See Robert Reich's Memo to President Obama here. ("Six things you must do to save universal healthcare")
"Co-ops" are not the answer, either.
The public option is anathema to Republicans and corporate Democrats, because it would give consumers more choices. In most parts of the country, one or two companies dominate the health insurance market.
Also, a government-run plan would have lower overhead costs than private insurers, especially for-profit insurers that need to reward shareholders. Experts predict that tens of millions of Americans would choose the public option. Private insurance companies would have to change their business practices in order to compete. . . .
I'm all for Congress allowing people to form health insurance cooperatives if some people believe in that model. If they work well, they will grow in popularity. However, cooperatives should compete alongside (not instead of) a real public option. Citizens need the option of buying into a nationwide plan like Medicare on day one, not years after discovering that the local cooperative is a raw deal.
Also, I can't see how a policy from a state-level member-owned cooperative could be portable for policy-holders who move across the country. . . .
As I understand it, using reconciliation would force Congress to revisit the issue in a few years, when the political climate might be less favorable for health care reform.
I see a lot more downside to weakening the plan in order to get Republican votes. On May 27, I spoke with Dean by telephone and asked him about efforts by Senator Ron Wyden and others to create a health care plan without a public option, with the goal of getting 70 to 80 votes in the Senate. Dean said "there's no great grace in getting 70 votes" for a bill that doesn't do anything. "All that's going to do is bankrupt the federal treasury." . . .
Democrats control the legislative and executive branches, and if we get health care reform right, we could achieve political realignment in our favor. If we screw up this chance, voters will hold us accountable. No one will remember how many Senate Republicans voted for the bill. . . .