Public option gains traction in Senate health plan

The Senate has long been seen as opposed to the federal government selling health insurance in competition with private industry, but now senior Senate Democrats and White House officials are strongly considering including such a measure in health care overhaul legislation, officials say.

The provision would permit individual states to drop out of the system, a design that could make it more palatable to moderates who have opposed the “public option.”

Liberals in Congress view a public option as an essential ingredient to overhaul the nation’s health care system, and President Barack Obama has said frequently he favors it. But he has also made clear it is not essential to the legislation he seeks, a gesture to Democratic moderates who have opposed it.

Sens. Ben Nelson, D-Neb., and Kent Conrad, D-N.D., said in separate interviews they had been told the plan was drawing interest in private negotiations led by Senate Majority Leader Harry Reid, D-Nev., who is merging health bills passed by two separate committees into a final package to bring to the floor.

“What I’m hearing is that this is the direction of the conversation,” said Conrad, who supports an alternative approach under which nonprofit co-ops would compete with private industry.

Nelson said he’d also heard the plan was drawing favor, adding he thought that was unfortunate.

The White House declined to comment. Reid’s office did likewise, and the Nevada Democrat left a meeting at the White House with other Democrats late Thursday without talking to reporters.

Several officials said no final decisions had been made, with one possibility that the idea was being circulated to see whether it could attract enough support to survive on the Senate floor.

If not, it surely would be jettisoned beforehand, with liberals urged to accept something less or risk defeat of health care legislation. There is little margin for error among Obama’s allies in the Senate as they confront nearly unanimous Republican opposition.

Democratic moderates are skeptical of allowing the government to sell insurance, concerned that it would mark an unwarranted federal intrusion into the private marketplace and potentially jeopardize payment rates to doctors, hospitals and other providers.

Conrad, for example, has said repeatedly he could not accept a plan with payments tied to Medicare, the federal health care program for the elderly, because rates in North Dakota are too low to give doctors an incentive to treat additional patients.

Legislation taking shape in the House is also expected to include a public option, although it is unlikely states would be allowed to opt out.

After months of struggle, both houses are expected to vote in the next few weeks on sweeping legislation that expands coverage to millions of Americans who lack it and bans industry practices such as denial of coverage for pre-existing medical conditions.

The House and Senate measures aim to expand coverage to about 95 percent of the population, and include federal subsidies to help lower-income families afford coverage and permit small businesses to provide it for their employees.

The two bills differ at many points, although both are paid for through a combination of cuts in future Medicare spending and higher taxes.

House Speaker Nancy Pelosi said at a news conference she and her leadership were entering the “final stages” of assembling a health care bill to be voted on this fall. Officials have said the measure would cost $871 billion over a decade, but that total excluded a handful of items not directly related to expanded coverage that would push the total to well over $1 trillion.

Democrats hold a 60-40 majority in the Senate, counting two independents, precisely the number needed to overcome a threatened Republican filibuster. Sen. Olympia Snowe, R-Maine, voted for the health care bill that cleared the Senate Finance Committee recently, but she has long voiced opposition to a public option along the lines under consideration, as has Nelson, and other moderate Democrats have voiced skepticism. Without 60 votes, the legislation could stall even before debate began in earnest.


Associated Press writers Charles Babington, Ricardo Alonso-Zaldivar and Erica Werner contributed to this report.


  1. Sandra Price

    Jim C. I guess if you had been part of CHB in the past, my affiliation with Capitalism would not be a question for you to ask. I am a firm believer in free enterprise. I have written volumes on the problem of apathy in the voters and greed in the government. We can argue from now until dooms day about Ayn Rand and it is true that Greenspan was wrong and trusted the integrity of the government.

    Sadly I have to agree that the American people allowed the government to have their way with us. The IRS has destroyed our integrity more than you realize. How to fix this? My husband and I worked for years on “The Liberty Amendment” and twice got it on the ballot in California. The American people were too lazy to even read the petition and refused to vote to repeal the 16th Amendment. I have personal reasons for stopping the IRS any other way.

    Once the IRS was officially given the right to take money from Americans we could not stop its growth. Again the American people want a government controlled health care system that once legislated will never be controlled or repealed.

    I wish I could understand what turned off the decision-making ability of the voters. I have tried for years to get petitions signed to wake up the voters that this is their government that is taking away our individual rights. Americans decided years ago to allow the government to tell us what we must not do.

    The only way Capitalism will return would be to take it away from government control. It means we must keep an eye on all phases of Wall Street and the Contracts issued by our government. Instead we elect a congress and Administration as if we are casting a movie. In other words, we get the government we elect. The voter base is too easily swayed by both parties that have morphed into one giant user of all of us.

    I am snd have been invested in many capitalistic ventures. I have made mistakes and money. I have been heavily taxed for making a profit but got to rebate for losing income. I have my own reasons for the dumbing down of the American voter but dare not mention this here.

    One of the best books on what went wrong in our government can be found in the story of Enron. “The Smartest Guys in the Room” showed the sickness of what money can accomplish when the White House overlooked the obvious. Not only the White House but both Houses of Congress and even our Supreme Court failed the Constitution and the people.

    Yes, our markets couid use some regulations but not by our federal government. Some day the voters might use integrity as part of their campaigning instead of social issues and how pretty they look to a world based on television popularity.

    I am heading for 77 in a few months and have been retired on my investments. Hell, I’m so heathy that I may outlive my income. I don’t care if I have to live on the desert in a tent, I will never break federal law just to demonstrate what I have been warning about for many years.

    Tax deniers are being sent to prison in large numbers. Tney had many chances to work as a team to repeal the 16th Amendment but that involved intelligent action. In many cases they were wanted on many other crimes before they joined the revolution. It is much easier to march on D.C. than to work with the system and throw the bastards out of the government.

    Capitalism that I understood is dead; swallowed up by the ignorance of the American voters. I went online 13 years ago to search for the reason the people allowed the corruption to bloom in D.C.

  2. almandine

    The “magic of the market place” has not been allowed to flourish for a long, long time. Show me one (1) putative example otherwise, and I’ll show you a regulatory scheme by which the govt (politicians) has stacked the deck to determine the outcome.

    Hell, look at the banks.

    Citizens have not been “the” govt for quite some time… their “power” has been squandered by allowing their elected reps to run the show. THAT is what has produced the rigged game we think of as “investing”.

  3. griff

    Of course it is. Given enough time and enough television “programming” we’ll accept anything and everything.

    The Pied Piper is tuning up and the mice are all ears.

  4. Jim C

    I wouldn’t get to excited about what’s being discussed as a ” public option ” , it’s a ruse . The so called public option being considered will only be available to the very poor and unemployeed that qualify , it’s very narrow in scope . Unless anybody who wishes can get it it’s not only worthless but doomed to fail . I am afraid that there will be much hullabaloo then they will pass this fectless piece of crap and hail it as a great victory . We will then discover that we are forced to buy health insurance from the thieving parasitic insurers with no other option . Unless anyone can buy in , it’s worthless .

  5. Sandra Price

    Jim, I believe that the new system of health care will be Medicare for everyone. The anger around the Insurance companies will be torn apart instead of regulated. The bankers are next and then the Corporations. The American people seem to trust the government far more than the corporations and banks who have abused the people and probably deserve to be overthrown by Big Daddy.

    On another part of CHB (RR) there was a discussion on Ayn Rand and had we all read and understood the true meaning of individual freedoms we would have put the government out of business and kept Insurance Companies and the Banks losing their customers when they became abusers. The power of the American people was always the strength of the American people but something went very wrong and the people simply didn’t care. It took the economic failure and the loss of so many retirement plans to wake us up. But we learned nothing from it except to ask the government to take over the responsibility.

    We all will be rationed and nothing will be done to improve the academics of the next 3 generations who will learn how to use and abuse the government to suit themselves. It annoys me that we were powerful and then became apathetic.

    Soylent Green is us!

  6. CheckerboardStrangler

    Sandra, in theory I really do agree with your very salient points about the true meaning of freedoms, but I have to the conclusion that true libertarianism and freedom are meaningless in an economic system based on debt currency/fiat money.
    Fiat money is a debt based currency, a slave token that cannot be used to legally pay a debt.
    It can only discharge debts while the overall total sum debt remains unpayable.
    This is because the total debt always exceeds the total sum of the currency available.

    As long as we accept fiat money, banks will continue to be abusers,
    corporations will continue to be enthroned.

    In fact, we are headed to a time where corporations will be ultimately enthroned
    as the unelected leaders of a privatized world system of governance, a technotronic
    tyranny which renders any notion of individuality, freedom or privacy entirely meaningless.

    We had our chance on several occasions to listen, to heed the warnings.
    We’ve ignored every single signpost along the way.
    We ignored the urgings of our very best scientists and political leaders to
    free ourselves from dependency on oil from hostile nations as far back as 1957.
    In fact, on the two or three occasions that I have even posted an eerily prophetic
    speech by Admiral Hyman Rickover titled “Energy Resources and Our Future” the result
    was the chirping of crickets! Not a single response whatsoever!

    We ignored the opportunity to unseat a president who allowed the confiscation of lawful money,
    who forced us to accept slave currency in 1934.
    We ignored the opportunity to unseat a sitting president who disconnected our money from
    the gold standard.

    We have ignored every possible opportunity offered to us that would have reversed the course.
    Now, nearly all wealth and nearly all resources are in the hands of sociopathic corporations and
    bank cartels.

    Sandra, it is a little too late to be worrying about libertarianism or whether or not
    we can expect the government to do a good job, or at least a better one than our serial abusers.

    At this point we have nothing left to lose, and the only recourse we have is to sit down and
    utterly refuse, EN MASSE, to buy, sell or pay taxes, to work or to consume, except for
    what’s necessary to go on breathing.

    The only way we will get another chance to take back what we allowed to be stolen from us is
    if we starve the beasts into submission, and act as one.

    Then…we can start talking about libertarianism and freedoms.
    But for now, we must make sure that we will be able to stay alive,
    and that calls for a certain amount of pragmatism.

  7. Jim C

    Well Sandra , when I read the first paragraph I thought to myself , ” Sandra’s making sense ” , then I read the rest of it and , well , not so much . First , we are the government , the problem is that big money has polluted it , before it can be fixed the money changers have to be driven from the peoples temple . You keep referring to the government as if it’s some kind of seperate entity , again , it’s not , it’s us . As far as that self absorbed high priestess of greed and selfishness Ayn Rand even her dimwitted disciple Greenspan has admitted that her half baked toxic nonsense doesn’t work . You do understand that the problems we now face we are the direct result of allowing the ” magic of the market place ” to rule , unregulated corporations doing what they always do when unchecked and unregulated , the economic equivalent of raping and pillaging . The idea that all you have to do is turn them loose and everything will be fine is beyond ridiculous . The power of the american people ” is ” our government , not the unchecked greed of multinational corporations . The only ” magic ” an unregulated market place produces is to make your security , money and freedom disappear . By the way Sandra , I don’t know what you do but I am a capitalist . I make a high percentege of my income investing in the market and have for a long time . The main thing that makes investing possible is knowing the markets are well regulated , otherwise it’s nothing but a rogues gallery where the games are rigged and the law of the jungle prevails , no thanks .

  8. griff

    I urge everyone to read this column and think about some of the facts presented. I know it probably seems crazy that someone other than a Democrat or Republican would have any ideas on how to address this “crisis,” but wasn’t it that madman Ross Perot who warned us of the problems with NAFTA?

    A few excerpts…

    “It may be hard to believe, but back in the 1950s health insurance cost just a few dollars a month for most people — and it was available to virtually everyone, including people with pre-existing conditions.”

    “In 1980 fully 97% of the companies with 100 or more employees provided medical coverage. By 1995, only 77% were doing so.”

    “Once again, the politicians are seizing the opportunity to save us from their own handiwork.”

  9. Sandra Price

    Griff. Ross Perot looked like a clown and most people would not listen to him or his charts. I have said for years, we cast our candidates for their television appeal and we ended up with a group of utterly stupid actors. I spent several years working for the Perot campaign and was laughed at. He was man enough to step away from elected positions and is now spending his money on our returning Vets who are inflicted with diseases that our own government neglected. He is a true American hero.

  10. Sandra Price

    Sorry Checkers, I will not break federal laws to prove a point. Being in prison is not a good place to demonstrate anything.

    I would rather work as a team to prove we are right. We have several right here at CHB who understand what was done to us while we were asleep.

    Too many Americans refuse to see the truth about what has happended to all of us. When we attempt to explain it, we are shunned and often verbally abused. I’m tired of the fight for individual freedoms that comes from libertarian agendas. I will not go to prison for any reason.

    I’m out of here for a couple of weeks. I will continue to read your posts but will answer by email. You are most certainly correct in your analyses of our problems.

  11. Jim C

    I’m not sure what you took away from that article Almandine but the problem isn’t the government per se , it’s that our government has been corrupted by corporate money . All one needs to do is look around at other countries that have government run , socialist , whatever you want to call it healthcare and you can see it works best by far . We are being screwed because 1. it’s for profit 2. we’ve allowed private business to run it . The evidence abounds and is overwhelming .

  12. almandine

    You, Jim, just don’t get it.

    That article was directed SQUARELY against govt control of ANYTHING economic. Especially health care in this instance.

    WHY? Nothing our economic system has ever done has been NOT FOR PROFIT – if it was intended to survive, to support the folks that were making it happen, to support its citizens, to provide for the future. (I find it interesting that you claim above to be a capitalist and make your money INVESTING, but here you decry the profit motive. Betting on losers are you?)

    Let me ask – do you go to work to make just enough to pay for your needs that day? Or do you work to get a little extra for tomorrow… gas to get back to the job… work clothes… rent… a new car… vacations… to be able to save… to provide for your future? To retire?

    Think about it. No enterprise (private or govt) designed to provide goods and services that ever made less than it took in lasted longer than the first economic storm. Unfunded ventures cannot replenish raw materials… infrastructure… nor build inventory to sell. The founders, workers, customers are destitute in short order. None would survive. It is PROFIT that makes these things possible.

    Think about this – what govt enterprise has EVER made a profit… or been able to accomplish anything without demanding the funds of its citizens… or without setting up regulatory systems that gave it competitive advantage?

    The answer is::: (drumbeat!!!) NONE

    Yes, Jim, I took the proper info away from that article. Look around the rest of that website to discover why any entity managed by your narrow view of economics is bound to fail.

    Read and learn… and make more money???

  13. issodhos

    That would certainly be a statist argument. “Government is fine, We just need some more laws to keep the corporate rabble in line.” Of course, a corporation is a government-created legal entity existing at the convinience of the State, so what is accomplished by thinking that the State will fix itself?;-)

  14. griff

    Yep. We can’t let silly things like facts and logic muddy the emotional waters of presidential campaigns. But he did get almost 20% of the popular vote, so he did some damage and the two parties learned some valuable (for them) lessons. They wouldn’t let it happen again with Ron Paul.

  15. Sandra Price

    Several here wrote in Ron Paul’s name. The problem is that he is associated with the Deniers of the IRS and is no longer my chosen candidate. I no longer have the energy to work another campaign. I am focused on State projects and will never venture into federal laws again. Trying to control the Lobbiest is like rowing against the Colorado River.

    It is the Congress who breaks the laws by accepting the money from the Corporations and changing their vote. I wrote up the “pay for votes” right here in 1999 and the Republicans on Reader Rant nearly went to the point of a law suit against my words. I had visited the D.C. Congressional meetings enough to recognize graft and corruption. The RR Republicans thought bringing a born again Governor from Texas would never allow such terrible things. OY!

  16. Sandra Price

    I say again and again that the problem today is not the corporations but the Congress who accepts their money and then acting in their behalf on contracts.

    The voters need to know who they are voting into power. The voters want only men who do not believe in evolution and can hide the fact they cannot keep their pants zipped.

    Right versus wrong in all respects.