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One of the few strictly accurate things that Pres. Barack Obama routinely says about his health-care reform is that it’s much bigger than just the so-called public option.
Yet when his administration signaled over the weekend that the public option could be dropped, the Left threw a collective tantrum. The always coolheaded Howard Dean pronounced health-care reform impossible without it. Yelps of betrayal echoed throughout the inflamed left-wing “netroots.” Obama’s aides quickly explained that he is as committed to the public option as ever — a meaningless reassurance, since Obama has long broadcast flexibility on the public option.
Why the uproar over what Obama at his Colorado town hall called a “sliver” of reform? After all, the Left should be delighted about the movable feast of statism in the congressional bills: new mandates on employers and individuals, $1 trillion in new spending over ten years, heavy regulation on insurers, a vast accretion of new bureaucratic power, and higher taxes. What’s not to like?
But nothing offers the near-term promise of moving toward a single-payer, government-controlled system quite like the public option. A few Democrats are occasionally unguarded enough to speak about it publicly. A single-payer activist confronted liberal lion Barney Frank with a camera, demanding to know why he didn’t support single-payer. Frank shot back that he favors such a system, only he realizes Obamacare’s public option is the best way to get from here to there.
Obama supported single-payer as recently as 2003, before disavowing it in his presidential campaign. Surely, he didn’t experience a deep change of heart. Indeed, Obama says at his town-hall meetings that moving to single-payer would be “too disruptive” — too many people now get insurance through their employers. By beginning to tip people out of private coverage, Obamacare’s public option would conveniently remove that prudential obstacle to a government-run system.
Last week, Obama invoked the post office’s poor showing vis-à-vis FedEx and UPS to prove private players can survive government competition. Never mind that the post office has a monopoly on the delivery of first-class mail. Economics blogger Keith Hennessey points out that Fannie Mae and Freddie Mac, the Tennessee Valley Authority, and terrorism reinsurance programs all crowd out private competitors. Medicare now has a program allowing private insurers to compete within the program with government — and Obama wants to ax it.
All of this makes the public option a laughably ill-disguised Trojan horse. The Left is emotionally vested in it for exactly this reason. It’s the proxy for the long-cherished goal of socialized medicine. If it can’t be achieved by a new, young, liberal president with sizable majorities in both houses of Congress, what’s the use? Even without the public option, Obamacare will effectively transform the private insurers into public utilities and set the predicate for more government intervention later. But it won’t hold the same ideological romance.
The question is whether Obama has already waited too long to dump it. He’s poisoned the well with Republicans who are disinclined to sign on to anything big, and he may have ruined his health-care brand with the center. If so, he’ll get little credit for modifying his plan, only blame from his agitated base. And he’ll need all the political juice he can muster if he’s really going to march congressional Democrats through a party-line vote for an expensive bill partly paid for by cutting a half-trillion dollars from Medicare and Medicaid.
It’s not inconceivable that the entire effort could collapse. Obama learned every lesson of Hillarycare except the essential one. Hillary wrote a bill in the White House; Obama gave Congress free rein. Hillary got savaged by the special interests; Obama bludgeoned them into cooperating. And Obama probably figured he is smarter, defter, and more persuasive. So he managed to avoid all of Hillary’s tactical mistakes while repeating her central error of proposing a frighteningly sweeping takeover of health care. Ain’t arrogance grand?
– Rich Lowry is the editor of National Review. © 2009 by King Features Syndicate