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It's Not Just the Public Option

Topic number one in health care reform right now is the public option--and, in particular, Senator Harry Reid's decision to push a bill that includes an "opt-out" proposal. But Nancy-Ann DeParle, director of the White House Office of Health Reform, had relatively little to say about it on Tuesday, when she appeared at TNR's health reform conference.

Her keynote address barely touched upon the subject. When, during a subsequent question-and-answer session, I asked her to respond to progressives unhappy with the administration's ambivalence towards Reid, she gave a generic response about how far the health reform debate has come--and a generic restatement of the president's preference for a strong public plan.

Of course, all of this was by design. DeParle wasn't there to make news on the public plan controversy. Instead, she was there to address the conference topic--"Will Reform Work?" And she chose to answer it by reminding people about some of the other benefits reform would bring.

She talked about making it easier for consumers to figure out what their plans actually cover--and whether their insurance companies were spending enough on patient care. She noted that young adults would be able to stay on their parents' plans until the age of 26--and noted that one of the congressional bills would make available special, slimmed-down plans available only to young adults.

It's a refrain we've heard before, from the president and his advisers: There's more to reform than the public plan. But however familiar and unsurprising, the argument happens to be right. And it's something worth remembering in the coming days, if--as I expect--the public option becomes an all-consuming preoccupation.

Don't get me wrong: I am a longtime public plan supporter. I find its unlikely resurgence exhilarating, as much for the politics that made it possible as the policy it may yet produce. But the fate of the public option is still just one of the many issues on which reform's fate rests. 

There are the obvious questions, like whether a new health care system will include the kind of subsidies and affordability protections necessary to make sure all Americans can get medical care without enduring financial hardship. And there are some non-obvious questions, like whether the new insurance exchanges will operate properly.

No, DeParle didn't make news. But she did make sense.