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Public Option Plan Still Up For Discussion

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Public Option Plan Still Up For Discussion

Health Care

Public Option Plan Still Up For Discussion

Public Option Plan Still Up For Discussion

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  • <iframe src="" width="100%" height="290" frameborder="0" scrolling="no" title="NPR embedded audio player">
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This could be the week House and Senate leaders unveil the health overhaul bills they intend to take to their respective floors for debate. The government-run public option may still be on the table. Senate Democrats are trying to come up with a bill that can overcome a threatened Republican filibuster.


It's MORNING EDITION from NPR News. I'm Steve Inskeep.


And I'm Renee Montagne.

We'll get an update now on an urgent health problem and also a long-term one. The urgent problem is swine flu, and in a moment we'll find out why it has been so hard to get the vaccine.

INSKEEP: We begin with the debate over the future of health care - Congress is considering that now. And it's starting to look like a government-run insurance plan, a public option, is a real possibility after all.

NPR's Julie Rovner has been covering the story. Julie, good morning.

JULIE ROVNER: Good morning.

INSKEEP: Remind us again what a public option is or would be.

ROVNER: Well, to start with, it's an option, a choice, not a government takeover of the health care system. The idea is that within these new marketplaces that would be set up for individuals and small businesses, there'd be a choice of insurance plans run by private companies and possibly one sponsored and/or run by a government, perhaps a federal government, perhaps a state government, perhaps some combination. Now supporters say the public option is needed to provide some competition to private insurance companies to keep prices down. Opponents, including the private insurance industry, say the government would be an unfair competitor and would soon take over the entire insurance market.

INSKEEP: Which, of course, Republicans have been happy to say that this is a secret takeover. That's their description.

ROVNER: That's right.

INSKEEP: Who's winning the argument here, though?

ROVNER: Well, you know, if you had asked me this question back in June or July, I would have said there would definitely have been a public option in the bill the House was going to pass - that's much more heavily Democratic - and probably there wouldn't have been one in the bill the Senate was going to pass. And then there would be some kind of compromise hashed out with the House Senate Conference Committee. Then in August, there was that huge backlash against the entire health overhaul effort, and it looked like there wouldn't be a public option in either bill.

Then a couple of weeks ago, it looked again like there'd be a public option in the House bill and maybe liberals in the Senate would try to add an amendment on the floor. But now it looks like there may be close to 60 votes in the Senate for some sort of public option. And we're hearing that Senate Majority Leader Harry Reid may put it in the bill that he brings to the floor. So, supporters won't have to add it via an amendment after all.

INSKEEP: You say, 60 votes - we should clarify, if you've got 60 votes in the Senate nobody can filibuster your bill to death. You can actually get it in. But you also said some sort of public option. What do you mean by that?

ROVNER: Well, there are many different types of public option now. If you thought health care was full of jargon, there is an entire jargon for just the public option. There is something called the robust public option you may be hearing about. That's more like Medicare, where payments to doctors and hospitals are basically set by the government. Then there is something called the level playing field public option. That's where the plan would negotiate rates with those health care providers. That's more...

INSKEEP: In other words they don't have quite as much power to jam down prices, OK.

ROVNER: That's right, exactly. And that's favored more by moderates and conservatives. The robust public option is more favored by liberals. Then you may have heard something called a trigger, that's favored by Republican Senator Olympia Snowe of Maine. She is important. She is the only Republican so far in either house who has voted for any of the health overhaul bills in a committee. A trigger means a public option wouldn't take effect unless certain things happen or in this case fail to happen.

Finally, we have the state opt-out or opt-in, where individual states could decide if they want to have a public option offered in that state or not.

INSKEEP: Meaning New York could have a public option and Alabama - just to pick a state at random - might not have one.

ROVNER: Exactly.

INSKEEP: And that's something that's considered plausible. That's considered a real alternative, state by state?

ROVNER: That's considered a real alternative.

INSKEEP: Well, let me ask you, though, Julie Rovner, because this public option seemed dead in August, not so long ago, what has brought it back from the dead?

ROVNER: I think there are two things. First is public support. You know, even with all the yelling and angry town hall meetings in August, complaints and complaints about government takeovers, the public option never really fell all that far in the polls. It did dip but more recent polls show it's had really quite the comeback. Most put it generally in the high fifties, some have it even higher in public support. But I think even more important is that according to the Congressional Budget Office, a public option saves money.

It says that having a government-sponsored plan as one choice will cost less. Now, you can argue about whether that's good or bad - and people will. But when lawmakers are scrambling to squeeze every penny of savings out of these bills to keep the price tag as low as possible, it's making a public option look more and more attractive, even to moderate and conservative Democrats who don't really love the idea philosophically.

INSKEEP: Julie, thanks very much.

ROVNER: You're very welcome.

INSKEEP: That's NPR's Julie Rovner.

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