Prof pushes public option

When the leading democratic candidates in the 2008 presidential race adopted Stanley B. Resor Professor of Political Science Jacob S. Hacker’s GRD ’00 proposal for a government-sponsored health care program, the idea gained national prominence. Nearly two years later, President Barack Obama and many congressional Democrats are currently promoting a version of the proposal.

Q: What kinds of structural support or special resources does Yale provide you with to do your public and scholastic work?

A: Yale offers great support for its faculty, but it could expand the support it offers for faculty members who want to do public policy work. I’m working on creating a policy center that would allow professors to bring their work to public office, and also include an undergraduate teaching component. That’s currently being discussed, and Yale is willing to support it, even in this economic climate. I’ve always felt that the [undergraduates] at Yale are very engaged in public policy, and many want to work in Washington for non-profits or think tanks. But Yale doesn’t offer enough of a chance to do that. If there’s a story in this saga of the public option that’s more specific to Yale, it’s that Yale has a lot of people who do similar work to what I’m doing. But I think we could have a stronger commitment going forward for a policy center — one that’s building on the hunger of undergraduates, where policy teaching is rigorous and unbaised that lets the undergraduates apply their technical learning to concrete problems.

Q: Can you describe the research that led up to the writing of your “Health Care for America” proposal?

A: In 2001, I published “Medicare Plus.” That proposal argued for something that looked relatively similar to what was embraced by the candidates in the recent presidential campaign. In 2006 the Economic Policy Institute asked me to prepare a revised version of the proposal, which I renamed “Health Care for America.” The newer proposal more explicitly stated that there would be a public insurance plan competing with private plans, thus creating more creative tension between the competition. That proposal came out in January of 2007, just around the same time that the Democratic candidates were beginning to explore this issue within their campaigns. I had contact with the Edwards, Clinton and Obama campaigns, all of which eventually embraced a proposal that was relatively similar to the one I put out. Thus, the public plan was born as a major element of the Democratic candidates’ proposals. After the election, I turned from focusing on the presidential candidates to working with members of Congress.

Q: Why has the public option, especially, been so vilified by conservatives?

A: It’s threatening to conservatives because it says that our government has a positive role to play and it actually could be an effective counterweight to private insurance. The estimates that have been done by the congressional budget office don’t suggest that this is going to be a massive government takeover. And one thing that I’ve been trying to tell everyone is that this debate will not be over with, even if we get major landmark health reform legislation. There’s so much unfinished business in these reform bills. The fact is that it has become a symbol on both the left and the right. As such, it has taken on an importance that’s greater than its intrinsic value in the reform bills.

Q: Do you think that if President Obama had been more forceful in his support for the public option over the summer, critics would be less vociferous and the inclusion of public option would be more assured?

A: I’m hopeful in the next few weeks that the president will insert himself a bit more centrally into the legislative and political process. I actually think the hands-off strategy the administration has pursued in the public sphere has made Congress step up and take a hands-on approach; the real pressure on health insurance plan has come from members of Congress. President Obama has rightly not taken the lead in designing every aspect of the legislation. But now, we’re at a critical phase where the President should step in and be stronger in supporting not just the public health insurance plan, but also making sure that the coverage is going to be affordable after reform. What worries me is that there could be a political backlash against the legislation if people have to buy coverage and there isn’t a strong guarantee that it’s going to be affordable. The president’s power to persuade the public is not unlimited, but it’s substantial. In the coming days, it is absolutely critical that Obama totally takes the lead in a conference committee if and when both houses of Congress passes reform legislation. And if he does those things, I think he has a much better chance of getting a bill that’s true to the principles that he articulated during the campaign, during the early part of this year and most recently in his speech before Congress.

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