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The public option: a point on substance, a point on procedure

The public option: a point on substance, a point on procedure
By Eric Black

On the Strib’s Saturday op-ed page, Myles Spicer skillfully dissected at least some of main arguments against the “public option,” arguments that take as three postulates that 1. the government cannot do anything as efficiently as private, for-profit businesses, 2. that only the profit-motive can lead to innovation, efficiency and the best services for the best prices, and 3. that private businesses cannot survive if they have to co-exist with a public sector competitor.

Spicer went deep into the oft-used analogy between the public option’s possible role and coexistence with private health insurance companies and the coexistence between the U.S. Postal Service and private deliverers like Federal Express and UPS. Yes, USPS does require a taxpayer subsidy to stay in business. On the other hand, it provides certain services that are valuable to daily life and commerce, like deliver letters to the recipients’ door for 44 cents, that Fed Ex and UPS do not offer. Spicer doesn’t make the main point that Obama gbenerally does when he uses this analogy, which is that the existence of a not-for-profit public option in the field of letter and package delivery does not seem to preclude the existence of for-profit alternatives.

But the toughest true thing that Spicer wrote kicks back at the notion that private companies, competition and the profit motive are the only way to provide an incentive for innovation and a quality product offered at competitive prices, at least the area of health insurance. Wrote Spicer:

“This is 180 degrees wrong. For insurers, stronger profits do not reside in streamlining anything. They rest with raising rates to the highest market price possible, then insuring only the healthy, then denying claims whenever possible. That is what increases their profits.”

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On to the procedural point

On the Lehrer Newshour’s regular Friday roundup of the week’s politics with David Brooks and Mark Shields, Shields brought up a point that hadn’t occurred to me before.

With 60 votes, the Dems would be able to pass anything through the Senate. But if even one Dem senator joined the Repubs on a filibuster, the bill could not come to a vote. If (as seems to be the case) there are Dem sens who would not vote for a bill with a public option in it, and others that would refuse to vote for a bill without one. If so, there will be no bill that can get 60 votes.

There’s long been talk that Senate Dems might decide to use the reconciliation process to enact a health care bill, which is a sneaky technical way of avoiding a filibuster. I am not the master of the rules that determine when reconciliation can be used this way.

But Shields suggested another more obvious, and less sneaky way to ensure that bill with majority support in the Senate can come to a vote. It’s pretty simple, Shields said that Majority Leader Harry has to tell the members of his caucus that they are all free to vote their conscience on final passage of a bill, but that the 60 Dems must stick together to vote cloture against Republican filibuster. I don’t know if there is much precedent for such an arrangement. David Brooks seemed a little skeptical. Here’s the exchange:

MARK SHIELDS: You can get — 60 votes is very simple. What you have to get — Harry Reid has to get out of his caucus is an agreement on procedural votes, that if there’s a — if there is a filibuster on any issue, that all 60 will vote to cut that filibuster off. And that’s the…

JIM LEHRER: No matter what their positions are on a specific…

MARK SHIELDS: That’s right. You can vote your own conscience. You can vote your own constituency on the issue itself. But if they’re going to try and filibuster an issue, that I have to have your vote.

JIM LEHRER: Does that make sense to you?

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DAVID BROOKS: Well, I guess so. I just think it’s a huge advantage to get 60 on the substance. I think people are going to still be nervous. If you look at — we’ve had all this debate. We had the summer and then we’ve had the debate. The public is still extremely skeptical, and it’s still extremely skeptical in swing states.

What think?