The New Health Dialogue

The public plan has seen more reincarnations than the Dalai Lama.

When Harry Reid released his merged Senate bill, he breathed new life into the debate, by including a public health insurance option that would allow individual states to opt out. Now, Senator Tom Carper (D-DE) hopes to reach that 60 vote threshhold  with a compromise that could assuage moderates'  fears while keeping liberals on board.

The details, which could be unveiled as soon as next week, are still up in the air. Carper’s been working closely with Senators Chuck Schumer (D-NY) and Mary Landrieu (D-LA) as well as a familiar dealmaker from Maine, Senator Olympia Snowe. The Hill’s J. Taylor Rushing and Bob Cusack provide an overview  and lay out in broad strokes what Carper’s plan might look like:

Carper has been working on variations of the public option for months. Recently, he has touted a so-called hammer public option that he believes answers centrists' criticisms that the public option in Reid's bill is government-run and government-funded. The public option would kick in for states where insurance companies fail to meet standards of availability and affordability of plans. Unlike Snowe's trigger proposal, which would give insurers at least one year to satisfy those requirements, Carper's public option would start the first year the bill goes into effect. States might be permitted to opt into the public option even if the benchmarks are met.

As Carper told the paper:

A public option is not the most important element. But it’s not unimportant… The question is, if we allow states to do all of those things and there are still states where there’s not very much competition and as a result there’s not very good affordability, what do we do about it?

A well crafted public plan can help achieve the goals of health reform, but it is not a panacea and should not be a poison pill that prevents reform bill’s passage. So as senators work toward a compromise, they should remember some wise words that may or may not have been uttered by the 14th Dalai Lama: “Remember that not getting what you want is sometimes a wonderful stroke of luck.”