Jonathan Bernstein wonders whether liberals have “forgotten about the public option.” I think the point here is that liberals have forgotten about politicians expressing nominal support for the public option.
It’s still very early, but the first hints are a lot less promising than I would have expected for public option supporters. I checked the web sites of non-incumbent Democrats running for the Senate with decent chances of winning this year: those running in open seats and weak Republican seats in Nevada and Massachusetts. Of the seven candidates in six states that I looked at who had issue positions listed (a few still have only placeholder or minimal sites so far), none of them mentioned a public option. None. Two mentioned drug reimportation; two didn’t mention health care at all […] Hey, liberals! You want a public option on health insurance? Make it a mandatory position for Democrats running for Congress, and sooner or later the Dems will have a good year and they’ll pass it. Or, if you forget about it now, odds are it will never be passed.
Bernstein adds that it would be easier to add a public option rather than the entire bill, because it could get accomplished through reconciliation in the event of a Democratic landslide.
I too was mildly hopeful that the public option would become a litmus test in future Democratic primary campaigns. But I think Bernstein misreads several factors. First of all, we’re still in the midst of an economic crisis, particularly for the core of the Democratic base, rather than the elites. Any candidate with a message other than a narrowly targeted one on jobs isn’t going to advance very far. After three years of high unemployment and counting, that’s all anyone wants to discuss. Reform has to take a back seat to saving the patient on the gurney at this time.
But more to the point, the public option debate will be seen in future years as a seminal event in progressive politics, one which fundamentally transformed the tactics and strategies of whatever is left of a progressive movement. What Bernstein wants reflects what many progressives did during the health care debate. They demanded clarity from politicians on the issue. They ran ads. They raised money in support of those ads and the work of those advancing the policy. And in the end, the base discovered that none of this mattered as much as the whims of the hospital industry.
Even if you don’t believe in the theory that there was some secret plan to kill the public option, the fact of the matter is that those tactics fell short in 2009-2010. And the trust of the base to use the normal mechanisms of politics to advance goals simply crumbled. That’s why you’re seeing a dearth of promises from candidates about the public option. Base voters have become increasingly cynical that those promises mean anything. So why bother making the promise in the first place?
The progressive movement is undergoing a transformation where they no longer see engagement with candidates as the best or only strategy to advance goals. Those not hopelessly alienated by the entire political process prefer outsider strategies that force political pressure from the bottom up, rather than relying on the promises of those politicians to carry the day. That’s the new reality, and the public option fight was such a catalyzing event, that I don’t see it changing anytime soon.
Anyway, as Sarah Kliff correctly points out, the public option fight has moved to the states. Oregon and Montana and Massachusetts and Alameda County, California want a state-based public option. Vermont passed a single-payer bill. Those fights are far more consequential to the future of health care from a progressive perspective in America than banking on a Hail Mary reconciliation process in some future Congress.