When Theodore Roosevelt famously branded the White House a “Bully Pulpit,” this is not what he meant:

Q (from Michael Perlmutter of Durham [NC] for Obama) [A]ll of my volunteers say the same thing — they’re behind reduced cost, they’re behind guaranteed choice, they’re behind health care for all. And they believe, and I believe, that the only way to do this is to guarantee a public option available to anybody who wants one. And my question is, if that’s the solution that you believe in, why aren’t we pushing it harder? And if that’s not the solution, what other solutions out there would accomplish all three goals that you have?

THE PRESIDENT: Well, it’s a great question, and this is an example of sort of a controversy that has been somewhat manufactured this week. So let me just be clear: I continue to support a public option, I think it is important, and I think it will help drive down costs and give consumers choices.

The only thing that we have said — and this continues to be the truth — and I mean, sometimes you can fault me maybe for being honest to a fault — is that the public option is just one component of a broader plan. . . .

Yeah, since you on the one hand say that it is part of a broader plan, but then work behind the scenes to bargain away that part, then no, I won’t fault you for being honest to a fault. . . but sorry, I’ve interrupted. . . .

Now, my point is, this is sort of like the belt-and-suspenders concept, to keep up your pants. You know, the insurance reforms are the belt. The public option can be the suspenders. And what we’re trying to just suggest to people is, is that all these things are important, and that if the debate ends up being focused on just one aspect of it, then we’re missing the boat.

So, your point is that everything is an important part of the plan, so we have to pass the whole plan?

Or. . . not:

If all we’re talking about is the public option, then the 80 percent of the American people who already have health insurance in the private insurance market, they say to themselves, well, what’s in it for me? Their attitude will be, this is not relevant to me, and in fact they start getting scared thinking, maybe what the public option means is that you’re going to force me to give up my current private insurer and go into a public option.

OK, but since you are the President, up there on a bully big stage, and you have just gone to some length to lay out the opposition’s talking points, you are now going to debunk that, right?

Or. . . not:

That’s what those who are opposed to reform have been counting on, is to try to twist the debate and feed into Americans’ natural suspicion about government and to use that to cloud the fact that right now people are not getting a good deal from their insurance companies.

So I just want to make sure that we’re focusing on all the elements of reform — what will benefit people without health insurance, what will benefit small businesses, what will benefit people who do have health insurance — so that we can build the largest coalition possible to finally get this done.

And that’s it; next question please. The president might use the word “cloud,” but that doesn’t go anywhere near far enough in explaining why the public option is very much in the interests of the 80 percent of Americans that already have insurance through private providers. Which is, honestly, pathetic.

So, let me pick up the fumble: The choice provided by public health insurance as one option available to consumers provides a level of competition that encourages increased efficiency and compliance in the private sector. If private insurers have to compete with a government-run program like Medicare, which operates with less than a tenth the overhead of private plans, then insurance companies will likely be forced to reduce their currently usurious 35 percent cut.

In addition, there will be increased pressure for insurers to provide a level of service equal to that of the public option: more compliance with those “belt” rules, fewer denials of coverage, maybe fewer hoops to jump through for dispersals and reimbursements. Maybe even easier protocols for doctors and hospitals to get their take.

And, because of that, everyone benefits—the 20 percent, the 80 percent, even those that don’t qualify for the “exchange” that will offer them the choice of the public plan.

That’s what the president had the opportunity to explain, but did not. Instead, he just repeated the bullshit claims that a public option is not as important as insurance reform.

But, you know what, I think it is even worse than that—at least a little. . . maybe a lot—because by structuring it as the “what’s in it for me” argument for the bulk of Americans that have their own private medical insurance, he is reinforcing a deeper, darker meme.

Throughout the long national nightmare that has been the battle for health care reform, there has been an underlying ugliness—a classist, racist ugliness. For, in a system where most people who have health insurance get that insurance from an employer, those that don’t have coverage are assumed to be, rightly or wrongly, unemployed.

Unemployed. . . lazy. . . shiftless. . . .

Black.

Yeah, I said it was ugly.

And it only gets uglier when our first African American president, in order to play an electoral strategy straight out of the Bill Clinton/Rahm Emanuel playbook, plays right into the hands of his obstructionist, racist opponents.

And, if you think all that sounds ugly, than think about this: If the Obama Administration forces through a crippled, compromised “reform” package—one that does not include a public option, does not cover many uninsured, does not rein in costs, does not force private insurers to compete, but does funnel taxpayer dollars into the private insurers’ coffers—and calls that a victory for the president, the Democrats, and the American people, then Democrats are going to pay dearly at the polls. Voters will see this as a failure at best—maybe even a betrayal—and they will vote accordingly.

And then we will really see some elephants on parade.


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