What I'm seeing is a lot of confusion about what sort of "public option" is possible.

[clear eye]

I see people abandoning the struggle for HR 676 (single-payer) with the idea that since, theoretically, a public option could be devised that would do all we want and gradually phase out private insurers, one like that is politically more realistic than single-payer. In reality a plan like that has a snowball's chance of even getting on the table, (and less chance of passage than single-payer) for the following reasons:

Health insurance companies aren't stupid about their own interests. They know that such a viable public option is a threat to their continued existence. They're already fighting it tooth and nail, just as they are fighting HR 676, which is the reason nothing like what we would call a "good" public option is being proposed.

If anything like that were to be brought up it would bring on a disinformation campaign all over the media by the insurers, and die a quick death, since Congress could drop it and still look as though they were working toward a decent public option. Congressmembers couldn't put over such a hoax regarding HR 676. Either Medicare for all is created, or it isn't.

Once we have gone down the road to a mixed plan, and given up HR 676 as not "politically feasible", we have used up all our political captital on the issue and are stuck with 'yes' or 'no' on whatever economically and socially disastrous public option gets to the table. We are then forced to accept it or to try to make our Congressmembers vote against all healthcare reform. They would see that as a terrible political move, given the demand for improvement.

In other words, there is equal opposition from insurers to either single-payer or a "robust" public option. The difference lies in what happens next.

With the public option, Congress can fool themselves and many of the public by creating a weak public option of the sort that insurers won't viciously fight, and still claim that they have backed a public option and supported healthcare reform. This gives them an easy out, which most of them will take. That sort of public option leaves serious care and coverage problems, and actually worsens the economics by creating subsidies that the insurers would use to raise their charges (part being paid by the gov't) and adding more administrative costs. This would be a further drain on our already poor economy.

On the other hand, when insurers go all out against single-payer, Congressmembers can only do one of two things and both will be really obvious. Refuse to support it (or remove support they have previously given) and upset the public, or stand firm and get grassroots gratitude.

Unless we get it clear that HR 676 is actually more feasible than anything we would see as a "good" public option, we will be moving in the wrong direction.

(Crossposted from GD.)