Laying the groundwork for a letdown

LAYING THE GROUNDWORK FOR A LETDOWN…. Sen. Kent Conrad (D) of North Dakota told Fox News this morning that there’s no point in pursuing a public option as part of health care reform. It’s futile, he said, to continue to “chase that rabbit” because it doesn’t have 60 votes. “The fact of the matter is there are not the votes in the United States Senate for a public option. There never have been,” Conrad added.

As a procedural matter, Conrad’s point is largely wrong. If a reform bill reaches the floor, and every Democrat in the chamber agrees that the legislation should get an up-or-down vote, reform with a public option needs 50, not 60, votes. The issue, then, is whether there are some Democratic senators who would vote with Republicans on a filibuster. Conrad seems to be suggesting there are. Indeed, he might very well be one of them.

And with that in mind, it seems the White House is slowly beginning to make the case that health care reform may pass without a public option. We heard it this morning….

“I think there will be a competition to private insurers,” Health and Human Services Secretary Kathleen Sebelius said in an interview that aired Sunday on CNN’s State of the Union, “that really is the essential part, that you don’t turn over the whole new marketplace [after health care legislation is enacted] to private insurance companies and trust them to do the right thing. We need some choices, we need some competition.” […]

Sebelius also told CNN Chief National Correspondent John King that “what’s important is choice and competition.” A public option “is not an essential element,” the Cabinet secretary said Sunday.

…and we heard it yesterday.

“The public option, whether we have it or we don’t have it, is not the entirety of healthcare reform. This is just one sliver of it, one aspect of it,” Obama said. “And by the way, it’s both the right and the left that have become so fixated on this that they forget everything else.”

It’s a point that’s been coming up more and more lately.

Part of the problem, as I see it, is strategic. Consider any set of negotiations, in any context. One side says, “I’m dead-set against X under any circumstances.” The other side says, “I’d really like X, but I’m willing to give up on it as part of our talks.” Guess what happens to X? Any chance X is going to survive the negotiations? Not so much.

The same is true here. Even for Democratic policymakers in Congress and the administration who think quality, meaningful health care reform is possible without a public option, there’s a temptation to tell them, “Shhh! If reform advocates signal a willingness to compromise on a public option, it’s dead.” Indeed, hearing the president’s remarks yesterday, and Sebelius’ comments this morning, it’s hardly a stretch to think the proposal is, at this point, in very deep trouble.

Which then leads to the question of whether reform can still be worthwhile without a public option. Opinions, obviously, vary quite a bit, but I’m reminded of something Paul Krugman said recently: “It’s not so much that the public option has to be in the final bill, but if it’s not in, there better damn well be something else, some really serious reforms. In a sense, it has become a litmus test. If the bill does not have a public option, it’s going to take a much, much higher bar on the rest of it to get me to accept it.”

From where I sit, I really want a public option. I think a public option makes a lot of sense, it should be in the bill, and I applaud those who are fighting tooth and nail to get it in the bill. That said, as per Krugman, if lawmakers drop the public option, the rest of the legislation better be pretty damn amazing.