There are two shopworn excuses for excuding a public option as part of health care reform: (1) It is a subterfuge designed to pave the way for single-payer insurance — a prime example of that dreaded bugbear, socialism. Yet when Representative Anthony Weiner (D-NY 9th District) made his brilliant “end run” around his GOP confreres by offering the House a bill that would jettison Medicare — single-payer-socialism-in- action-Medicare — the bill was defeated unanimously. Even GOP representatives know that Medicare is extremely popular among retired Americans. (2) A public option is simply too expensive. Where were some of these senators when massive tax cuts were passed for the wealthiest Americans at George Bush’s instigation? How about funding for a trumped-up war in Iraq? Or, closer to home, how do they explain all the costly earmark (pork)legislation that has been passed recently? President Obama has repeatedly “done the math” for those who are listening to him. We cannot afford NOT to have a public option. Each day, as more jobs are lost, so are the health care benefits subsidized by employers. some employers must choose between subsidizing employee health insurance or giving them pay raises. Still others find that they simply cannot afford to pay the rapidly escalating cost of insurance premiums and drop their coverage. Each time someone drops his/her coverage, the cost increases for those still in the system. Where and when does this spiral cease? It is not difficult to imagine the US economy collapsing completely under the burden of health care costs.

There are also tacit reasons for ditching a public option: Some members of Congress fear constituent backlash although two senators, Nelson of Florida and Carper of Delaware represent states that went for Obama in 2008. One (Lincoln) is up for re-election in 2010 and apparently faces stiff opposition in a very red state; her situation at least is understandable if not admirable. Others (Baucus, Conrad, Carper) may seek a reliable, substantial source of campaign funding. Since these three represent states whose total population is fewer than three million — a relatively paltry base for funding — they may find outside funding much more attractive than contributions from “small donors.” At least one of these, Baucus, is heavily funded by the insurance hegemony — nearly $1.4 million over the past five years. Are those who take substantial funding from corporations putting their own interests ahead of the welfare of their fellow Americans?

Even a hint of criticizing President Obama pains me, as I worked long and hard for his election — and I’m still in the trenches, doing all I can to encourage Congress to pass the truly meaningful health care reform for which he campaigned. Yet he needs to take a page from FDR’s playbook. Author Jonathan Alter (THE DEFINING MOMENT: FDR’S HUNDRED DAYS AND THE TRIUMPH OF HOPE) describes the First Inaugural Address. At one point, FDR “was acknowledging Congressional authority but putting the legislative branch on notice: Work closely with me or I’ll make you irrelevant.” President Obama needs to send a similar message to Congress, particularly to the Blue Dog Democrats, whose tenure on the Hill is tied closely to his in the White House.