It is time for some very simple political math. The public option–or a public alternative like a Medicare buy-in–has always been extremely popular. Despite a multi-million dollar, all-out campaign against it, the public option never stopped polling well. Back when the health care bill still contained a public option, the health reform was more popular.
The private health insurance companies are very unpopular. The individual mandate, requiring people to buy a product from the private health insurers or face a fine, is extremely unpopular. The Senate health care bill with the unpopular individual mandate forcing people to buy a product from the very unpopular private insurance companies is (surprise!) very unpopular.
A public alternative to the private insurance companies is so popular that it makes the individual mandate amazingly acceptable for most people. Americans, for the most part, don’t mind forcing people to buy health insurance if they have the option of buying it from the government instead of only from the private health insurance industry.
What is now facing Congressional Democrats is an unpopular Senate bill that contains a very unpopular mandate forcing people to buy private health insurance. Unfortunately for Democrats, even in swing districts, the majority of voters have not completely soured on the general idea of health care reform. When asked if they would prefer if their Representative vote against any possible health care bill, the results in each of the three districts we polled were below 50%. (It was 48% in AR-02, 40% in OH-01, and 41% in NY-01.)
If Democrats move with clarity, it is possible that they could still make voting for the health care bill reasonably popular, or, at least, not politically damaging. They can use reconciliation to add the very popular public option–that would make the individual mandate more popular, and save the government money. They could use that money to help fix the incredibly unpopular tax on employer-provided insurance benefits to make that provision less unpopular, too. Or, Democrats could use the money saved by the public option to provide some Americans immediate health care relief before the 2010 election. This would make selling the bill and voting for the bill much easier.
This is not rocket science. To make an unpopular bill more acceptable to the American people, Democrats can add a very popular provision, the public option, stand up to the very unpopular insurance companies, and make some very unpopular provisions less politically unpalatable. Or, the other option is to use a special parliamentary tool to raise taxes for what would appear to be a special tax break for labor unions. Congressional Democrats, please don’t make me have to explain–even more simply–why the second choice is the wrong one.