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Pelosi: Public option is "next best", after single payer. Don't the American people deserve the best?

Pelosi at C&L:

For 30 years I have supported a single payer plan, but our next best choice is to support an exchange and a public option.

I'm with Obama on this one:

In 2003, that is. Bill Moyers:

In 2003, a young Illinois state senator named Barack Obama told an AFL-CIO meeting, "I am a proponent of a single-payer universal healthcare program...
All of you know we might not get there immediately because first we have to take back the White House, we have to take back the Senate and we have to take back the House."

Well, we gave the Dems that, plus 60 votes in the Senate.

So let me translate what Leader Nance is saying: "I supported single payer for 30 years until I had the chance to try and pass it."

Why don't the American people deserve the best, Nancy?

NOTE See Hipparchia here on things to do.

No votes yet


Submitted by Anne on

As follows:

In a Q-and-A recently posted on the website Crooks & Liars (see, Nancy Pelosi responded to one of the questions by saying, “For 30 years I have supported a single payer plan, but our next best choice is to support an exchange and a public option. “ The question that her response prompts from me is, why are we giving up on the best solution and settling for something that, from all appearances, is a whole lot less than “next best?”

The House plan is not set to go “live” until January of 2013. No, that is not a typo. Pelosi’s explanation for that, also via that same Q-and-A was, “some aspects of the bill will go into effect immediately but it will take 2-3 years to set up the exchange and the public option which will be ready by January 2013. Because this represents major systemic change, it requires time to make it right with consumer protection and insurance industry regulation.”

If I told you that in less than a year after the historic Medicare legislation was signed into law, the program was up and running, and millions of older Americans had been enrolled and were getting health care with hardly a hiccup, wouldn’t you wonder why it’s going to take so long to get essential elements of this version of reform in place? Wouldn’t you wonder why the elements that are designed to help the millions of uninsured are the ones that are going to take the longest to implement?

Or, maybe, you wondered if there’s a political reason why the plan won’t be fully operational until 2013, like the fact that we will have a presidential election in November of 2012, and it might not be good for the fortunes of the current president, or the Senators and Representatives up for re-election, if a new health care system is not going well or is not all it was advertised to be.

So, what will the millions of currently uninsured people do between now and 2013? And, with an economy in decline, thousands of people losing their jobs every month and losing their coverage or not able to afford the COBRA premiums, with more employers changing to plans that cover less and cost the individual more, or dropping coverage altogether in order to stay in business and at least keep people employed, how much more dire will things be in four years?

What will the insurance companies be doing between now and 2013? How will they be positioning themselves to accommodate the changes that are coming? What will we see from them in the next 3 1/2 years that will signal they have even the slightest interest in improving our access to and delivery of actual health CARE?

Because, in spite of the best efforts of Congress and the media to make this about making sure we all have insurance, what this is really all about, where the focus should have been from Day One in reforming the system, is CARE. I put that in all caps because it cannot be said strongly enough: what people really need is CARE, and that CARE needs to be affordable. Having a shiny new insurance policy will not help, if the out-of-pocket costs (cost-sharing) are such that people still cannot afford to see the doctor, or get the medications they need.

All of the major developed nations have some form of single-payer, their spending per-person on health care is less than half what we spend here, and their people are, by most accepted measures, healthier than we are. Why are we writing 1,000 + page bills, creating a Rube Goldberg-ian system whose biggest benefit will be to insurance companies that have done nothing in the last several decades to improve the current system – but a lot to assist the political careers of more than a few members of Congress who are crafting this “reform” – and making those who need accessible and affordable CARE the most wait the longest to get it, when we have a single-payer model – Medicare – that we know works well and could be expanded or duplicated with relative ease and in a much shorter period of time?

Why are our members of Congress settling for something that is less than the best? Is that our new standard? Why strive for the best when we can settle for less? Is that the “uniquely American” way in which President Obama thinks this problem can and will be solved? Are we now a nation whose motto is “Well, It’s Better Than Nothing?”

We could have done so much better, and sadly, it is those who most need the reform, who most need CARE, who will once again suffer the consequences.

It's way too long to be published, but I felt good writing it. We'll see.

Submitted by lambert on

To the editor:

In an online interview (, July 15) House Speaker Pelosi said that the "public option" in the health care reform bill now before the House (HR 3200) is the "next best" solution to the health care crisis after single payer.

I would like to know why Speaker Pelosi believes that Americans deserve second best. Why not the best?

Single payer has saved both lives and money in other countries; we know it works. That's why single payer is the science-based solution. Why have the Democrats taken single payer off the table, in favor of the complex, experimental, and Rube Goldberg-esque legislation they are advocating instead?

a little night musing's picture
Submitted by a little night ... on

Post-Katrina America has trouble trusting that their government provide services when they are needed. Bush sure did a great job there.

This could have been a great opportunity for the Democrats to emphasize the role of government as the medium for our taking care of each other, instead of an evil thing that sucks up our money and then stands by when we are in trouble. But no, we get the "bipartisan" shite.

(I note in passing that in that C&L thread Leader Nancy was repeatedly asked WHY it was so important to be "bipartisan", and she never really answered. She said something about it being the responsible thing to do, some words to that effect, I'm too annoyed to look it up, and that was it. When I was in high school, during the Viet Nam war, I learned to despise the word "responsible", which was usually used to mean "doing what we tell you to do instead of trying to figure out what's right".)

cal1942's picture
Submitted by cal1942 on

so often leads to more deaths, more casualties, more property destruction and in the case of 'bi-partisanship' insuring that the bleeding will continue.

dblhelix's picture
Submitted by dblhelix on

Pelosi is running around referring to a "robust public option." Where? Surely, the crippled RomneyCare (House/HELP) isn't it? Are "progressives" calling this the public option?

Valley Girl's picture
Submitted by Valley Girl on

Lambert- could you email me- I sent you email at reg. addy, but don't know if that got through. Many thanks, VG

Submitted by Anne on

being argued...I'm reading US News & World Report's "America's Best Hospitals" issue, and there's an article by Bernadine Healy titled, "Health Reform's Effect on You," that I started reading with some interest. She lists "seven ways in which your health care experience is likely to change."

The number one item on the list starts out thusly:

You've had a heart attack or lost your job? No matter what, you'll always have access to affordable health insurance.

I had to read that several times, each time not understanding why we should be comforted by always having access to insurance. Insurance? What about always having access to affordable health CARE???

Why don't they get this? Arrgh.

These articles may be online - I'm actually reading a hard copy of the magazine.

What I see so, so clearly is that is is impossible to have an honest discussion about reform if those who are opposed to it insist on repeating false and misleading information. Yeah, I get that they do it because they can't defend their position without lying about it, so I guess we just have to keep pointing out that their lies are being told at the expense of the lives and health of real people.

BDBlue's picture
Submitted by BDBlue on

how they keep saying that advocating for single payer won't help them get a good public plan. As if folks who want something better than their version of a public option somehow hurt the fight for a public option. Huh?

You'd think you wouldn't need decades in the legislature to figure out that if the current situation is shitty and you're working on a plan to get to 2% less shitty, then the people who are demanding 100% less shitty aren't undermining the move away from shitty to 2% less shitty. If anything, they should be a help since they're pulling you in the right direction.

It's just so disingenuous. Those single payer folks are totally killing healthcare reform!

dblhelix's picture
Submitted by dblhelix on

As if folks who want something better than their version of a public option somehow hurt the fight for a public option. Huh?

Howard Dean wants you to know:

As of yesterday, both the U.S. House of Representatives, led by Speaker Nancy Pelosi, and the Senate Health, Education, Labor and Pensions Committee—ably led by Sen. Chris Dodd and guided by the wisdom of Ted Kennedy—demonstrated that they are listening to the American people. Both have passed plans that represent real reform. While the bills are not perfect, they include a public-health-insurance option like the American people have asked for.

I can't believe how cynical this all is. I supported Dean in 2004, and now I just want to take a shower.

I like how they (various Democratic front groups and blogs) went around fundraising for "the public option" with all that blather on how it had to be Medicare-like, accept all comers, from Day 1, etc, and now they're crowing "Mission Accomplished." What a bunch of scammers.

The finale will be the continued watering down of crippled RomneyCare by that ole debbil Blue Dog. Get out your harmonica for another round of the blues.

dblhelix's picture
Submitted by dblhelix on

that since Obama's poll nrs started dropping:

1. No taxing of health beneifts! Staunchly opposed! (although it may get left to the Blue Dogs to try some dirty work here).

2. Hurry! Rush! Quick! They don't want ppl taking a closer look at this insurance company bailout.

Submitted by hipparchia on

they keep saying that advocating for single payer won't help them get a good public plan

if enough people understand about single payer, the public option would be dead in the water. and it's debatable whether they [the politicians] even want a good public option.

BDBlue's picture
Submitted by BDBlue on

if you take people like Pelosi at her word, she wants the best plan she can get and even concedes that single payer is best. So people arguing for that should be helping her in two ways - 1) as a leverage against people who don't even want her shitty public plan, and 2) as a way to possibly, someday, maybe get to single payer.

Nothing single payer advocates are doing is going to drive Blue Dogs away from the public option. They may use it as an excuse, but we aren't ending up with an incredibly weak public option because so many people want single payer. We're ending up with one because the insurance companies - like the banks - own Congress and both political parties. Single payer advocates have nothing to do with it, if we did, we'd have a seat at the table.

So for her to say that we're undermining the public option by supporting single payer is just incredibly disingenuous. I guess we could be undermining it with the public, but it's pretty clear that what the public wants doesn't matter. Poll after poll show Americans want single payer and/or a public option and yet single payer can't be discussed (except to deride it and tell its supporters to STFU) and the public option is incredibly limited in scope and doesn't start until 2013 (and that's in the good bill). So clearly, what Americans want is irrelevant.

This, IMO, is just setting the left up to take the blame when their shitty plans fails and Pelosi, of all people, should know better than to do that.

Submitted by hipparchia on

So for her to say that we're undermining the public option by supporting single payer is just incredibly disingenuous.

one of the tactics that got the republicans as far as they did was to basically never be seen disagreeing in public. democrats, otoh, are disagreeing with each other all over the place, which does make it harder to get things done.

of course, from my perspective, all these supporters of the public option are undermining single payer.

also, pelosi's correct about me, since i am now actively working to derail this train wreck they're calling health reform. better no bill than a bad bill has become my mantra.

i'd have supported [reluctantly] a bill that allowed anybody and everybody to buy directly into medicare, while still keeping the current system running alongside, even if such a bill didn't do anything else to address medicare's deficiencies. that's the only way that would truly let people vote with their feet [and with their $$]. but they've all been against that from the beginning, which means one of two things: they're either stupid or lying if they say they want single payer.

BDBlue's picture
Submitted by BDBlue on

The elected GOP folks and party apparatchik rarely disagreed. Actual Republicans, however, disagree quite a bit. If they didn't, they wouldn't need groups like Club for Growth to threaten to primary elected officials to keep them in line. And there has always been a split between the religious conservatives and their corporate overlords. In fact, the GOP depended on a rowdy base far to the right of what could actually pass to move the bills that would pass to the right.

The Dems problem is that the elected officials fight and this weakens them. If the elected officials could come up with a Democratic Plan - as opposed to at least three separate Democratic plans - and stick to it, they'd be much better off. This is why Obama's idea of letting Congress take the lead is a disaster (although one I suspect he knew was coming because he doesn't really care what's in the bill, only that it passes).

But in the absence of that unity, which is really the job of people like Pelosi to get, she tries to create the illusion of unity by shutting up the base. That's exactly backwards. Democrats who care about really reforming healthcare - not just passing any old shitty bill - should encourage a rowdy base to exhort pressure on their Blue Dog members to stick with the Democratic plan. But, of course, the Democrats don't actually have a plan. They have multiple plans, all of them designed to benefit the insurance companies over their base. And that's their real problem - they aren't giving Americans what they want or even close to it. As you say, a decent public option would probably calm down a lot of single payer advocates. And you'd think that's what people like Pelosi would want. But you're wrong, she just wants to pass SOMETHING.

And that's how Democrats differ from Republicans. The GOP would be using their base to try to get the "best" bill they could get. The Dems try to shut up their base and suck up to the GOP to get any bill, no matter how bad. Because they don't share the ideology of their base like the GOP does. So moving to the left isn't something a lot of them want to do, even if that's what their voters want them to do. There's just too much money in doing otherwise.

That's why I say Pelosi is disingenuous - she's not really fighting for a good bill, the best bill she can get. If she were, she'd welcome the pressure the base is putting on her caucus. She just wants to pass a bill and that's why single payer advocates are the problem. They might settle for less, but they won't settle for nothing.

a little night musing's picture
Submitted by a little night ... on

The GOP would be using their base to try to get the "best" bill they could get. The Dems try to shut up their base and suck up to the GOP to get any bill, no matter how bad.

Submitted by lambert on

Enter... Public option!

Submitted by hipparchia on

that word that the reader/listener is meant to think includes the reader/listener, but that really only refers to the speaker/writer and his/her cronies.

alternatively, it's you and your pet mouse.

cal1942's picture
Submitted by cal1942 on

If the House version doesn't take effect until 2013 we have all the answers.

It's after the next Presidential campaign so the effectiveness of the bill is of no consequence. The idea is to pass SOMETHING to run on. As an earlier commenter said: 'Mission Accomplished.'

It would be interesting if the Republicans were to assault that tactic during the campaign by attacking the impending plan from the left and it wouldn't surprise me if that happened.

Proves again that when in doubt pass good effective legislation.

During the primaries Obama scared the crap out of me. Since inauguration day I've become all the more frightened.