Why I Want a Public Option in the Health Care Bill

Rep. Steny Hoyer is now backing away from the public option, according to The Politico. While surprising at first glance, this is a very shrewd political move.

A bill with a public option will probably not pass. Too much opposition. But one without it probably will. Conceding on the public option allows people who support more government involvement in health care to still get much of what they want.

They can always try for a public option later. People will always be dissatisfied with their health care. There will always be calls for reform. Politicians can always win votes by being seen doing something about it.

The main reason the public option has become such a lightning rod probably isn’t ideological. It’s just too big of a change for people to be comfortable with it. Institutions are sticky. Dislodging them with sudden, major changes always creates backlash. Inertia always wins.

But slow, persistent nudges can get the job done without backlash. That’s why even people who want nationalized health care are not calling for it in 2009. They thought the public option would be a small enough step in that direction for the change to stick.

They guessed wrong. That’s why smart tacticians like Rep. Hoyer are backing off. But they’re still going to offer a bill to increase the public sector’s health care presence, if by not as much as originally hoped. Baby steps. Give the electorate a little time to digest the change. Then take the next step.

That’s why I would like Rep. Hoyer and the rest of the leadership team to keep the public option. It very likely dooms their bill to failure. Government is far too involved in health care as it is.