One of the stronger criticisms of the Progressive Block campaign for a public health insurance option is that the versions of the public option that have made it through congressional committees are so weak as to have a minimal impact on health care costs and coverage. I do not entirely dispute those assesments, except that getting a small public option now is a more viable path to a meaningful public option down the road than just giving up on the public option altogether. What I do dispute is that the public option fight is only, or even primarily, about health policy. Instead, it is about who runs the country.
In one camp, there are conservatives and private health insurance companies who oppose the public option in all forms. Their basic argument is that the public option would work too well, offer health insurance that is too affordable, and as such will deny private health insurance companies more business. A secondary argument from this group is that a public option supposedly cannot pass the Senate, even though a list of Senators is never provided with this claim and even though either reconciliation or the nuclear option would allow a public option to pass with 51 votes.
In the other camp are House and grassroots progressives. Their basic argument is exactly the same as the first camp: a public option, even in its current form, would offer lower-priced health insurance than private companies. This group is composed of the most reliable Democratic votes in all of Congress, the most Democratic districts in the country, and organizations that provide a huge percentage of pro-Democratic activism.
So this is about who the Democrats in Congress and the White House are going to govern with:
--Those who think that protecting large industries is more important than providing lower cost health care;
--Those who think offering lower cost health care is more important than protecting large industries.
Additionally, the first group is lying about Senate procedure and are the top political opponents of Democrats, while the second group is just about the most loyal and active group of Democrats in the country.
If grassroots and House progressives can't even get a watered down public option in this environment, then it is very difficult to conclude that we are actually part of the governing coalition in this country. And really, that is what this campaign is about who runs the country at least as much as it is about health policy.