With the year-end deadline for health care legislation looming, what is the likelihood of the public option making it into the final bill? What will happen if it isn’t? First, let me explain what the public option would do. I’ve found that too often over the past few months, debate has raged without a clear understanding of the subject.
The public option would be just that, one insurance option of many. More importantly, it would only be available as part of the health insurance exchange, the marketplace of insurance options for those without employment-based insurance.
A public option would have two broad goals.
First, it would serve to lower costs across the board. A public option would have the ability to bargain for lower service prices and offer substantially lower administrative costs, savings that would be passed to consumers. This would in turn pressure private insurers to lower their own costs (and profits) and improve services. Second, a public option would serve as a safety net for Americans lacking workplace coverage and small businesses that can’t offer decent health options.
But keep in mind, a public option is expected to be a very small portion of the overall insurance market. The Congressional Budget Office predicts only 17 million Americans will go that route. Furthermore, the government will not subsidize the public option. It will have to stand on its own legs. Criticisms that this is the first step to government-run health care are way off the mark.
I can say that after several months of debate on this bill, both in Washington and around the Central Coast, I believe an overwhelming majority of people support a public option. Recent polls agree, including a recent Wall Street Journal/NBC poll that found 73 percent of Americans are in support of a public option. And we’ve seen support from some unexpected quarters, with Republican leaders from Gov. Schwarzenegger to New York Mayor Michael Bloomberg to former presidential nominee Bob Dole coming out in favor of reform.
Ezra Klein, a writer at the Washington Post, put it best: “The private insurance market is a mess. It’s supposed to cover the sick and instead competes to insure the well.”
It’s time we make sure that health insurance really insures people against illness. And I believe a robust public option is a big part of how we get there.
This month marks eight years since U.S. and British military launched a military offensive in Afghanistan; this year, President Obama has approved troop increases to boost the effort against al-Qaida and the Taliban. Eight years later, what has been accomplished and is there an exit strategy in sight?
I want to be clear: I’m very skeptical about what the U.S. military can accomplish in Afghanistan. After eight years, it doesn’t appear the people of Afghanistan have much affection for us, our military or the government we’re propping up.
It’s troubling that we’re spending so much money for little gain. It calls into question the fundamental idea of nation building. If the ability to evolve a functioning society isn’t there, our chances for success seem slim. My doubts are compounded by the Hamid Karzai government, which has proved to be unreliable and corrupt. So far, our lack of progress and the inability of the Afghan government to improve its own lot doesn’t give me much confidence.
But I’m optimistic that our leaders understand our position. Richard Holbrooke, the U.S. Special Envoy for Pakistan and Afghanistan, has made comments recently that indicate the Obama administration is moving in a very different direction than the previous administration.
Just last year, the United States was doing very little to build capacity in Afghanistan. Only a small fraction of aid was going through central, provincial or local governments in Afghanistan. American contractors were sucking aid money out of the country, doing little to ensure Afghanis can learn to help themselves.
That strategy has changed. We’re now developing strategies to drive much more of our aid through the Afghan government. I believe this is essential. It’s crucial that the Afghan public sector provides services and wins the confidence and affection of the people they’re serving.
Even with the improvements we’re making, it needs to be stressed that nothing can be accomplished without security. Security gains will provide space necessary for improving life in communities throughout Afghanistan. But we must focus as much attention as possible at weaning the Afghanis off our aid so we can leave their country as soon as possible.