Demand a real public healthcare option

Don't be fooled by the watered-down versions that desperate Democrats are using to lure Republican votes.

Published June 12, 2009 10:12AM (EDT)

President Barack Obama meets with Senate Democrats to discuss health care, Tuesday, June 2, 2009, in the State Dinning Room at the White House in Washington.
President Barack Obama meets with Senate Democrats to discuss health care, Tuesday, June 2, 2009, in the State Dinning Room at the White House in Washington.

Here's the latest contortion from Senate Dems trying to win over a few Republicans to a "public option": Let nonprofits create healthcare cooperatives, then call them the public option. Kent Conrad, of North Dakota, chair of the Senate Budget Committee, came up with this bamboozle. Finance Committee chair Max Baucus, D-Mont., is impressed, and some Republicans — even Chuck Grassley of Iowa — seem interested. Watch your wallets.

Nonprofit healthcare cooperatives won't have any real bargaining leverage to get lower prices because they'll be too small and too numerous. Pharma and Insurance know they can roll them. That's why the Conrad compromise is getting a good reception from across the aisle, just as Olympia Snowe's "trigger" (whereby there's no public option until sometime down the pike, and only if Pharma and Insurance don't bring down costs and extend coverage a tad) is also gaining traction.

The truth is that there's only one "public option" that will truly bring down costs and premiums — one that's national in scale and combines its bargaining power with Medicare, and that's allowed to negotiate lower drug prices and lower doctor and hospital fees. And that's precisely what Pharma and Insurance detest, for exactly the same reason.

Whatever it's called — public option or chopped liver — it has to be able to squeeze Pharma, Insurance, and the rest of the medical-industrial complex. And the more likely it is to squeeze them, the more they'll fight it. And the greater the opposition from Republicans and from Dems who either believe any bill has to have some Republican support or who have sold themselves out to the medical biggies.

As long as single payer is off the table, then we need a real public option. Don't be fooled by labels. Demand the real thing.


By Robert Reich

Robert B. Reich is Chancellor's Professor of Public Policy at the University of California at Berkeley and Senior Fellow at the Blum Center for Developing Economies. He served as Secretary of Labor in the Clinton administration, for which Time Magazine named him one of the ten most effective cabinet secretaries of the twentieth century. He has written 15 books, including the best sellers "Aftershock", "The Work of Nations," and"Beyond Outrage," and, his most recent, "The Common Good." He is also a founding editor of the American Prospect magazine, chairman of Common Cause, a member of the American Academy of Arts and Sciences, and co-creator of the award-winning documentary, "Inequality For All." He's also co-creator of the Netflix original documentary "Saving Capitalism."

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