NP: Incubus, Make Yourself

I've seen several headlines and blog post subject lines -- which seem like they should be the same thing, but I'm not sure that they are -- opining about Jay Rockefeller pouring cold water on this effort to revive the public option now that the Democrats seem committed to passing health care reform through reconciliation. Predictably, I'm seeing a lot of wringing of hands and gnashing of teeth on the left about how this is the best chance for the Democrats to get something at least close to what they really wanted all along.

Last night, I watched Howard Dean on Olbermann, and his comment about it was that the best way to pass a public option through reconciliation would be via an expansion of Medicare. My question is, if the current reform package can make it through as it stands right now -- which, admittedly, is still an open question -- what's to stop an effort to expand Medicare down the road?

The obvious answer, of course, is the midterms, but while everyone seems to assume the Democrats will lose Senate seats in the fall, it's a lot less likely that they'll lose the chamber altogether. Plus, if they hold more of their seats than they expect -- a possibility if jobs start coming back by early summer -- they can spin that as a mandate to continue the work they've started.

This comes down to a fundamental difference in strategy between camps on the left. On the one hand, you've got those who think that, if we don't do it now, we may not ever have the chance for a public option. On the other hand, you've got the more pragmatic view that, if we don't do it now, we may not ever have another chance for any health care reform at all, and including the public option increases the likelihood of nothing getting done now by a number bigger than zero, so it's not worth the risk.

Which, in turn, is why 23 signatures from members of the Democratic caucus supporting the public option via reconciliation strikes me as largely irrelevant, because until you have 50 signatures, the uncertainty simply is more than I think the White House will tolerate. And I'm not a policy expert by any means, but, again, I don't see why you couldn't do something like drop the minimum age for Medicare after the fact.