Looking for Silver Lining
Even without a public option, health reform would - so far as I can tell - still include the following:
1. Individual mandate would require Americans to be insured, even young healthy people who think they don't need it.
2. New regulations would prohibit insurance companies from denying coverage to the sick, and from dropping people just for changing jobs or losing their job. Regulations would prohibit caps on coverage.
3. A health care exchange would operate as an entry point for those not covered through their employment - it would list a menu of private health coverage options from insurance providers, offering citizens the same options that federal employees have.
4. Government subsidies - calibrated to an average of the 3 lowest prices in the exchange - would help low-income and lowish-income Americans pay for health insurance. With the mandates and the subsidy, near-universal coverage would be achieved.
5. Companies (of a certain size) that refuse to offer medical coverage to their employees would be required to pay into the subsidy pool.
6. Small businesses would receive tax incentives for covering employees.
There are surely others, but those are the ones I've heard the most, and none of them depend on a public option added to the exchange (do they?). The public option would help keep coverage costs down, and keep insurance companies honest in other ways, and those things alone make it a badly needed element of reform, but does it really render the other accomplishments "not real reform" as so many (including Howard Dean, God love him) are saying? Are we over-reacting on the left? Am I just pissed about losing yet another political fight to Republicans and other government-haters and fear-mongerers? Or is this really worth a line in the sand? These are honest questions and I am educable here, so help me out.
I tend to believe reports that the White House was completely surprised by the public option becoming the lynch-pin of reform, and that President Obama really sees it as only one small piece of the broader reform effort - not one of the principles but only one of his preferences for achieving them. Tell me how my glass half-full thought here is off base - as I'm sure it is. Are we right policy-wise to make the public option the defining piece of real reform? Politically, are we right to do it, given that surely this is the frame most comfortable to Republicans?