I'm ambivalent on the merits of including a public plan in the exchange. But I think its advocates are wrong in elevating the public plan to litmus-test importance.Perhaps Marcus fails to understand that Americans want Government intervention because experience tells them that private insurance does not work.
Nonetheless, perhaps because the insurance companies don't want any competition, the US Congress will bend to their wishes and insurance companies won't get any new competition. Instead trillions more of our tax dollars will be exclusively directed toward the same for-profit entities which Americans already do not trust.
In fact, the reason that the public option appears so expensive is that it is conceived as government purchasing insurance to pay private practitioners the same exhorbitant fees for medical services and medications that have bankrupted too many Americans already.
If the government is not going to begin offering health services itself, as governments offer police and fire protection, then it would be better to do nothing at all about insurance and to focus on issues like medical records, research and epidemiology where consensus can be reached and where additional government expenditures might actually do some good.
The government should greatly expand programs of training for nurses and doctors wherein medical education would be free in exchange for a number of years working as a salaried staff member in a government clinic or hospital.
If the US Congress cannot do what countries all over the world do, which is to guarantee services or payment for services for all Americans, then they should simply admit that they have failed and that they are beholden to insurance interests and doctor's lobbies. They should go before the voters in twenty months and admit that they were unable to do anything meaningful and cost-effective about the voters' principal priority.
I believe it may be time for President Obama to belly up to the table and tell the US Congress to either pass a public option or stop wasting America's hopes and dreams on a system that will simply lard insurance companies coffers with tax monies without producing significant increases in the availability of medical care.
President Barack Obama should announce that those who oppose a public option are those receiving the most money from insurance lobbies and he will not campaign for their reelection in 2010 unless they pass a meaningful government program of health insurance in 2009. If this is what a Democratic Congress does with our health care dollars, Americans may well prefer a horrid Republican Congress in 2010, to put the brakes on wasteful spending that doesn't accomplish the real reform Americans are demanding.