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How the Dems and "progressives" are selling you the "bait and switch" of public option

Spoiler: There's a number they don't want to talk about.

Kip Sullivan:

The people who brought us the “public option” began their campaign promising one thing but now promote something entirely different. To make matters worse, they have not told the public they have backpedalled. The campaign for the “public option” resembles the classic bait-and-switch scam: tell your customers you’ve got one thing for sale when in fact you’re selling something very different.

When the “public option” campaign began, its leaders promoted a huge “Medicare-like” program that would enroll about 130 million people. Such a program would dwarf even Medicare, which, with its 45 million enrollees, is the nation’s largest health insurer, public or private. But today “public option” advocates sing the praises of tiny “public options” contained in congressional legislation sponsored by leading Democrats that bear no resemblance to the original model.

According to the Congressional Budget Office, the “public options” described in the Democrats’ legislation might enroll 10 million people and will have virtually no effect on health care costs, which means the “public options” cannot, by themselves, have any effect on the number of uninsured. But the leaders of the “public option” movement haven’t told the public they have abandoned their original vision. It’s high time they did.

Digby? Jane? Started out with 130 million, ended up with 9, does that ring a bell? BooMan? Bueller? Bueller? Bueller?

“Public option” refers to a proposal, as Timothy Noah put it, “dreamed up” by Jacob Hacker when Hacker was still a graduate student working on a degree in political science....

Hacker claimed the program, which he called “Medicare Plus” in 2001 and “Health Care for America Plan” in 2007, would enjoy the advantages that make Medicare so efficient – large size, low provider payment rates and low overhead. (Medicare is the nation’s largest health insurance program, public or private. It pays doctors and hospitals about 20 percent less than the insurance industry does, and its administrative costs account for only 2 percent of its expenditures compared with 20 percent for the insurance industry.)

Hacker predicted that his proposed public program would so closely resemble Medicare that it would be able to set its premiums far below those of other insurance companies and enroll at least half the non-elderly population. These predictions were confirmed by the Lewin Group, a very mainstream consulting firm. In its report on Hacker’s 2001 paper, Lewin concluded Hacker’s “Medicare Plus” program would enroll 113 million people (46 percent of the non-elderly) and cut the number of uninsured to 5 million. In its report on Hacker’s 2007 paper, Lewin concluded Hacker’s “Health Care for America Plan” would enroll 129 million people (50 percent of the nonelderly population) and cut the uninsured to 2 million.

Until last year, Hacker and his allies were not the least bit shy about highlighting the enormous size of Hacker’s proposed public program. ....

Hacker’s papers and the Lewin Group’s analyses of them have been cited by numerous “public option” advocates. For example, when Hacker released his 2007 paper, Campaign for America’s Future (CAF) published a press release praising it and drawing attention to the large size of Hacker’s proposed public program.....

When the Lewin Group released its 2008 analysis of Hacker’s 2007 paper, CAF’s Roger Hickey wrote in the Huffington Post, “efficiencies achievable … through Hacker’s public health insurance program” would save so much money that the US could “cover everyone” for no more than we spend now. ....

Now let’s compare the “single national health insurance pool covering nearly half the population” that Hacker and other “public option” advocates enthusiastically championed with the “public option” proposed by Democrats in Congress, and then let’s inquire what Hacker and company said about it. ...

Obviously the “public option” in the Senate HELP committee bill (zero enrollees; 17 million people left uninsured) and the “public option” in the House bill (10 million enrollees (maybe!); 34 million people left uninsured) are a far cry from the “public option” originally proposed by Professor Hacker (129 million enrollees; 2 million people left uninsured). Have we heard the Democrats in Congress who drafted these provisions utter a word about how different their “public options” are from the large Medicare-like program that Hacker proposed and his allies publicized? What have Professor Hacker and his allies had to say?

In public comments about the Democrats’ “public option” provisions, the leading lights of the “public option” movement imply that Hacker’s model is what Congress is debating. Sometimes they come right out and praise the Democrats’ version as “robust” and “strong.” But I cannot find a single example of a a statement by a “public option” advocate warning the public of the vast difference between Hacker’s original elephantine, “Medicare-like” program and the Democrats’ mouse version.

Where's the self-congratulatory correcting blogosphere on this one? In his post on the Obama health care campaign telcon, dday wrote:

With that, the President took questions, and it was truly unlike most press conferences you'd see by the heavily pancaked White House press corps. Bloggers wanted to know about two things - the tactics for getting a bill through, and the substance of that bill.

Substance, eh?

The mainstream press has a number that it never, ever mentions: That "our" health care system costs twice as much as the next most expensive (France).

Looks like our tribunes of the people on the A list of their own number they never, ever mention: The 9 million "public option" will enroll now, as opposed to the 130 million it enrolled when they started their shilling advocacy.

I've been screaming for detail on public option for some time; now we've got it. Thanks to PNHP, and doctors who care about keeping their Hippocratic oaths.

No votes yet


Submitted by lambert on

... to forward this link to this post on to Kip. Just so he can see what the simple-minded are doing with this stuff. For example. Got to sharpen the blade...

UPDATE My response to Kip.

Submitted by brucedixon on

The whole thing rests on three legs.

One is the corporate media who energetically restrict the publicly visible debate on health care so that it's only between Obama and the folks to HIS right.

The second leg is our utterly corrupt political setup which allows big money, and whose money is bigger than private insurance --- to triumph over the wishes of actual humans every time. A huge number of Congresspeople are actually invested in the health care industry.

And the third is the willful self-deception of leading lights of the blogosphere and progressive universe who are telling us to shuddup and support the president because his plan now has the "public option" in it. That p-word sounds good in there, doesn't it? That's whatchu want, ain't it?

Lookit this from today's National Journal

Liberal Blogs To Help Sell Health Plan

President Obama and key advisers appealed to liberal bloggers during a conference call Monday evening, urging them to support the administration's healthcare reform agenda. Obama was joined by David Axelrod, healthcare guru Nancy Ann DeParle and White House Online Programs Director Jesse Lee. The call marked Obama's first serious interaction with the progressive blogosphere since taking office, bloggers who were invited to participate said. Obama gave brief remarks about the healthcare reform debate, noting that the blogs can cut through the conventional wisdom and debunk myths about this legislative battle. He also pressed them to keep the pressure on members of Congress in the run up to August recess because the default position in DC is "inertia."

Obama took questions from John Amato from Crooks and Liars; Jonathan Singer from MyDD; David Dayen from D-Day; Cheryl Contee from Jack and Jill Politics; Gerald Weinand, formerly of Turn Maine Blue; and Joan McCarter from DailyKos, according to a post by Joe Sudbay of AmericaBlog. On the call, the president outlined his criteria for reform: (1) Does it cover all Americans; (2) Will it drive down costs over the long-term; (3) Will it improve quality; (4) Are prevention and wellness included; (5) Does it contain insurance reforms on issues like pre-existing conditions; (6) Does it provide relief to small business; and (6) Is there a serious public option? He warned that House and Senate bills may not have all of the above but the conference committee will be critical.

Listen to a recording of the entire call with liberal bloggers here.

On another note, can you imagine the White House trying to "mobilize" the 13 million email addresses and phone numbers collected in the campaign, now OFA behind this thing? Here is another National Journal article which appears to contemplate it.

I have a hard time visualizing that. Too many of them might actually try to read it, and balk. It would be dangerous for them to even try such a thing before the absolute last minute, because it might break the spell. Especially given the number of people who raised single payer at the December hopuse parties held by OFA, trying to use those lists for a push to get this bill through seems awfully risky for them, and a possible opportunity for us. Just sayin'.

Oh, and lambert, I really like this WSYWYG thingie you're using in what is, I guess Drupal 5.x. What is it?

Submitted by lambert on

What you said on the blogosphere, I just said kinda, but shorter and snarkier and missing, like, analysis ;-)

Personally, I'm very encouraged that single payer advocacy is being labeled as "kabuki."

* * *

The editor is BUeditor, which to my mind is the best compromise between raw HTML (which is faster, once you get the hang of it) and the (no longer maintained) TinyMCE and that ilk.

I assume it's available on D5. Why are you running D5 and not D6? Huge difference, especially as an admin.

Submitted by brucedixon on

Don't recall what that reason was any more.


Didn't see whatchu wrote till a minute ago. Bad habit of mine, speaking first and listening late, if ever. Promise to work on it.

Gonna go look for my kabuki mask and gown now. And a sword.

Submitted by brucedixon on

and sometimes I test out what I'm gonna say at BAR here. Gotta siddown and grind out the week's piece on Obamaca --- uhhh --- the president's fake health care plan.

Maine Owl's picture
Submitted by Maine Owl on

As Health Plan Falters, Maine Explores Changes of its goals was to cover the estimated 130,000 residents who had no insurance by 2009... So far, it has not come close to that goal. Only 18,800 people have signed up for the state’s coverage and many of them already had insurance. "I think when we first started, in terms of making estimates, we really were kind of groping in the dark," said Gov. John E. Baldacci, who this month proposed a host of adjustments....

That was two years ago. The number enrolled now is sub-10,000. As far as I can tell, the Democrats have proposed almost the same thing as Dirigo. The "public plan" would be run by PRIVATE insurers under contract. The only thing the legislation says is that the "insurance risk" can't be privatized in the public plan. No matter, every other aspect of it can. The "product" will look the same or worse than the "private" plans.

Valley Girl's picture
Submitted by Valley Girl on

Thanks for the link- I'll pass it along to Kip in case he hasn't seen it. I'm "From Away", ;) but interested in Maine.

healthforall's picture
Submitted by healthforall on

A recent study shows that single-payer would be major stimulus for the us economy:

** 2.6 Million New Jobs,
** $317 Billion in Business Revenue,
** $100 Billion in Wages, and
** $44 Billion New Tax Revenues

Here’s the study:

How to pay for single payer reform: HR676 -- public financing and private delivery:

Yet Baucus and his cronies have prohibited the Congressional Budget Office from “scoring” single payer healthcare reform. They know single payer is the only economically viable solution, yet they continue to service the insurance companies and health industry that line their pockets with cash.

What can Americans do in the face of the corrupt, profit-driven, rich Congress and insurance industry that place profits before Americans’ health and lives? IF the single payer bills – HR 676 and S 703 are scored by the Congressional Budget Office (CBO), it will be clear that single payer is the only solution.


1. Contact your Representative and Senators and request that the Congressional Budget Office score the single payer plans (it will become quickly clear that Single Payer is the only financially viable option). You can find your legislators’ contact information here:

2. ASK President Obama to support Single Payer reform and to look at the billions in savings that would occur with Single Payer reform. Ask him to INSIST THAT THE CONGRESSIONAL BUDGET OFFICE EVALUATE THE FINANCES OF THE SINGLE PAYER PLANS. People are dying because of our current healthcare system. Single payer reform is a human right!

CALL AND FAX: Phone: Comments: 202-456-1111;?Switchboard: 202-456-1414; FAX: 202-456-2461

3. And ask President Obama, your Senators, and your Representative to watch this show, “Wendell Potter on Profits Before Patients” on Bill Moyer’s Journal, at: (and watch it yourself)

4. Attend the Single Payer Rally and Lobby Day in Washington, DC on July 30th. More information here:

Only a single-payer approach to healthcare reform will end the inhumanity of our failed healthcare insurance system, where profits are more important than patients’ health, and where people die because of it.

Submitted by Paul_Lukasiak on

Digby? Jane? Started out with 130 million, ended up with 9, does that ring a bell?

here's a fun experiment. Go to any A list "progressive" blog, and do a search for "single payer". Then do a search for "Mark Sanford" and/or "Sarah Palin". Over at Firedoglake, since January 1 "single payer" gets 18 hits, "Mark Sanford" gets 32 hits, and "Sarah Palin" gets 79 hits.

I think we know where the real kabuki has been -- and its been with the A listers who emphasized sideshows like Sanford and Palin for the last six months instead of paying attention to what was going on in the "health care reform" debate....

Submitted by ralphb on

Is anyone urging people to call their congressman at 877-762-8762, which happens to be 877-SOB-USOB ? I can't think of a more appropriate number.