There’s a lot of talk flying out there about what the president needs to say tomorrow night in order to appease the right, soothe the left, keep the Democratic majority safe and get re-elected in 2012. Frankly, not one of those things is a good goal for a presidential speech – the ONLY goal on which this speech should be focused is getting Congress to pass legislation that is badly needed by this country. But hey, what do I know?
 I’m just a working mom with a working brain and a conviction that politics is the enemy of getting things done. That being the case, and knowing that there’s no chance in hell that I’ll ever be in the position of a Van Jones, where my words can be used to force me out of a policy-influencing position, here’s what I wish the president would say tomorrow night.

Good evening. Welcome back to Washington. I hope you’re ready to work harder than you’ve ever worked, because this is not the time to repackage old, failed solutions with shiny new ribbons and pass it off as new work. The issues that are facing this country are not issues that can be fixed with half-assed solutions designed to line the pockets of big industry players while leaving the working people out in the cold.

Going into the August recess, I made it clear, as I have been doing since the earliest days of my campaign for the presidency, that reforming the system of health care delivery and access is of vital importance to this country. That has not changed, and it will not change. I made it clear from the start that while I believe a single payer system works fine for other countries, it is not the right solution for the United States.

I have repeatedly stated my goals for health care reform in this country. They are not that hard to understand, unless you happen to be a journalist looking for a way to stir up controversy. I have said that any health care reform bill must do four things:

  • It must provide access to quality health care, including preventive health care, for all people.
  • It must contain the costs of health insurance and health care – bend the cost curve.
  • It must provide health care security by eliminating discrimination for pre-existing conditions, removing cost-sharing for preventive care, limiting the use of annual and lifetime caps, reducing the amount of out-of-pocket expenses and abolishing the use of rescission to drop coverage on those that become sick.
  • It must be budget neutral.

I have said over and over again that I believe a public option is the best way to accomplish those goals, particularly the ones that provide competition for private health insurance companies and reign in the outrageously steep climb of health insurance premiums – but that I’m willing to listen to other ideas to accomplish that aim.

Well, I’ve been listening for eight months, and all I’ve heard are ideas that will enrich the insurance companies without providing any guarantees that the American people will get any benefit at all. These ideas – tort reform, deregulation, non-profit coops – have been tried and do not work – except for the corporations they are meant to protect. After eight months of listening for new ideas that might work, I’m more convinced than ever that the best way to force insurance companies to be competitive and provide good service is to offer a public option.

Now, let me be clear about what a public option is and what it is not.

A public option is a non-profit health insurance plan that will be managed by the federal government. It will be open to anyone who does not have access to health insurance through an employer or other group mechanism. It will be started with an initial infusion of taxpayer money to get it off the ground. That initial infusion will be repaid as any other loan or investment would be paid. Aside from that initial infusion, it will be forced to exist on the premiums it collects from those who buy the plans it offers.

The public option will not be mandatory for anyone. It will not be free. It will not provide health insurance for illegal aliens. It will be one of many plans offered through a health insurance exchange where any citizen of the United States who does not have access to affordable health care is guaranteed the ability to buy a health insurance plan.

With all of that said, the public option is only one part of effective health care delivery reform. There are many things that we all agree upon. The lack of a public option will not destroy reform – it will only make it far less effective. Without an efficient mechanism to force insurance companies to stop gouging the American public, a health care bill will still stop rescission, cap out of pocket expenses, do away with annual and lifetime caps on coverage and guarantee that you can renew your insurance even if you actually use it. It will, however, cost far more to do those things without a public option.

And that may be good enough for you, but it’s not good enough for me. The hard working people who voted you into office deserve at least as much consideration as the corporations that put money into your campaign war chests. I will not sign a bill that forces people to buy health insurance unless it also contains the most effective and efficient option to make sure that those health insurance costs are bearable. Unless I see something radically different than I’ve seen to date, that option is a government run public option.

If you can not in good conscience vote for a bill that includes that reform, you can return to your constituents and let them know that you were willing to throw them under the bus so that health insurance companies could keep paying their CEOs and vice presidents more money every year than most of them will ever see in their lives. If you don’t, I will make sure that they get that message loud and clear.

A lot of the political pundits out there have been calling on me to give you a plan and tell you to pass it. Writing the laws is not my job – it’s yours. It’s your job to pass legislation that is in the best interests of your constituents, and that’s what I expect you to do.

So welcome back to Washington. I hope you enjoyed some fishing and some ice cream and some family time. It’s time to get back to work, so get out there and do your job.


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