If the public option really is "failing", whose at fault and what should be done...

[andym]

First of all, it is important to realize that nothing is written in stone. Until bills are amended and put to a vote, nothing is settled.

I came across an article that I believe explains a lot of why a strong "public option" may be withering (if it really is).

http://www.nytimes.com/2009/08/15/health/policy/15ground.html

Health Debate Fails to Ignite Obama’s Grass Roots
By JEFF ZELENY
Published: August 14, 2009
.....
As the health care debate intensifies, the president is turning to his grass-roots network — the 13 million members of Organizing for America — for support.

Mr. Obama engendered such passion last year that his allies believed they were on the verge of creating a movement that could be mobilized again. But if a week’s worth of events are any measure here in Iowa, it may not be so easy to reignite the machine that overwhelmed Republicans a year ago.

Here in Iowa, the Organizing for America effort resembles the earliest days of a presidential campaign, a shoestring operation where homemade signs hang from the walls and only the most diehard of supporters attend events. Many of the young campaign aides who became familiar faces in towns across Iowa are now working in Washington, so a new crop of workers has taken over to help direct older volunteers.
....
“People came out of the woodwork for Obama during the campaign, but now they are hibernating,” Ms. Smith said. “Now it is hard to find enough volunteers to fight the Republicans’ fire with more fire.”
--------------------------------

The bottom line is that too little firepower is being focused from the grassroots at the problem.
Now I understand that many potential supporters want single-payer, and are less enthusiastic about any plan that leaves insurance companies room to squeeze money from citizens. But, there are some among this group, myself included, who do want to see significant movement in the direction of affordable health care for all, and believe (perhaps naively) that it is possible to do something productive. So for those who do support evolutionary change, we need to get out there NOW. The Senate and the 15-20 senators who do not yet support the Public Option, but are potential supporters are the key targets. Take a look at this list of supporters (http://standwithdrdean.com/where_congress_stands). If your Senator is not onboard, please take the time and try to convince your friends to take the time and chat with their staff members about your preferences (or write a letter). Be prepared to know your facts. I know that I will be calling Senator Feinstein's office again on Monday and hope to convince two others to do so as well.

[laconicsax]

1. Could it be that the grassroots is becoming disillusioned?

[polichick]

7. Absolutely. nt

[alsame]

2. Part of the problem with mobilizing a movement right now is that

there isn't an actual plan yet...it's hard to go out and campaign for something without specific details of what the President is proposing.

Just look at the confusion today - public option or no public option? Co-ops or not? A healthcare exchange? Is single payer completely dead?

How can we go out and change minds when we don't yet know what the product is? All we can do right now is fight the smears and lies, we can't hold up a concrete plan and say "this is it and this is why it's better than what we have now."

[andym]

3. The amorphous nature of the reforms is definitely problematic. nt.

[kenny blankenship]

4. It's hard to ride a wave of populist support for "TO BE ANNOUNCED."

And another thing. The public option isn't just undefined - it's something that could be a benefit, but it could just as easily be written to be a "reform" that's worse than nothing. The Grass Roots instinctively understands that the "public option" segregates citizens into 1st and 2nd class. It might be good enough...but that would be bucking American history. Anything that provides services to only the worse off of society is, in America, almost BOUND to suck. People with money will make sure that the political system, which responds primarily to them and their wants, will make funding the needs of those on the Public Option a low, low priority. Single Payer is a concept that gets grass roots enthusiasm because we understand that if we're all in this thing together-not only do we have unparalleled bargaining power, but we would all have the motivation to fix the system if it wasnt' working right. Contrasting that with "public option", grass roots Dems and progressives get Reeeel cautious about anything that proposes separating citizens into different classes of service. If it's not working for the ostensible beneficiaries, there's no incentive for the more powerful classes to fix it. They could even fix things to line their own pockets and shaft the people who are supposed to have their lives and health improved by the public option. Then you throw in the fact that Our Leader isn't running in front with a plan of his own...

Well what do you expect?

[alsame]

5. Excellent point about 1st and 2nd class citizens. That's why

single payer is the best choice - a totally level playing field for all of us.

[slipslidingaway]

6. Excellent points...I do not want to compete against....

fill in the blank, the poor, the elderly ....

[andym]

8. Huh?! The proposed public option does not aim to provide 2nd class service to the "worse off"

The worse off are still supposed to be part of Medicaid-- a good single-payer system, although perhaps underfunded. They are currently getting better care than many who have bought insurance policies.

The public option is for those who have "individual insurance" policies where much of the malignant power of the insurers is currently felt. It is also supposed to include small business. It sounded good enough to me that I was going to try to convince my boss to choose it (should it exist in the way that resembles the way it is written in the HELP bill)

[kenny blankenship]

9. I'm sorry I called you one of the worse off. Would "less well-off" be more soothing?

I count 47 million uninsured, and those alone at the mercy of insurance co.s as the worse off in the context of a healthcare/insurance reform. You are not part of the abject poor as the phrase "worse off" could be interpreted to mean. But I think from the point of view of insurance you are at a disadvantage compared to, say my BIL, who has health insurance for life for himself and his family because he worked 20 years- or whatever it was- for KLM airlines. Hasn't worked for them for years - still has the insurance.

The Public Option isn't intended to provide 2nd class service, but public health professionals worry that insurers will game the system to dump those they believe will become sick and cost them money, into the public pool, which together with requirements that the Community plan reimburse providers at the going private insurance rate, not public sector rates (like Medicare) and restrictions on who is eligible to join, seem likely to produce a system that can't control its own costs let alone "keep insurance companies honest" and may be under strain from the very start. Restricting eligibility to the worse off employees --ooops sorry--of a company that provides private insurance but which provides an insurance plan that is deemed unaffordable to some of those on the company payroll, is not a recipe for a plan that has broad public support and will be attended to by politicians over the long haul. It's a class dividing formula, a diluting formula. It's a recipe for a plan with perhaps 13 million subscribers ten years hence, as the CBO scores it, and a plan that MAY be neglected because more well off classes --more politically powerful classes-- have no interest in its success or well being. And to get back to the original point about the un-finalized status of The Plan - it ain't great now and in all likelihood it will be battered some more before arriving at a final version that gets voted on by both houses. So it should surprise nobody that grass root Democrats, who had their preferred plan rejected out of hand by Obama and the ever disappointing Harry Reid, are lukewarm to calls to rally around the we know not what exactly that will fill in the outlines of the Public Option. Especially when our President can't even bring himself to declare a public option the essential, non-negotiable core provision of health care reform.

The public option was the compromise. For us, the creation of the public option, albeit imperfect, was the point - it stood as consolation prize or substitute for the point: affordable healthcare for all. We don't give a damn about passing something just to save face. Give us something to care about besides Obama's personal political fortunes.

[amborin]

10. who's

not 'whose'