Reich: Last Chance for The Public Option

Please spare two minutes, thirty-nine seconds and find out what you can do for meaningful health reform, courtesy of economics professor and former Labor Secretary Robert Reich:

Lunchtime for Timorous Thomas

Take a gander at the lunch menu (left) that Escambia County School Superintendent Malcolm Thomas claimed was too important to interrupt for an inspirational message from President Barack Obama. Them there peaches must be really somethin', Malcolm!

Then (with apologies to Dan Gutman), if you have more courage than Timorous Thomas, watch the speech:

Public Option or Bust

We won't know for sure until Wednesday night's presidential address, but Duncan Black has it nailed for now:

[Democrats] seem to have lost track of the fact -- a fact Republicans understand and have been quite open about for decades -- that passing a popular health care bill will make voters love Democrats and passing an unpopular one, or perhaps none at all, will make voters hate them. The Republicans were always going to oppose whatever the Democrats came up with, I just didn't know the Dems would let them do that while also letting them work to make sure anything they came up with is really unpopular.

Partisanship is hardly the most important perspective from which to analyze this health care debate, but it does drive many in Congress. So, it's worth noting that, strictly from a partisan perspective of the Democratic Party, it should be nothing less than "public option or bust."

Without a public option, health care reform will look, at best, like the Baucus "compromise" plan -- an incremental improvement here and there, but more obviously a massive giveaway to the corporate health care industry, with little or no improvement in the quality of medical care for the rest of us. In which case, Republicans will get their wish; the Obama administration will be toast.

Which means, in the next election the "blue dog" Democrats in conservative states and districts will be the first to be thrown out of office. And, wouldn't that be ironic! A lack of personal courage and failure of vision leads to the defeat of incumbent politicians.

Crazy People and School Administrators

Here's the speech crazy people -- and Northwest Florida school superintendents -- don't want school kids to hear:

Prepared Remarks of President Barack Obama
Back to School Event

Arlington, Virginia
September 8, 2009

The President: Hello everyone – how’s everybody doing today? I’m here with students at Wakefield High School in Arlington, Virginia. And we’ve got students tuning in from all across America, kindergarten through twelfth grade. I’m glad you all could join us today.

I know that for many of you, today is the first day of school. And for those of you in kindergarten, or starting middle or high school, it’s your first day in a new school, so it’s understandable if you’re a little nervous. I imagine there are some seniors out there who are feeling pretty good right now, with just one more year to go. And no matter what grade you’re in, some of you are probably wishing it were still summer, and you could’ve stayed in bed just a little longer this morning.

I know that feeling. When I was young, my family lived in Indonesia for a few years, and my mother didn’t have the money to send me where all the American kids went to school. So she decided to teach me extra lessons herself, Monday through Friday – at 4:30 in the morning.

Now I wasn’t too happy about getting up that early. A lot of times, I’d fall asleep right there at the kitchen table. But whenever I’d complain, my mother would just give me one of those looks and say, "This is no picnic for me either, buster."

So I know some of you are still adjusting to being back at school. But I’m here today because I have something important to discuss with you. I’m here because I want to talk with you about your education and what’s expected of all of you in this new school year.

Now I’ve given a lot of speeches about education. And I’ve talked a lot about responsibility.

I’ve talked about your teachers’ responsibility for inspiring you, and pushing you to learn.

I’ve talked about your parents’ responsibility for making sure you stay on track, and get your homework done, and don’t spend every waking hour in front of the TV or with that Xbox.

I’ve talked a lot about your government’s responsibility for setting high standards, supporting teachers and principals, and turning around schools that aren’t working where students aren’t getting the opportunities they deserve.

But at the end of the day, we can have the most dedicated teachers, the most supportive parents, and the best schools in the world – and none of it will matter unless all of you fulfill your responsibilities. Unless you show up to those schools; pay attention to those teachers; listen to your parents, grandparents and other adults; and put in the hard work it takes to succeed.

And that’s what I want to focus on today: the responsibility each of you has for your education. I want to start with the responsibility you have to yourself.

Every single one of you has something you’re good at. Every single one of you has something to offer. And you have a responsibility to yourself to discover what that is. That’s the opportunity an education can provide.

Maybe you could be a good writer – maybe even good enough to write a book or articles in a newspaper – but you might not know it until you write a paper for your English class. Maybe you could be an innovator or an inventor – maybe even good enough to come up with the next iPhone or a new medicine or vaccine – but you might not know it until you do a project for your science class. Maybe you could be a mayor or a Senator or a Supreme Court Justice, but you might not know that until you join student government or the debate team.

And no matter what you want to do with your life – I guarantee that you’ll need an education to do it. You want to be a doctor, or a teacher, or a police officer? You want to be a nurse or an architect, a lawyer or a member of our military? You’re going to need a good education for every single one of those careers. You can’t drop out of school and just drop into a good job. You’ve got to work for it and train for it and learn for it.

And this isn’t just important for your own life and your own future. What you make of your education will decide nothing less than the future of this country. What you’re learning in school today will determine whether we as a nation can meet our greatest challenges in the future.

You’ll need the knowledge and problem-solving skills you learn in science and math to cure diseases like cancer and AIDS, and to develop new energy technologies and protect our environment. You’ll need the insights and critical thinking skills you gain in history and social studies to fight poverty and homelessness, crime and discrimination, and make our nation more fair and more free. You’ll need the creativity and ingenuity you develop in all your classes to build new companies that will create new jobs and boost our economy.

We need every single one of you to develop your talents, skills and intellect so you can help solve our most difficult problems. If you don’t do that – if you quit on school – you’re not just quitting on yourself, you’re quitting on your country.

Now I know it’s not always easy to do well in school. I know a lot of you have challenges in your lives right now that can make it hard to focus on your schoolwork.

I get it. I know what that’s like. My father left my family when I was two years old, and I was raised by a single mother who struggled at times to pay the bills and wasn’t always able to give us things the other kids had. There were times when I missed having a father in my life. There were times when I was lonely and felt like I didn’t fit in.

So I wasn’t always as focused as I should have been. I did some things I’m not proud of, and got in more trouble than I should have. And my life could have easily taken a turn for the worse.

But I was fortunate. I got a lot of second chances and had the opportunity to go to college, and law school, and follow my dreams. My wife, our First Lady Michelle Obama, has a similar story. Neither of her parents had gone to college, and they didn’t have much. But they worked hard, and she worked hard, so that she could go to the best schools in this country.

Some of you might not have those advantages. Maybe you don’t have adults in your life who give you the support that you need. Maybe someone in your family has lost their job, and there’s not enough money to go around. Maybe you live in a neighborhood where you don’t feel safe, or have friends who are pressuring you to do things you know aren’t right.

But at the end of the day, the circumstances of your life – what you look like, where you come from, how much money you have, what you’ve got going on at home – that’s no excuse for neglecting your homework or having a bad attitude. That’s no excuse for talking back to your teacher, or cutting class, or dropping out of school. That’s no excuse for not trying.

Where you are right now doesn’t have to determine where you’ll end up. No one’s written your destiny for you. Here in America, you write your own destiny. You make your own future.

That’s what young people like you are doing every day, all across America.

Young people like Jazmin Perez, from Roma, Texas. Jazmin didn’t speak English when she first started school. Hardly anyone in her hometown went to college, and neither of her parents had gone either. But she worked hard, earned good grades, got a scholarship to Brown University, and is now in graduate school, studying public health, on her way to being Dr. Jazmin Perez.

I’m thinking about Andoni Schultz, from Los Altos, California, who’s fought brain cancer since he was three. He’s endured all sorts of treatments and surgeries, one of which affected his memory, so it took him much longer – hundreds of extra hours – to do his schoolwork. But he never fell behind, and he’s headed to college this fall.

And then there’s Shantell Steve, from my hometown of Chicago, Illinois. Even when bouncing from foster home to foster home in the toughest neighborhoods, she managed to get a job at a local health center; start a program to keep young people out of gangs; and she’s on track to graduate high school with honors and go on to college.

Jazmin, Andoni and Shantell aren’t any different from any of you. They faced challenges in their lives just like you do. But they refused to give up. They chose to take responsibility for their education and set goals for themselves. And I expect all of you to do the same.

That’s why today, I’m calling on each of you to set your own goals for your education – and to do everything you can to meet them. Your goal can be something as simple as doing all your homework, paying attention in class, or spending time each day reading a book. Maybe you’ll decide to get involved in an extracurricular activity, or volunteer in your community. Maybe you’ll decide to stand up for kids who are being teased or bullied because of who they are or how they look, because you believe, like I do, that all kids deserve a safe environment to study and learn. Maybe you’ll decide to take better care of yourself so you can be more ready to learn. And along those lines, I hope you’ll all wash your hands a lot, and stay home from school when you don’t feel well, so we can keep people from getting the flu this fall and winter.

Whatever you resolve to do, I want you to commit to it. I want you to really work at it.

I know that sometimes, you get the sense from TV that you can be rich and successful without any hard work -- that your ticket to success is through rapping or basketball or being a reality TV star, when chances are, you’re not going to be any of those things.

But the truth is, being successful is hard. You won’t love every subject you study. You won’t click with every teacher. Not every homework assignment will seem completely relevant to your life right this minute. And you won’t necessarily succeed at everything the first time you try.

That’s OK. Some of the most successful people in the world are the ones who’ve had the most failures. JK Rowling’s first Harry Potter book was rejected twelve times before it was finally published. Michael Jordan was cut from his high school basketball team, and he lost hundreds of games and missed thousands of shots during his career. But he once said, "I have failed over and over and over again in my life. And that is why I succeed."

These people succeeded because they understand that you can’t let your failures define you – you have to let them teach you. You have to let them show you what to do differently next time. If you get in trouble, that doesn’t mean you’re a troublemaker, it means you need to try harder to behave. If you get a bad grade, that doesn’t mean you’re stupid, it just means you need to spend more time studying.

No one’s born being good at things, you become good at things through hard work. You’re not a varsity athlete the first time you play a new sport. You don’t hit every note the first time you sing a song. You’ve got to practice. It’s the same with your schoolwork. You might have to do a math problem a few times before you get it right, or read something a few times before you understand it, or do a few drafts of a paper before it’s good enough to hand in.

Don’t be afraid to ask questions. Don’t be afraid to ask for help when you need it. I do that every day. Asking for help isn’t a sign of weakness, it’s a sign of strength. It shows you have the courage to admit when you don’t know something, and to learn something new. So find an adult you trust – a parent, grandparent or teacher; a coach or counselor – and ask them to help you stay on track to meet your goals.

And even when you’re struggling, even when you’re discouraged, and you feel like other people have given up on you – don’t ever give up on yourself. Because when you give up on yourself, you give up on your country.

The story of America isn’t about people who quit when things got tough. It’s about people who kept going, who tried harder, who loved their country too much to do anything less than their best.

It’s the story of students who sat where you sit 250 years ago, and went on to wage a revolution and found this nation. Students who sat where you sit 75 years ago who overcame a Depression and won a world war; who fought for civil rights and put a man on the moon. Students who sat where you sit 20 years ago who founded Google, Twitter and Facebook and changed the way we communicate with each other.

So today, I want to ask you, what’s your contribution going to be? What problems are you going to solve? What discoveries will you make? What will a president who comes here in twenty or fifty or one hundred years say about what all of you did for this country?

Your families, your teachers, and I are doing everything we can to make sure you have the education you need to answer these questions. I’m working hard to fix up your classrooms and get you the books, equipment and computers you need to learn. But you’ve got to do your part too. So I expect you to get serious this year. I expect you to put your best effort into everything you do. I expect great things from each of you. So don’t let us down – don’t let your family or your country or yourself down. Make us all proud. I know you can do it.

Thank you, God bless you, and God bless America.

=========================

How to Watch

• The President's message will be streamed live on WhiteHouse.gov/live, and broadcast live on C-Span

• For school districts hoping to access the satellite feed, it will be available beginning at 11:00 AM (EDT) using the following coordinates:

Galaxy 28/Transponder 17, Slot C (9 MHz)
Uplink Frequency 14344.5 Horizontal
Downlink Frequency 12044.5 Vertical

Labor Day Crossword

Labor Day Crossword.
(click to see and print)

Answers
(no fair cheating)

Learning Lunacy in Pensacola

Sunday's Pensacola News Journal predictably gives the heaviest headline ink today to local crazies who are objecting to President Obama's inspirational speech to school children. Not a word is mentioned by the reporter, or the censorious lunatics Rebekah Allen quotes, about George H. W. Bush's 1991 address to school children, or whether local school superintendents similarly embargoed that inspirational address to school students.

To her credit, Allen's report does quote a number of local citizens who strongly object to the lunacy of closeting an encouraging educational message for students from the President of the United States. And, her report advances the story a bit by illuminating the extreme contortions Escambia County school superintendent Malcolm Thomas is going through to explain why encouraging remarks to "study hard" and "stay in school" will not be shown to students who are enrolled in one of the nation's worst school systems, where too few students study and too many drop out.

Superintendent Malcolm Thomas -- who is, after all, required by the county's demented educational system to be just another politician -- told the PNJ reporter, as she paraphrases it, "Logistically, it does not make sense to stop students who may be at lunch, recess, or in an unrelated class to watch a video that is not time-sensitive."

Lunch! Recess! Of course! Eat first, drop out later.

A Plea to Obama: "We Need a Fighter"

"Poor Obama. He came to town preaching the religion of nice. But every time he bows politely, the harder the Republicans kick him.

No one's ever conquered Washington politics by constantly saying "pretty please" to the guys trying to cut your throat."

----------------

Bill Moyers, a real journalist who has seen more of America, and who knows more about it, than nearly anyone in the media today pleads with the President: "Show us America is more than a circus or a market."

Text:

September 4, 2009

BILL MOYERS: The editors of The Economist magazine say ["Keep It Honest"] America's health care debate has become a touch delirious, with people accusing each other of being evil-mongers, dealers in death, and un-American.

Well, that's charitable.

I would say it's more deranged than delirious, and definitely not un-American.

Those crackpots on the right praying for Obama to die and be sent to hell — they're the warp and woof of home-grown nuttiness. So is the creature from the Second Amendment who showed up at the President's rally armed to the teeth. He's certainly one of us. Red, white, and blue kooks are as American as apple pie and conspiracy theories.

Bill Maher asked me on his show last week if America is still a great nation. I should have said it's the greatest show on earth. Forget what you learned in civics about the Founding Fathers — we're the children of Barnum and Bailey, our founding con men. Their freak show was the forerunner of today's talk radio.

Speaking of which: we've posted on our website an essay by the media scholar Henry Giroux. ["Living in a Culture of Cruelty: Democracy as Spectacle"] He describes the growing domination of hate radio as one of the crucial elements in a "culture of cruelty" increasingly marked by overt racism, hostility and disdain for others, coupled with a simmering threat of mob violence toward any political figure who believes health care reform is the most vital of safety nets, especially now that the central issue of life and politics is no longer about working to get ahead, but struggling simply to survive.

So here we are, wallowing in our dysfunction. Governed — if you listen to the rabble rousers — by a black nationalist from Kenya smuggled into the United States to kill Sarah Palin's baby. And yes, I could almost buy their belief that Saddam Hussein had weapons of mass destruction, only I think he shipped them to Washington, where they've been recycled as lobbyists and trained in the alchemy of money laundering, which turns an old-fashioned bribe into a First Amendment right.

Only in a fantasy capital like Washington could Sunday morning talk shows become the high church of conventional wisdom, with partisan shills treated as holy men whose gospel of prosperity always seems to boil down to lower taxes for the rich.

Poor Obama. He came to town preaching the religion of nice. But every time he bows politely, the harder the Republicans kick him.

No one's ever conquered Washington politics by constantly saying "pretty please" to the guys trying to cut your throat.

Let's get on with it, Mr. President. We're up the proverbial creek with spaghetti as our paddle. This health care thing could have been the crossing of the Delaware, the turning point in the next American Revolution — the moment we put the mercenaries to rout, as General Washington did the Hessians at Trenton. We could have stamped our victory "Made in the USA." We could have said to the world, "Look what we did!" And we could have turned to each other and said, "Thank you."

As it is, we're about to get health care reform that measures human beings only in corporate terms of a cost-benefit analysis. I mean this is topsy-turvy — we should be treating health as a condition, not a commodity.

As we speak, Pfizer, the world's largest drug maker, has been fined a record $2.3 billion dollars as a civil and criminal — yes, that's criminal, as in fraud — penalty for promoting prescription drugs with the subtlety of the Russian mafia. It's the fourth time in a decade Pfizer's been called on the carpet. And these are the people into whose tender mercies Congress and the White House would deliver us?

Come on, Mr. President. Show us America is more than a circus or a market. Remind us of our greatness as a democracy. When you speak to Congress next week, just come out and say it. We thought we heard you say during the campaign last year that you want a government run insurance plan alongside private insurance — mostly premium-based, with subsidies for low-and-moderate income people. Open to all individuals and employees who want to join and with everyone free to choose the doctors we want. We thought you said Uncle Sam would sign on as our tough, cost-minded negotiator standing up to the cartel of drug and insurance companies and Wall Street investors whose only interest is a company's share price and profits.

Here's a suggestion, Mr. President: ask Josh Marshall to draft your speech. Josh is the founder of the website talkingpointsmemo.com. He's a journalist and historian, not a politician. He doesn't split things down the middle and call it a victory for the masses. He's offered the simplest and most accurate description yet of a public insurance plan — one that essentially asks people: would you like the option — the voluntary option — of buying into Medicare before you're 65? Check it out, Mr. President.

This health care thing is make or break for your leadership, but for us, it's life and death. No more Mr. Nice Guy, Mr. President. We need a fighter.

That's it for the Journal. I'm Bill Moyers. See you next time.

Expect Less from Local School Superintendents

Reginald Dogan comes down hard today on Malcolm Thomas and Tim Wyrosdick:

As superintendents of schools in Escambia and Santa Rosa counties respectively, they should lead by example, not by their conservative Republican political partisanship.They shouldn't allow parental pressure or party politics to prevent students from hearing President Obama's national address on Tuesday to school children across the nation.
* * *
Unrealistic skepticism and unfounded fear separated from reason is paranoia. It undermines the rational foundations upon which democratic self-government depends.

We expect more reason and less hysteria from our school leaders.

No, actually, we don't expect more rationality. Or, at least we shouldn't. Remember, under the demented Florida "local option" system, school districts are organized by counties; and each county has the option of requiring its school superintendent to be popularly elected, rather than appointed.

Truly, the lunatics run the asylum around here; or, more precisely, the stupid elect the schoolmasters. All three counties in this poorly-educated corner of Northwest Florida elect the school superintendents. And it shows. Overall, Florida panhandle schools are nearly the worst of the worst.

To be sure, there are isolated bright spots here and there. The best schools are at Pensacola Beach Elementary (a nonsectarian charter school) and all Gulf Breeze schools. (It's probably no accident that the best schools around here also happen to be the farthest from the school district superintendent offices).

Overall, however, Escambia, Santa Rosa, and Okaloosa county schools rank among the worst in the state -- and Florida is a state which ranks "48th nationally in student scores on the college-prep ACT test," as today's PNJ editorial page points out while taking a more oblique swipe at the craven Thomas and Wyrosdick.

Electing school superintendents is a guaranteed formula for rotten schools. It ensures they will be run by pusillanimous pandering pols who always will have their own political fortunes uppermost in mind, not the education of their students.

Accountability Art

When politicians like Alberto Gonzalez openly trample the rule of law by enabling the torture of our adversaries, and then pundits like David Broder try to cover up their crimes by trying to excuse them from answering questions under oath -- and brazenly lie about it, too -- sometimes the only instrument of accountability left in the hands of the people is the power to humiliate them for all time through an enduring artistic work. Call it accountability art:

(Libretto for your local productions now available free! CLICK HERE)

Tickets for the Philadelphia performance on sale now.

The Education of Right-Wing Talk Show Hosts

So many prominent right-wing media names are encouraging students not to go to school Tuesday, that we got to wondering about their own educational levels. How much do these guys know about schools or education?

It didn't take long to run that down. And, guess what?

• Rush Limbaugh turns out to be a college drop-out from a fourth-rate college in the Missouri boot heel. (We know it was "fourth-rate" because a former high school coach of ours was hired to coach that college's football team, and that was his verdict.) Limbaugh's own mother says he "flunked everything" including "dance."
  
• The twice-divorced, mentally unstable Glenn Beck took exactly one college course in his life -- in theology, no less -- and dropped it, then quit school.
• Sean Hannity dropped out of two colleges, and never graduated anywhere.
  
• Matt Drudge, the news aggregator, "graduated 341st out of a class of 355 from Norwood [Maryland] High School" in 1984. He then underwent psychiatric treatment and held a number of retail clerk jobs before the national news media began using him as their assignment editor.

Now, we'll be the first to admit that a college degree isn't a guarantee of anything. Lots of people squeak through high school and college but remain stupid. George W. Bush, for instance.

On the other hand, most parents want their kids to "work hard, stay in school" do their homework, and get the best education possible. Why? Because they know that education opens up a wider world of ideas and the opportunity, if not the certainty, to become well informed, better skilled, and more content with life.

So, why would any rational parent take advice about whether to send their kid to school on Tuesday from such a motley collection of drop-outs, dunces, and psych cases? They wouldn't, unless "something is going very wrong in the heads of a substantial number of Americans."

Dept. of Amplification
9-4 pm

MSNBC:

John Harwood: [I]f you believe that it's somehow unhealthy for kids for the president to say "work hard and stay in school," you're stupid!

Monica Novotny: (laughter)

Harwood: I'm worried for some of those kids of those parents who are upset. I'm not sure those parents are smart enough to raise those kids.

Homework Hazard

"Just when you thought August recess couldn't get any wackier, conservative talk show hosts have stirred up a hornets' nest over President Obama's planned speech to the nation's schoolchildren next Tuesday. Obama plans to tout the value of education, encouraging kids to work hard and stay in school.

But now, after working themselves up into a frenzy over death panels and Nazi symbols, conservative critics are inspiring a new wave of madness, calling the speech a political recruiting tool and partisan propaganda. Florida Republican Chairman Jim Greer took an incredible leap of logic, saying that Obama intends to 'indoctrinate America's children to his socialist agenda.'"

-- Katie Connolly, Newsweek Magazine

"This is no small, isolated fit, thrown by random nutjobs. The New York Times, Washington Post, LA Times, AP, and others all ran stories this morning about the coordinated national effort to either keep children at home so they can't hear their president's pro-education message, or demanding that local schools block the message altogether."

-- Steve Benen, Washington Monthly

It figures the nut jobs in Pensacola ["Schools Skipping Obama's Message"] are against "encouraging kids to work hard and stay in school." An educated electorate in Northwest Florida that does its homework is the last thing they want.

Health Alert

Who knew too much Florida sun makes you a lunatic?

Modern Memoirs

Might it be a warning sign about the decline of our civilization that a major magazine publishes, and millions will read, an autobiographical memoir by a 19-year old high school dropout whose one claim to fame is that he fathered an illegitimate child by an equally uneducated, aimless girl whose singular contribution to the world is that unfortunate child? Gail Collins:

It’s hard to totally resist an article that has sentences that start with: “In early August, before I went hunting and Sarah was picked, Bristol and I were at a tattoo parlor in Wasilla. ...” Or information like the fact that baby Tripp’s middle name is Easton in honor of “my favorite hockey-equipment company.”

Money Honey Moron

Would you take investment advice from this idiot?

Dept. of Amplification

The other side of Maria Moon-beam:

I'm very much inclined to support the underlying assumptions of Bartiromo's argument. Perhaps policymakers should simply make Medicare available as an option to anyone who wants to be part of it. We can call it the Bartiromo Plan.

Formerly, we had proposed it as the "napkin plan." But we're not proud. Bartiromo Plan? Okay by us.

What is Bill Nelson's "Lever"?

Florida senator Bill Nelson, who courts the reputation of being a blue dog, told the Lakeland Register the other day that "Health care reform will pass Congress this year, but without many of the provisions in the House bill and without a public option."

Strictly speaking, Nelson's comment reads like a prediction, not a prescription. Still, what he said sounds a lot like predicting "the surgery will be successful, but the patient will die." And that may be the reality, particularly if Nelson and his fellow blue dogs desert their constituents to vote in favor of the insurance industry lobby.

Don't mistake it: There can be no realistic "health care reform" without a public option, or a government-run alternative to private health insurance. Doubt it? Read the detailed study by the Commonwealth Fund (click on "Issue Brief").

From the perspectives of efficiency and equity, the advantages of group insurance such as large-employer-based coverage, Medicare, Medicaid, and CHIP are considerable. There are economies of scale inherent in selling plans to sizeable groups as opposed to individuals.

In addition, employer coverage forms a natural risk pool: people of all ages and health status enroll when they take a job rather than when they are sick, thereby reducing the potential for adverse selection and the associated costs of underwriting. The lack of underwriting in the large-employer-group market also ensures that workers are not excluded from coverage, or charged different premiums, on the basis of health status or age. Premiums in the group markets are more in line with actual medical expenditures than are those in the individual market.

Indeed, while it has largely been the sole option for people who lose employer-based coverage and do not qualify for Medicaid, the individual market has in fact provided coverage to less than 10 percent of the under-65 population, even as employer coverage has declined in recent years. The Commonwealth Fund Biennial Health Insurance Survey found that of people who ever thought about purchasing a plan on the individual insurance market during 2005–2007, a majority never wound up with a plan. They either could not find a plan that met their needs, could not afford the plan, or were turned down or charged a higher price because of a preexisting condition.

As the Commonwealth Fund analysis shows, and everyone who knows anything about health care reform privately acknowledges, a public option is the key to substantial savings in health care delivery as well as health insurance reform. As Real Clear Politics points out:

The public option is designed to control health care costs -- essential to the profitability of American business and workers' raises. It would compel private insurers to spend more premium dollars on actually delivering health care. (And private competitors would force the public option to keep up on benefits.)

Last week, economist Simon Johnson offered an intriguing thought experiment. Imagine, he said, a health reform bill without a public option -- exactly the kind of health reform bill Senator Nelson is predicting:

Insurers have to charge the same price regardless of customers' medical history; everyone has to buy insurance; and poor people get subsidies to help them afford it. From the insurers' perspective, they get more than 40 million new customers, they subsidize the old and sick by overcharging the young and healthy (who have to overpay because of the mandate), and the government even pays people to buy their product. There are no new competitors (additional choices for customers), and there is no pressure to reduce costs.

Such an outcome is entirely unsustainable, as Johnson makes clear. It could be "only a temporary solution because rising costs would force the government to go back to the drawing board (to pay both for Medicare/Medicaid and for those subsidies)."

Johnson ends his thought experiment with a trenchant question, one that should be asked of every blue dog Democrat: If there is an alternative to the public option, he points out, "It has to be some other lever to force private insurers to reduce costs. Saying that people can get all the care they want and private insurers will simply pass on the costs as higher premiums is not a solution."

So, Senator Nelson, what is the "other lever" you have in mind "to force private insurers to reduce costs?" Without a credible answer to that question, Nelson and his fellow blue dogs have no business voting against the public option.