 2037.

Medicare on the other hand is a different story, mainly due to the spiraling costs of health care -- where the for-profit insurance companies have increased premiums 130% since 2000 and saw their profits rise 500% during that same period. Actually, 2009 was the first year that Medicare is in the RED, but it is not broke yet, by any means. That's why we need to reform health care now, especially before 80 million baby boomers retire over the next 2 decades.

Stop the LIES and DECEPTIONS by foxnewsus propagandus!

[thusspokezara]

After we have passed health care reform, I hope that we can
1. Reform immigration
2. Raise taxes on the wealthy
3. Pass gun control legislation
4. Close Guantanamo.
5. Bring Bush and Cheney before the World Court on charges of crimes against humanity.
6. Undermine Israel
7. End Don't Ask Don't Tell
8. Build a 30 mile runway for the mother ship that is nearing the Milky Way Galaxy
9. Help the Cubs win a World Series.

[hungry1968-16]

by Marc1986 August 21, 2009 12:11 PM EDT
Why is someone who makes $50,000 or $75,000 living in a place with a high cost of living would be something I'd have to question.

The average cost of coverage for a single citizen runs between $4500 and $5000 per year. Now in a family of 4, if you make <$50,000 your kids are more than likely covered. So your costs would be a bit lower than that.







Okay. Now I get where you're coming from.

In EXPENSIVE places to live, like San Francisco or San Diego, EVERYONE - including waitresses and janitors - MUST make enough money to live there, or else they have no right to complain, correct?




And how would your "kids be covered" in a family of four making less than $50,000, if you and your wife weren't covered already?

You DO KNOW that there are limits on how much you can make while applying for SCHIP, don't you?





I give up on you man, you're clueless, and I'm not getting paid to educate you.

Good luck - you're obviously going to need it to figure out the whole "health care reform" thing.

[hungry1968-16]

by Marc1986 August 21, 2009 12:13 PM EDT
When did I say I liked the plan they were proposing? I only said that I think tax credits are a good idea. You're putting words in my mouth hungry.







So you think it's a "good idea", but you don't like it?

Confused much?

[hungry1968-16]

by Marc1986 August 21, 2009 11:54 AM EDT

We allow competition across states in just about every private industry in America. I don't see Ford and GM merging? I don't see UPS and FedEx merging?






Was GM "too big to fail"? Did they need to be bailed out?

How about Bank of America? Citigroup? AIG?

And you want to make "Blue Cross and Clue Shield of America" ANOTHER "too big to fail" business?

Dude, you're clueless.

Or dangerous.

[hungry1968-16]

by Marc1986 August 21, 2009 11:57 AM EDT
You make me laugh haha.






I'm not kidding.

Don't just believe their lies, or what I'm telling you.

Fact check Fox's BS, and you'll see it for yourself.

[hungry1968-16]

by Marc1986 August 21, 2009 11:57 AM EDT
If they're poverty stricken, they might be eligible for SCHIP/Medicare.





Hey genius: the ONLY people that are eligible for the "tax credits for health care" that the republicans are proposing, MUST be under the federal poverty level ($20,560) to qualify.

Anything MORE than that, and they don't qualify for the republicans "health care plan", which is more of a joke, than an actual plan.

[hungry1968-16]

by Marc1986 August 21, 2009 11:43 AM EDT
I see 17 million people who live in households that make over $50,000 per year, 8 million of those over $75,000 per year. With that income range, healthcare is more than likely MORE than affordable.






What?!?!

Someone making $50,000 a year, is taking home about $35,000 of that after taxes. And then they're supposed to spend $14,000 of THAT on JUST health insurance?!?!


And exactly how far do you think $50,000 or $75,000 would go in San Francisco, San Diego, or somewhere else that's very expensive to live?!?!?



You're pretty clueless. I'm assuming that the 1986 is your birth year, because you sure do talk like a naive 23 year old that hasn't been out in the real world very long.

[hungry1968-16]

by Marc1986 August 21, 2009 11:25 AM EDT
And CBS/CNN/NBC/ABC always tells the truth? Please...

Who says its not in the health reform bill? CBS? How do we know they aren't lying?







READ the legislation for yourself!!

I specifically checked the parts that ClusterFox was lying about, and NOTHING that they claimed was in there, actually was.

Fox COUNTS on people believing what they say, instead of fact checking them.

They COUNT on stupid and uninformed viewers. That alone should tell you something.

[hungry1968-16]

by Marc1986 August 21, 2009 11:19 AM EDT
Competition across state lines, and issuing tax credits for Americans who buy their own insurance are GOOD ideas. Too bad Nancy Pelosi and Barney Frank only have tunnel vision for a public option.







Laughable!!

How is a poverty stricken family, supposed to buy a $14,000 health care policy, (which is the national average), with a $5,000 "tax credit"?

[AK-47_Justice]

Let's see, marc would say they could just fork over that extra $9,000 per year by paying a mere $750 each and every month, and hope they didn't have to use that for-profit health care, since they would then have to worry about deductibles and the other 20% co-pay for serious problems -- not to mention income while out of work.

GEEZ.....I just love the convoluted republican't parallel universe!

[hungry1968-16]

by Marc1986 August 21, 2009 11:22 AM EDT
Everyone hates Fox because they are so caught up on what CBS tells them. What they seem to forget is that by shooting down Fox, they are also shooting down CBS/NBC/CNN/ABC. What makes Fox any different from CBS other than the fact Fox leans conservative and CBS leans liberal? NOTHING!






FOX LIES!!!

They make up and fabricate all sorts of BS, that they KNOW will spin everyone in to a frenzy.

The HC bill specifically says that it WILL NOT provide coverage to illegal aliens, (section 246), but that doesn't stop Fox from reporting that it will!!

And that's merely ONE EXAMPLE.

By the way, CBS/NBC/CNN/ABC ALL disputed Fox's lies, and ALL said what was and wasn't in the bill - and it COMPLETELY contradicted what Fox was making up.

[AK-47_Justice]

Actually marc, you seem like a twenty-something kid lacking any experience in the world at all, and make us all laugh at your nonsense from the foxnewsus propagandus network!

[sam-kiley]

bonjour
j'avoue ne pas etre au courant des anciens plans gouvernementaux, encore moins du plan proposé par mr obama,néanmoins. si monsieur obama a un plan digne de ce nom autrement dit en "béton", qui peut garantir, une meilleure qualité de soins, une meilleure prise en charge..et surtout une meilleure couverture par les assurances..pour l'américain moyen et autres sans emplois qui vivent une précarité sans précédent..
sans oublier l'amélioration des revenus des médecins, personnel para-médical.leur condition de travail..aussi, un meilleur équipement des hopitaux,etc , etc..eh bien si ces conditions parmi tant d'autres sont réunies il arrivera a faire passer sa réforme..au revoir

[hungry1968-16]

by Marc1986 August 21, 2009 11:17 AM EDT
@hungry

WRONG. Most Americans get health insurance through work. They're at the mercy of the execs at work who decide which insurance plan to buy into. My bet goes with the fact that CEOs will want to raise profits, so they'll choose the lower cost, rationed public option; which will down the line crowd out the private option and eliminate it completely.







The CEO's right now, are DROPPING health insurance benefits altogether, leaving employees with NOTHING!!

This is EXACTLY WHY we need the "public option" -- so that people have SOMETHING that resembles "health care".

Look at this from the right leaning "Kaiser Family Foundation":

http://ehbs.kff.org/images/abstract/7791.pdf


"Although firms report planning to increase the amount employees have to pay when they have insurance, few firms report they are very likely or somewhat likely to drop coverage (6%). One percent of firms offering coverage say that they are very likely to restrict eligibility for coverage next year, and an additional 12% say that they are somewhat likely to do so. About one in four firms offering health benefits but not offering an HSA-qualified HDHP say that they are very likely (4%) or somewhat likely (21%) to do so."





6% of ALL firms polled are "very likely or somewhat likely to drop coverage" for their employees.

Another 13% are "very likely or somewhat likely" to restrict offering health insurance to new employees.


25% of "high deductible health plan" participants are NOT going to offer it to new employees.






With ALL of these unemployed people trying desperately to get back into the workforce, what are THEY supposed to do for health insurance, when their new employers aren't even offering it to them?!?!

THIS IS EXACTLY WHY we *****NEED***** a public option!!!!!

[AK-47_Justice]

by Marc1986
"What we need to do is give them incentive to pick private insurance back up, or fix private insurance, not create a WHOLE NEW PUBLIC SYSTEM. Look at Medicare and SS for crying out loud. THEY ARE BROKE."
*************************************



Appears you are posting more foxnewsus propagandus, so that statement you made about listening to multiple 'news' sources is bull.

First off, neither SS or Medicare is broke!

While it's true that both trust funds have been stolen from since 1969, to pay for numerous military/industrial complex fanatical conflicts, SS is still producing a $250 Billion surplus each year -- down from the $300+ Billion surplus during bushworld. SS is hardly broke, and is now estimated to be fine until 2037.

Medicare on the other hand is a different story, mainly due to the spiraling costs of health care -- where the for-profit insurance companies have increased premiums 130% since 2000 and saw their profits rise 500% during that same period. Actually, 2009 was the first year that Medicare is in the RED, but it is not broke yet, by any means. That's why we need to reform health care now, especially before 80 million baby boomers retire over the next 2 decades.

Stop the LIES and DECEPTIONS by foxnewsus propagandus!

[hungry1968-16]

by Marc1986 August 21, 2009 11:11 AM EDT
@AK

The stuff we suggest you shoot down like a Turkey on Thanksgiving.

#1 - Eliminate fraud.
#2 - Cap malpractice issuances.
#3 - Make insurance competitive across state lines.
#4 - Eliminate federal lobbying.







These are a joke.

1 - how do you "eliminate fraud" from ANYTHING, other than more stringent regulations and laws, which republicans are steadfastly opposed to?

2- Tort Reform in Florida has been an ABSOLUTE DISASTER.

3 - Insurance across sate lines, is going to allow ALL of the insurance companies to MERGE. Remember "too big to fail", and the subsequent "bailouts" to save our economy? And NOW you want to add "health insurance" and "health care" to the mix?!?!? ARE YOU INSANE?!?! That's as crazy as Bush wanting to "privatize social security"!! Can you imagine the disaster that would have happened if THAT went through?!?!

4 - I'm all for that, but there is not ONE republican that would go along with this. They ALL have HMO money in their pockets right now - to the tune OF MILLIONS OF DOLLARS each. So don't tout this as a "republican idea", when ALL republican politicians are against it.