Suzy Khimm's post at The Treatment about Howard Dean's latest remarks on health care reform strategy shows the perils of the obsession with the public option on both sides of the barricades. After a fiery demand that progressives refuse to relent on the public option, the good Doctor allowed as how if we can't get that, he'd be fine with legislation that just regulated health insurance abuses.
Ironically enough, Dean seems to be embracing the same fallback position as his old adversary Joe Lieberman, who's said regulate-only legislation is all he'd be willing to support if a public option is included in a comprehensive reform bill. The problem, of course, is that absent an individual mandate to bring healthier people into the risk pool, or significant subsidies to lure them in, imposing a national system of community rating or guaranteed access to insurance on behalf of less robust Americans will likely boost private insurance premiums for everybody--not exactly an ideal outcome.
Now it's likely that Dean is really just engaged in a tactical effort to keep progressives fired up for the public option in order to keep pressure on Senate Democrats and the White House to insist on some competitive mechanism--perhaps a "triggered" public option, perhaps strong national or regional co-ops--that's significantly stronger than the weak state co-ops in the Baucus bill. And perhaps the reconciliation route means a "robust" public option can still be passed by the Senate. But at some point, when you keep urging people to say "my way or the highway," you have to look down that highway to see where it leads. And if the end-point is going to be a regulate-only bill, both Dean and Lieberman need to acknowledge that may actually be no better than the status quo, and could possibly be even worse.
Ed Kilgore is Managing Editor of The Democratic Strategist and a Senior Fellow at the Progressive Policy Institute.