Public option expected to dominate Senate debate on health reform this week

Much of the news coverage previewing the Senate floor debate on health legislation, which begins this week, focused on the public option.

The Associated Press: "... the all-hands-on-deck Democratic coalition that allowed the bill to advance is fracturing already. ... Some Democratic senators say they'll jump ship from the bill without tighter restrictions on abortion coverage. Others say they'll go unless a government plan to compete with private insurance companies gets tossed overboard. Such concessions would enrage liberals, the heart and soul of the party. There's no clear course for Senate Majority Leader Harry Reid, D-Nev., to steer legislation through Congress to President Barack Obama."

"But Reid is determined to avoid being remembered as another Democrat who tried and failed to make health care access for the middle class a part of America's social safety net. 'Generation after generation has called on us to fix this broken system, he said at a recent Capitol Hill rally. 'We're now closer than ever to getting it done'" (Alonso-Zaldivar, 11/29).

MarketWatch: "A bill that would overhaul the U.S. health-care system should have a mechanism to control costs, a Democratic senator said Sunday. ... Appearing on 'Fox News Sunday,' Sen. Evan Bayh, D.-Ind., said it's encouraging that the Senate's health-care bill begins to shrink the federal deficit. But he said, 'I think we need to have an enforcement mechanism in there, as best we can, to ensure that future Congresses will have the backbone to put some of these efficiencies into place'"  (Schroeder, 11/29).

Sen. Jon Kyl, R-Ariz., also appeared on "Fox News Sunday," The Associated Press reports in a separate story: "The No. 2 Republican in the Senate is urging his Democratic colleagues to start over in crafting a bill to overhaul the health care system. ... Kyl says the Senate bill doesn't actually deal with the problems facing Americans. He says there's no way to fix the bill" (11/29).

Washington Times: "The public insurance plan is going to play a significant role in the debate, despite the fact that the Congressional Budget Office estimated that only about 6 million people would end up on the plan. It has become the most significant lightning rod - many Democrats deem it necessary to drive down costs, while Republicans say it would give government too large a role in health care. ... In the Senate, where the bill can't pass without 60 votes, every lawmaker will matter."

The Washington Times says the senators  to "watch out for" in the debate include liberals Roland W. Burris, Sherrod Brown, John D. Rockefeller IV, Bernard Sanders and Sheldon Whitehouse, "swing votes: Sens. Ben Nelson, Mary L. Landrieu and Blanche Lincoln," Sen. Thomas R. Carper, who "has been working on a proposal, which he jokingly calls 'the hammer,' that would establish a public insurance plan only in states that don't meet certain criteria, ... the wild card: Sen. Joe Lieberman" and moderate Republicans Sens. Susan Collins and Olympia Snowe, both of Maine (Haberkorn, 11/29).

The New York Times: "For some lawmakers, the public option is crucial to bringing any real change overhauling the health care system, while for others it portends a government takeover that would spell the demise of the private insurance industry. But what about the public? Do people really care that much about the public option? Surveys show that a majority of the public supports it. But those supporters value other objectives of a health care overhaul, like lowering costs, even more. A deeper look at the polls suggests a disconnect between Washington and the public over the public option. It has become magnified as a political issue beyond its immediate effect on the health insurance system, although both sides say its power, for good or ill, would become evident over time" (Seelye, 11/28).

Las Vegas Sun: "One reason the public option has become the focus of controversy is that it symbolizes another step toward securing health care as a right for all Americans — not just those whose jobs come with insurance or who are old enough or poor enough to qualify for government-funded care. Democrats see in the public option an important antidote to the privately run health care system that has defined care in the United States. They believe a government-administered plan, like Medicare, would provide a lower-cost alternative and induce competition among private insurers. ... Republicans have criticized the public option as nothing short of socialism, a driving force in what they see as a big-government takeover of private insurance in the health care bill."

"Reid's job now will be to oversee the drafting of a new version of the public option that can draw those reluctant senators aboard without losing those he already has" (Mascaro, 11/29).

Finally, The San Francisco Chronicle has a front page story on the health care systems in the Netherlands, Switzerland and Germany, saying they offer "parallels, as well as lessons," for the U.S.: "Holland and Switzerland rely exclusively on private insurance, and all three rely on private doctors. The three European nations deliver universal coverage and world-class quality at a fraction of what Americans spend. All of them require that everyone purchase insurance, make sure everyone can afford it and ban insurers from such practices as refusing to cover the sick that are common in the United States."

"European health care is universal, but contrary to popular perception, it is not all nationalized. Facing rapidly aging populations, many European countries have gone much further than the United States in using market forces to control costs. At the same time, regulations are stronger and often more sophisticated. Most of Europe spends about 10 percent of its national income on health care and covers everyone. The United States will spend 18 percent this year and leave 47 million people uninsured. ... Europe has more doctors, more hospital beds and more patient visits than the United States (Lochhead, 11/29).


Kaiser Health NewsThis article was reprinted from khn.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.

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