Sebelius: Surrender or Slip-Up?

Sebelius: Surrender or Slip-Up?

The buzz of the late weekend was HHS Secretary Kathleen Sebelius saying the public option was "is not an essential part" of reform. The administration quickly walked that back, saying she "misspoke."

There's history of that, as least from my experience as this remark landed me at the top of Drudge for one wild afternoon. But maybe a Sebelius "misspeak" is like a Joe Biden misspeak: off-message, maybe, but not off base.

Don't get me wrong, I agree with the good doctor Dean that "you can't really do health care reform without" public option. (I still wish Dean had HHS and Sebelius was back in Kansas getting her Senate run ready. That's three Senate races the president screwed with his cabinet: Kansas, Arizona, and us.)

But it's quite possible that even with the biggest Democratic majorities in decades we still don't have the votes, thanks to Blue Dogs and insurance insustry bribery campaign contributions.


Nate the Great at FiveThirtyEight Silver counts votes better than anyone this side of Sam Rayburn, and he's reached the acceptance stage of grieving (though he says he's only at bargaining):

The fundamental accomplishments of a public option-less bill would be to (1) ensure that no American could be denied coverage because of a pre-existing condition or because they became sick; (2) subsidize health insurance coverage for millions of poor and middle-class Americans.

These are major, major accomplishments. Arguably, they are accomplished at too great a cost. But let's look at it like this. The CBO estimates that the public option would save about $150 billion over the next ten years -- that's roughly $1,100 for every taxpayer. I'm certainly not thrilled to have to pay an additional $1,100 in taxes because some Blue Dog Democrats want to placate their friends in the insurance industry. But I think the good in this health care bill -- the move toward universal-ish coverage, the cost-control provisions -- is worth a heck of a lot more than $1,100.

Universal-ish. Sounds a lot like truthiness to me.

Rachel Maddow, on the other hand, is not so pleased:

But ultimately, if the president decides that he's going to go with a reform effort that doesn't include a public option, what he will have done is spent a ton of political capital, riled up an incredibly angry right wing base who's been told that this is a plot to kill grandma, grandma, and he will have achieved something that doesn't change health care very much and that doesn't save us very much money and won't do very much for the American people. It's not a very good thing to spend a lot of political capital on.

Silver holds out hope that, down the road, public option will be addressed as a stand-alone provision. But Ross Douthat looks at the demographics. I'm not convinced by or knowledgable enough to endorse everything he says about costs. But he's dead on with the politics and demographics:

If the Democratic Party’s attempt at health care reform perishes, senior citizens will have done it in, not talk-radio listeners and Glenn Beck acolytes. It’s the skepticism of over-65 Americans that’s dragging support for reform southward. And it’s their opposition to cost-cutting that makes finding the money to pay for it so difficult.

And if you think reform is tough today, just wait. We’re already practically a gerontocracy: Americans over 50 cast over 40 percent of the votes in the 2008 elections, and half the votes in the ’06 midterms. As the population ages — by 2030, there will be more Americans over 65 than under 18 — the power of the elderly and nearly elderly may become almost absolute.

So that means... let's see, the first boomers are now 63, and the last boomers, which is me (December 1963) are 45... that means we either have to do it now or we have to wait until after I die. Which should be sometime around 2050, depending on... well, depending on what we get done about health care now, huh?

In any case, I hope Sebelius really did misspeak rather than tipping the administration's hand. But in the context of our current health care debate, a Sebelius "misspeak" is better than a Palin-Grassley flat out lie.

P.S. Two more reports on Dave Loebsack's forums -- one at Bleeding Heartland and one from the Burlington Hawkeye.