Jacob Hacker looks at the dystopia that would be created in the event that healthcare legislation passes without a public health insurance option, strong employer responsibility, and regulations that ensure that health care under an individual mandate is in fact affordable.  If anyone is wondering about why a public option and strong measures to ensure affordability are important, Hacker makes the case quite clearly. The only thing missing from Hacker’s dystopia is the consequences working Americans would face if their healthcare benefits were taxed.

In my view, Hacker’s piece is important because it shows the interconnectivity of the different components of a reform bill. A public option is critical in its impact to affordability and competition.  National scope does the same. Regulation of what sort of coverage private plans will provide ensures that there will be real improvements between the care people get today and where they are three or four years from now.

We can’t get the results we need if bipartisanship is more important than reform. That path leads us to one where we chip away at the needed provisions — or surrender things like the public plan in full — in order to get a few Republican Senators. It just doesn’t work. Senate Democrats and the White House will have to recognize this before any concessions get so far afield from what’s needed that the legislation misses its mark and Hacker’s national healthcare dystopia is realized.