American health-care reform
(c) Dick Locher

It's being hailed as the "great compromise" on health care reform. But it should be called the great sell-out.

No matter what Majority Leader Harry Reid claims, the compromise agreed upon by Senate Democrats is no public plan option. There's nothing public about it. It replaces the public option in the bill originally sent to the floor with a selection of private, nonprofit insurance plans -- making it a total gift to insurance companies. In fact, the Senate compromise could have been written by insurance company lobbyists, and probably was.

And, for once, Democrats can't blame this failure on Republicans. Democrats alone are responsible. The majority of Democrats supported a strong, robust public option. But they surrendered to the complaints of Democratic Senators Mary Landrieu, Blanche Lincoln and Ben Nelson -- and Independent Senator Joe Lieberman -- who never met an insurance company yet they didn't like and serve.

First, lest we forget, there's a lot of good stuff in the Senate health care reform legislation. Insurance companies could no longer deny coverage because of a "pre-existing condition," nor drop your coverage if you or a member of your family becomes seriously ill. Preventive care is covered, with no co-payment. And women are guaranteed coverage for mammograms and basic maternity care.

Still on the positive side: Senators have also added one important provision which is lacking in the House reform bill: an amendment to open up Medicare, allowing persons between the ages of 55 and 64, who do not have health insurance, to buy into the program. Of course, that doesn't go far enough. Ideally, Medicare should be open to all Americans, regardless of age. But it is the first expansion of Medicare since 1965. It takes effect immediately. And it could be further expanded in the future, leading to an eventual, total single-payer system. But that's still years away.

With all those good features, what's wrong with the Senate compromise? Again, the lack of a robust public plan option. As President Obama used to say in every speech about health care, the number one reason for reform was to cut costs. And the only way to cut costs is to provide choice for consumers and competition to insurance companies through the introduction of a government-run, public plan option.

The new Senate compromise contains no such public plan option. Instead, it offers a choice among a series of new private insurance plans, overseen by the federal Office of Personnel Management. Only sometime in the future, if insurance companies fail to cut costs sufficiently, could Congress pull the "trigger" to create a true public plan option.

In the meantime, the Senate plan hands insurance companies a veritable bonanza: some 40 million new customers. So where's the competition? There is none. An amendment by Sen. Jay Rockefeller -- requiring that insurance companies limit overhead, including profit, to 10 cents on every dollar -- sounds good. But who trusts them anymore not to fudge the books?

To me, the worst part is: this plan is being sold as the best we could get out of the Senate. Nonsense. Democrats, after all, control the House, the Senate, and the White House. There will never be a better opportunity to deliver real universal health care reform. With all that power, there was no need to settle for half a loaf. Majority Leader Harry Reid and President Obama should never have done so. They were too willing to cave, from the beginning.

Unfortunately, failure to deliver a stronger bill in the Senate reflects an underlying, defeatist attitude prevalent in Washington today. At every turn, you hear the phrase: "Politics is the art of the possible." So said Otto von Bismarck, but I don't believe it. Like Robert Kennedy I believe that politics is the art of the impossible. You can achieve great things. You can work miracles. You can actually change the world. But only if you're willing to fight like hell.

Granted, in politics, you don't always get what you want. There's often a need to compromise. But when you start out looking for what's possible, instead of what's best, you end up with second-best. And that's where we are with health care reform legislation today. If it gets any weaker, we'd be better off with no bill at all.

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(c) 2009 U.S. News & World Report