Or at least she does a pretty good job of conceding what every dyed-in-the-wool single payer activist who is unable to get behind a campaign for the public health insurance option would want her to concede. Naturally, sarcasm explodes the single payer assumptions and what’s left is clear: the public option is our last, best option for reform that keeps government involved in providing care on a non-profit basis.
The simple fact is that at this point in time the energy of the single payer community could help ensure that Congress passes legislation that includes a public health insurance option. Is it a bitter pill for single payer advocates to swallow? Sure it is, but it’s one driven by political reality to the extent that this community can still take action to determine the outcome of healthcare reform in 2009.
It’s hard for me to imagine that the single payer community would sit out any legislative fight that isn’t for a single payer solution. Imagine if the anti-war community who filled the streets in 2002 and early 2003 had, after Bush sent troops to Iraq, stopped advocating in support of legislation that would put a strict timeline for troop withdrawals as a requirement for interim funding (the positions of Ned Lamont in 2006 and the Feingold-Dodd language of spring 2007 come to mind). It is simply would have been absurd to presume that anti-war activists would not support anything short of instantaneous withdrawal, but that is the situation we are in now as single payer advocates threaten to walk away from progressive efforts to pass a public option.
Politics must take place in the world we are in and not the world we wish we were in. That is not to say that you should be “realistic” in the sense that most Beltway pundits and Conventional Wisdom worshippers take it. It is possible to change how the political community thinks about discourse and policy norms (again, see Ned Lamont in 2006 as a perfect example). Change that can be achieved requires organizing, persuasion, and support; in fact, the work done by Jane Hamsher and Chris Bowers, among others, to hold the line on the public option is a definitive of example of how we can change the political reality to conform to the better world we wish to achieve. The extent to which single payer activists grasp this and choose to take part in the outcome of the public option will likely be determinative of the effort’s success.