Dan Froomkin: The Public Option? It's About Accountability

Dan Froomkin
The Public Option? It's About Accountability

First Posted: 08-20-09 02:54 PM | Updated: 08-20-09 03:52 PM


It's fashionable in media circles right now to treat the "public option" as nothing more than the political football du jour, to discuss it only in the context of vote counts and political strategizing, to write it off as a particularly hysterical obsession of the political "left", and -- oh, yes -- to declare it dead.

But the fate of the public option is not yet sealed. And it's much more than just a bargaining chip. The concept of offering health care consumers a government-run alternative to the rogues that comprise the modern American insurance industry not only has a powerful appeal to the general populace, it's central to effective health care reform, both symbolically and concretely.

In fact, the most extraordinary thing about the mainstream media's attitude toward the public option is how an opposition movement so obviously born of the insurance industry's rapacious self-interest, so blatantly fueled by calls to arms that have little to no basis on reality, and so dependent on a particularly ugly strain of know-nothingism, has become viewed by our elite journalists as the pinnacle of rational centrism.

Let's be blunt. The public option -- emphasis on the word "option" -- is a way to hold the insurance companies accountable should they (entirely unexpectedly, of course) fail to live up to their promises, ignore the rules, and keep doing things the way they have for the past several decades.

By contrast, the core of the argument against the public option is nothing more than a sort of whiny plaint of "Leave the insurance companies alone!"

But it's a well-funded plaint. The public option is a grave threat to the regime of obscene profit-making that has left the health care industry with plenty of cash to now throw in reform's way.

The growing "opposition" to the public plan is a direct result of that money. This is -- remember -- exactly how money works in Washington. It buys congressmen. It buys message. It generates publicity. It even makes presidents flinch. For the political journalists to whom this is all just a big game, those are the things that matter the most: Who's up and who's down, who's winning the message wars, the soundbite battles and the day's "visuals."

more...

http://www.huffingtonpost.com/2009/08/20/the-public-option-its-abo_n_264397.html

I had a thought recently about "market-based" versus "govt-based" solutions, and it was: They each represent a different model of accountability. People who advocate market-based solutions to a problem are essentially advocating that accountability is best achieved via competition between private businesses. Competition keeps businesses honest. To advocate a govt-based solution is essentially placing accountability with the voters. If a govt program or institution is not run well, voters can make it known that they want the system improved, or they will vote the incumbents out of office and try somebody else.

Not sure where all that leads, except that we've seen pragmatically that market-based health insurance has not provided true accountability, and that is why we are advocating a govt-based system to place accountability with The People. Also, there are economic-theory reasons to expect that health insurance is not ideally served by a pure-market economy (see Krugman, Paul).