Reform Operation

Barack Obama’s health care reform project is not coming to fruition. After much public pressure, the president is surrendering on the issue of public health care.

Under pressure from public protests and a public relations offensive from private health insurance providers, it looks like Obama will have to give up a central element of his health care reform measures: the public option. This new choice for public health insurance would allow the millions of uninsured people, for whom private coverage is too expensive or unattainable due to preexisting conditions, to afford coverage. The public option was also thought of as a source of competition for private insurers that would force them to keep costs down and to insure high-risk individuals.

On Monday, the New York Times and Washington Post reported that Obama would drop the public option in favor of non-profit health care cooperatives. This would be a non-profit consortium not financed by the state. Experts predict that the co-op model would have less influence in the market when it comes to price negotiations with hospitals, doctors and the pharmaceutical industry, and would not be as competitive with the private insurers as the public option.

Obama’s reversal revealed itself over the weekend after protests across the country against government run health care. The president, at a town hall meeting in Colorado said, “The public option, whether we have it or we don’t have it, is not the entirety of health care reform. This is just one sliver of it, one aspect of it.” His Secretary of Health and Human Services, Kathleen Sibelius, brought up the co-op model as an alternative in an interview over the weekend. She also said that the public option is not “the heart of the reform.” Obama and Sibelius are emphasizing that every citizen having a choice and increased competition are more important.

Senator Kent Conrad brought forth the idea of a co-op option as a possible compromise. He is a conservative Democrat from North Dakota, and is a typical blue dog: center-right Democrats from traditionally Republican states who have been skeptical of Obama’s reforms and do not always agree with the president’s politics, even though they belong to the same party. “There are not the votes in the United States Senate for the public option,” Conrad said on Sunday. “There never have been. So to continue to chase that rabbit, I think, is just a wasted effort.” The co-op option is being modeled after energy co-ops in North Dakota.

Commentators emphasize that the public option was the central element of the planned reform. In a little under seven months since Obama’s inauguration, the debate surrounding the public option has been consistently altered. It has moved away from the fate of the approximately 47 million uninsured Americans, around 15 percent of the population, to who is going to put the brakes on the climbing cost of health care and put a limit on the financial pressure faced by those already insured.

Until now, there was neither a health care mandate, nor a demand from citizens for policies regarding commercially available insurance. Most Americans get their insurance from their employer, who negotiates with the health insurance companies. The coverage is not as comprehensive as what Germans know from their public health insurance; besides that, Americans have to pay a higher amount of the costs out-of-pocket, usually between 10 and 40 percent. Regardless, a majority say that they are happy with their current system and want to keep it.