Whatever the outcome of the health care saga, it seems safe to conclude that the public option is dead. It is worth analyzing its impending demise for what it teaches us about American attitudes towards government, and how political battles are won.
The key fact here is that the public option is not some long-standing, highly pedigreed idea engrained in the liberal psyche, in the way that school choice or private Social Security accounts have been for the intellectual right. In fact, the idea of a public option is very new. It was first raised in 2007 by Berkeley economist Jacob Hacker, and popularized as a device that would "someday magically turn into single payer."
Continues Mark Schmitt at TAPPED:
Following Edwards' lead, Barack Obama and Hillary Clinton picked up on the public option compromise. So what we have is Jacob Hacker's policy idea, but largely Hickey and Health Care for America Now's political strategy. It was a real high-wire act -- to convince the single-payer advocates, who were the only engaged health care constituency on the left, that they could live with the public option as a kind of stealth single-payer, thus transferring their energy and enthusiasm to this alternative. It had a very positive political effect: It got all the candidates except Kucinich onto basically the same health reform structure, unlike in 1992, when every Democrat had his or her own gimmick. And the public option/insurance exchange structure was ambitious.
The public option is an idea that was born, literally, in the last Presidential campaign. Even so, it was little discussed in 2008, when the main bone of contention was Hillary's individual mandate to purchase health insurance. A Google News search from the height of the Hillary-Obama primary battle shows two health care-related mentions of the "public option" in January 2008, zero in February, and two in March, one in April, and two in May and June.
That the public option was new and unfamiliar made it easily characterized as a ploy to introduce single-payer in miniature, which it was self-transparently was in the eyes of its originators.
Indeed, reading through the founding documents of the public option is about as damning as if one got ahold of a secret dossier of Milton Friedman's proclaiming school vouchers a necessary "compromise" that would eventually usher in the death of public education in America.
So, the public option was not serioiusly discussed in 2008. It was never seen as central to Democratic demands for health care until mid-2009. Since the failure of Hillarycare, Democrats have continually stressed that they would get to universal coverage by regulating and by building on the existing system. Indeed, for all that Hillarycare was being pilloried as socialized medicine, not even it contained as overt a nod to single-payer as a government-run health care "option."
Exactly like the Social Security fight in 2005, liberals hoped that by injecting more government into the health care system they could change the political culture, just as conservatives hoped private accounts would awaken more of us to the rich abundance of the free market.
However, as the economic crisis showed, the political system is only designed to tolerate sudden changes to America's economic model in a crisis atmosphere. We've seen more than a good bit of economic nationalization in recent years/months, but only as a response to a perceived crisis. Could health care in America be nationalized? Sure -- if the pandemic flu struck the United States and was well on its way to killing millions of Americans and private institutions were judged inadequate -- and even then, political leaders would caution that it was a temporary measure. Welcome to the "bailout" school of health care reform.
The problem for Obama is that after months of "crisis" after "crisis", the welcome mat has worn thin. Not unexpectedly, "emergency" moves toward socialism in the auto and financial sectors have sidelined elective moves towards the same in health care.