Senate Debate On Health Reform Begins Monday, Public Option Will Dominate

Much of the news coverage previewing the Senate floor debate on health legislation, which begins Monday afternoon, focuses on the public option.

The Wall Street Journal: "(L)awmakers from both parties are planning to introduce dozens of amendments, addressing issues from a government-run health-care plan to medical malpractice lawsuits to abortion and taxes. ... Any of the amendments will also likely require 60 votes to pass, because opponents can threaten to filibuster any amendment that has less support. That sets a high bar, but even unsuccessful amendments can send a message. Sen. Orrin Hatch (R., Utah), for example, is expected to offer an amendment to insert tough abortion restrictions in the bill ... Although the bill was crafted by Senate Majority Leader Harry Reid (D., Nev.), Democrats, too, have points to make, especially the liberal wing. Sen. John Rockefeller (D., W.V.) says he will probably offer an amendment to strengthen the public option, a government-run health plan that would compete with private insurers" (Bendavid, 11/29).

The Associated Press: "(T)he 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. ... 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).

Reuters: "Howard Dean, a physician and former governor from Vermont who has been critical of some of his fellow Democrats who do not back a public health insurance option, predicted on the same news show ['Fox News Sunday'] that Obama would succeed on healthcare reform. .... Republicans strongly oppose the public option, arguing that it would give government too big a role in healthcare and that private insurers would be unable to compete. They also argue the bill, which is paid for through tax increases and spending cuts, is too expensive. Many of the proposed spending cuts in the Medicare health program for the elderly are unlikely to go into effect, said Republican Senator Jon Kyl. 'There's no way to fix this bill,'" Kyl [said.]" Smith, 11/29).

USA Today: "On CNN's State of the Union, Sen. Richard Lugar, R-Ind., made the 'audacious suggestion' of putting off the Senate's health care debate and 'talk now about the essentials, the (Afghanistan) war and money.' No way, said Sen. Jack Reed, D-R.I. He told CNN that 'the health care debate is essential to our economic future' because of rising costs for businesses and individuals. ...  Sen. Carl Levin, D-Mich., said on CBS's Face The Nation that there's a 'decent chance' the Democrats can find the 60 votes needed for a final bill, one with 'a public option that the states can opt out from'" (Jackson, 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" (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).