Hacker: Still Alive.

“In short, it’s no time to be despondent about the fate of the public insurance option. For sure, pegging rates to Medicare and obligating Medicare providers to accept these rates would be far preferable, and a public plan with negotiated rates may do less to keep the insurers honest and drive down costs. But it’s still immensely valuable to give Americans an out — another choice — to let the insurers feel the heat of not being the only game in town. The fierce and continuing opposition of the insurance industry suggests that they think that a public option will prove a serious counterweight in an increasingly consolidated private market.”

In TNR, Jacob Hacker and Diane Archer make the case anew for a public option, specifically the one that made it into H.R. 3962. If all goes well, the House bill — recently endorsed by the AARP and the AMA — will get a vote tomorrow. (Yep, it’s a work day.) Update: Or later. Here’s the hold-up.

Better Dead than Red.

“As political scientist Jacob Hacker has argued, the basic obstacle was nothing less than the government’s failure to have adopted a comprehensive health insurance plan decades earlier. As a result, the system that emerged by 1994 entailed such a crazy quilt of private interests — corporations, small firms, insurers, doctors, unions, HMOs, and so on — that moving all Americans into a new framework without worsening anyone’s situation had become virtually impossible.Slate and Rutger University’s David Greenberg summarizes the history of health care reform, and of the epithet “socialized medicine.” “[T]he idea of government-run health care dates to the Progressive Era. Originally called ‘compulsory health insurance,’ it enjoyed favor in the 1910s among many quarters, including the American Medical Association…But as the debate heated up, doctors began to worry that it would hurt their incomes, and they banded with business groups like the National Association of Manufacturers to oppose reform. American entry into World War I tabled consideration of the issue, and the postwar Red Scare, Starr notes, ‘buried it in an avalanche of anticommunist rhetoric.’

Think Different.

Dick Gephardt tries to separate from the Democratic herd by offering a bold health care proposal that also repeals the ridiculous Dubya tax cuts. It was interesting to read of Gephardt’s proposal right after finishing Jacob Hacker’s The Divided Welfare State, since his proposal buttresses Hacker’s main point. Rather than develop a new public health care infrastructure a la the 1994 Clinton plan, Gephardt’s plan basically follows the path of least resistance and subcontracts health care out to private insurance companies. This will no doubt make it easier to pass in our neo-con political climate than the ’94 Clinton bill. That being said, as Hacker notes, letting the private sector run our social welfare regime severely cuts back on the redistributive potential of health care reform. But, hey, private universal health care coverage is better than no universal health care coverage. And it’s a smart move by Gephardt to appeal to the base.