A Senate staffer passes out paperwork prior to a health care news conference. (AP Photo/Harry Hamburg)
No provision of the health-care reforms being debated in Congress is as likely to generate a popular backlash as is the individual mandate -- the requirement that individuals purchase health insurance if they are not otherwise covered. But there is an alternative to the mandate as it is currently structured that can accomplish the same purpose without raising as much opposition.
The continuing rise in the unemployment rate, up to 10.2 percent in November, has to give a sense of urgency to Democrats in Congress and the administration about the work they have at hand before next fall's elections. In 2010 Republicans are looking to repeat the success they had in 1994 after Bill Clinton's first two years, and if Democrats do not produce results soon, Barack Obama may suffer the same kind of midterm reversal as Clinton did.
Senate Finance Committee Chairman Sen. Max Baucus. (AP Photo/Pablo Martinez Monsivais)
As the debate over health reform enters its decisive stage, there is a lot of talk about the need for compromise between Democrats and Republicans. That was a sensible point to make in years past when Republicans offered alternatives for reform to compete with Democratic proposals. But this year there are two problems with the idea of bipartisan compromise. The first is that Republicans in Congress have not even made a pretense of offering constructive alternatives. The second is that the Democratic proposals are built around the ideas that Republicans used to favor -- those proposals already are bipartisan compromises. Unfortunately, they are compromises with a Republican Party that no longer exists.
President Obama's speech to Congress on health care Wednesday evening succeeded at several levels. Beforehand, observers said that he needed to explain to a confused public what he is proposing and why it makes sense, and the speech did that. Analysts also said that the president needed to shift the momentum from August, to confront the ugly distortions of the opposition, and to mobilize support in his own party. In those respects as well, the speech did all that might have been expected of it.
A supporter of health-care reform leans on her sign during a rally in Belgrade, Montana. (AP Photo/Mike Albans)
Contrary to some overwrought reactions on the left, if a public insurance option fails to make it into this year's health-care legislation, it does not spell the end of worthwhile reform.
The president and Secretary of Health and Human Services Kathleen Sebelius have been entirely correct in saying that the public option is only a small part of the reform effort. The general framework for health insurance that Democrats are advocating does not depend upon a public option. And if a public plan is enacted, it may be so compromised that it could backfire on reformers and become a high-cost alternative rather than the cheaper option that progressives are hoping for.