Morgen on October 23, 2009 at 4:43 pm
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Way back on May 20 we produced and posted a video which we called “The Public Plan Deception“, the purpose of which was to expose how key liberals had admitted that the public option was really a back door way to move the nation towards a single payer system. This is a model, like the one in Canada, in which the government provides reimbursement for all healthcare costs, and thus essentially has control over the entire system.
A central figure in our video was Dr. Jacob Hacker, a Yale professor who has since come to be known as the “father of the public option”. Hacker developed a heathcare reform plan in the early part of this decade called “Medicare Plus”, which he altered slightly and re-branded in early 2007 as “Health Care for America“. A central feature of both of these plans was the creation of a new publicly-funded, Medicare-like plan which would be offered to individuals and businesses in competition to private insurance plans. During the election campaign last year, and in the current health care debate, Hacker’s concept has come to be known simply as the “public option”.
It’s also important to know that since the HillaryCare debacle in 1993, which was followed by Republican control of Congress for 12 years, liberal Democrats have adopted a strategy of incrementalism in reforming the health care system. Rather than aiming for comprehensive reform – which for most of them means single payer – they have sought to slowly increase the rolls of people who rely on the federal government for their health care. The children’s health insurance program (SCHIP) is an example of this strategy where they have been successful. And at various times they have also unsuccessfully sought to expand the Medicare ranks by lowering the eligibility age.
So in this context there really was no question from the get-go that the public option was yet another step in this direction. However, what was somewhat remarkable in the lead-up to the health reform debate was that so many prominent liberals would be so careless as to openly acknowledge this while being videotaped. And especially Jacob Hacker, since he was well aware of the political stakes involved, and in fact had crafted his plan specifically to avoid this controversy. “Choice and competition”, “if you like what you have, you can keep it”, etc.
So in this context (and if you haven’t seen our Public Plan Deception video, go watch it), observe Jacob Hacker as he responds directly to our video, and tries to explain away his comments:
I’ll say one thing for Hacker, he was no where near as careless in his words as others have been (see Schakowsky, Frank, Klein, etc.). But I really don’t think there is any question that he is being disingenuous in his response here. Particularly with his assertion that his infamous “it’s not a trojan horse – it’s just right there” statement was not referring to the fact that he expected his plan to lead to single-payer over time. He did, and he was also not at all troubled by this as evidenced by this less seen video clip I’ve also posted of Hacker. And if you need any more convincing, the American Prospect chronicled the entire sordid history back in August.
Really Hacker’s only legitimate defense – and one that he emphasizes – is that under the bills currently being considered in Congress, the CBO estimates that only a relatively few number of people will end up enrolling in the public option (around 10-12 million over 10 years). And the CBO may be right about this, but only because the legislation was specifically crafted to minimize this number. With only a couple of relatively minor modifications down the road, this could easily be changed. By allowing more people into the health insurance exchange – currently limited to the uninsured, small businesses, and those with individual insurance plans. And by modifying the reimbursement rates to providers for the public option, thus lowering the premium costs below which the private plans would be able to compete. (This is why the hardcore liberals in the House are fighting for a public option based on Medicare rates.)
And there is not a doubt in my mind that this is the strategy that liberals crafted behind closed doors earlier this year. Essentially, it’s a Trojan horse for a Trojan horse, since Hacker’s original plan was a little too obvious. Get some form of public option passed, establishing it as an entitlement program relied on by millions of Americans (meaning it can never be killed). And then tweak it over time so the system ultimately shifts in the intended direction.
This IS the plan. Jacob Hacker knows this. The President knows this. And the liberals in Congress know this. In fact, most Republicans in Congress probably realize this as well. They just don’t have the numbers to stop it. But we do. There is an election next year, and even if some form of public option is signed into law, it won’t be implemented until 2013. Personally, I think this is why the Administration has been so reluctant to fight for the public option. They know a short term victory for liberals may turn into a long term gain for conservatives starting in 2010. One way or another it’s hard to see how the public option survives. Especially as more and more Americans learn the truth.