MSNBC The Rachel Maddow Show - 26 Oct. 2009: 'HEALTH CARE FOR ALL*' Big asterisk on Reid's Public Option - Full Segment w/ Interview with Sen. Ron Wyden.
Rachel explains with props today's developments in health care reform.
What we have ended up is 'Public Option.' Only for the Uninsured.' 'Only in Some Places.' No trigger.
MADDOW: "We begin, with what was a very big day today in Washington. Today, just a few days shy of November, the U.S. Senate took one giant step closer to where President Obama wanted it to be in August. In a highly anticipated afternoon press conference today, the top Democrat in the Senate, Harry Reid, announced what the Senate will be voting on, when it votes on health reform. Months of speculation about whether there will be a public option in the bill has now ended. There will be a public option."
SEN. REID (VIDEO): "I believe that a public option can achieve the goal of bringing meaningful reform to our broken system. It will protect consumers, keep insurers honest, and insure competition. And that's why we intend to include it in the bill that we have submitted to the Senate... I've concluded, with the support of the White House, Senators Dodd and Baucus, that the best way to move forward is to include a public option with the opt-out provision for states."
MADDOW: "So there you have it. The public option lives. But it's a public option with a big asterisk. A state that doesn't want the public option can opt out of the public option.
There's a pretty big range of options overall on the table for trying to fix our broken health system. At one far end of the spectrum, we could have ended up with a
(holds up miniature British Union Jack) British-style nationalized health system. That's the government owning the health care system, employing doctors and providing coverage for every resident, man, woman and child. And that's what we have for veterans health care in this country, that's how the VA runs, and that's how England runs. If we can't get that, if we're too conservative a country to go for something like that for more than just our veterans... we could have also gone for the Canadian system
(holds up Canadian national flag), which is essentially Medicare. The government doesn't employ doctors and nurses like they do in England, but it's a single-payer system, the government provides insurance for everyone. That's what Canada has. That's what Medicare is.
Another more conservative alternative to that is... there's not flag for that
(holds up sign). It's the public option.
- snip -
But we also didn't get what they do in Britain, and the VA, or what they got in Canada... We also didn't get a public option that is available to everyone, or even a public option available only to uninsured people. What we got was a public option that's only available to uninsured people only in some places."
"(Weak 'Woo-hoo') Thank goodness we've got 60 Democrats in the Senate, right?"
"Of all the different things that Harry Reid could have put forward, of all the options that we had as a country, we've ended up, at least in the Senate proposal with a public option, but a really modest, conservative version of the public option. Maybe that means it will get 100 votes in the Senate? Yeah, right. Republicans will clearly all vote 'No' against this. Even Olympia Snowe said this is too much public option for her to stand."
- snip -
"One of the main arguments for the public option is that it would be big, and it would not only have the potential to give people another option at the consumer level, another choice of who you get your insurance from, it would also, because it would be big, have the potential to save the country a lot of money on health care..."
"If they only take up a really small part of the market, they're not going to have much bargaining power with the people who control how high health costs are. The smaller the number of people that are allowed to participate in the public option, the more you restrict who can get it based on things like where people live or whether or not they've already got some other form of insurance, the less likely it's going to be. The bigger it is, the more effective it's going to be at keeping costs down."
"So, politically, what's been created is an incentive, in which that conservative politicians can say at the state level 'The public option won't work.' And if enough of those conservative politicians can persuade their states to opt out of it, then that prediction that it won't work can become a self-fulfilling prophecy."
- snip -
"Joining us now is Sen. Ron Wyden of Oregon, who has been a consistent proponent of making the public option available to everyone. Senator, do you think that I was right with my props that that's sort of the descending cascade of conservative options that we had on health care reform?"
SEN. WYDEN: "Rachel, those were great signs, and the fact is that the public option will be a great tool, IF people can get it. Seems to me that Harry Reid deserves a lot of credit tonight. He's made it clear there ought to be options, but I continue to be concerned that, the way this proposal is written, more than 90 percent of Americans seven years after the bill becomes law, won't be able to hold insurance companies accountable... You can't get an accountable insurance industry with just a small fraction of the population. You've got to have the whole customer base of the industry on the line."
MADDOW: "... Do you think that what Sen. Reid is proposing could be amended to make it more effective, in your eyes."
SEN. WYDEN: "I think Sen. Reid has taken a strong step in the right direction. I do think when you ask the American people about this, you do a poll, for example, you never ask them if whether they support the idea of 10% of Americans getting the public option. You always ask whether all Americans should have it. I think the country supports that approach. That's what I'm going to fight for on the floor. The fact is that Americans all across the country use as a talking point that everybody should get this public option. Now we've got to get it in the bill."
MADDOW: "Let me ask you on the issue of talking points specifically, today Sen. Reid's office did put out a list of talking points on health care reform for Democratic Senators. And the last one caught my eye because I knew I was going to be talking to you, and it says:
'- Under our plan, if you like what yo have you can keep it, but if you don't there will affordable choices for you that can't be taken away.'
Is that really accurate, if such a small proportion of the American public is going to have access to the public option? ... Is that really true?"
SEN. WYDEN: Right now, reality is not in line with the rhetoric. Now, we have a lot of opportunities to turn this around. As I say, Sen. Reid has been a strong consumer advocate - he's advocating, for example, for McCarran Ferguson to take away the anti-trust break. But, yes,
we've got to make sure that it's possible for Americans who hate their insurance company, who feel their insurance company is abusing them, to have choices like members of Congress. Members of Congress, if you get ripped off in the fall of 2009, you have plenty of choices, but under this bill, seven years after it is adopted, 90 percent of Americans still won't have choice."
MADDOW: "It seems like the potential for passing something that is robust and ambitious in health reform increases ... as you get closer to a 50-vote margin for what you need for passing something. In other words, if the Republicans are able to filibuster this bill, set a 60-vote threshold for what it takes to pass something, our options as a country are much more limited, in terms of what we can get out of health reform. The only way Republicans can filibuster is if A Democrat sides with them. Do you think that a Democrat will side with Republicans...?
SEN. WYDEN: I think that if progressives stay at this, continue at the grassroots level to make the case that all Americans should have choice, all Americans ought to be able to hold insurance companies accountable, I think we will have sixty votes in the United States Senate for a strong bill. But obviously, this is the key time, Rachel. You asked, for example, about making sure that all Americans had choices not just talking points. If folks at the grassroots level, the folks who are carrying those signs about the public option now say 'Look, it's not good enough that only ten percent of the population can hold insurance companies accountable. It's not good enough, at a crucial time in American history, to have choice available only to a handful of people who are poor and sick and unemployed.'
That's almost like a health-care ghetto.
Let's hold insurance companies accountable the right way, by making them put their whole customer base on the line."
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