Is President Obama's Position on Public Plan Really "Unclear"?

MSNBC reports that President Obama's position on having a "public plan" option compete with private insurance remains unclear two days before his speech on healthcare reform. White House political advisor David Axelrod addressed the issue during an interview with the Associated Press (reported by MSNBC):

The president "believes it should be in the plan, and he expects to be in the plan, and that's our position," Axelrod told The Associated Press.

Asked if that means a public plan has to be in the bill for Obama to sign it, Axelrod responded: "I'm not going to deal in hypotheticals. ... He believes it's important."

The president "believes the public option is a good tool," said Axelrod. "It shouldn't define the whole health care debate, however."

White House Press Secretary Robert Gibbs also recently addressed the issue:

[]Gibbs . . . said the president believes a government plan would be "a valuable tool." But Gibbs danced around the question of whether it has to be in the final legislation.

Asked if Obama would sign legislation that lacked a government plan, Gibbs responded: "We're not going to prejudge what the process will be when we sign a bill, which the president expects to do this year."

Asked if Obama would say in his speech that he'd veto a bill without a government plan, Gibbs responded: "Well, I doubt that we're going to get into heavy veto threats on Wednesday."

I am not sure that this position is ambiguous. I think Axelrod and Gibbs are saying that Obama will "support" a public plan option, but that he will sacrifice it in order to pass other components of the legislation.

What Voters Need to Hear About a Public Plan
Voters need an honest discussion of the public plan -- not sensational discourse about socialized medicine and death panels. They need to know how the public plan relates to overall reform objectives (cost savings, expanding access to medicine, etc.). They also need to consider whether and how it will impact the delivery of medicine and whether these changes, if any, are good or bad for patients.

Voters also need to hear realistic opinions regarding the cost of the public option. Although the government certainly would have to fund it initially, the White House says that the plan would become self-sustaining due to premiums paid by policyholders. Republicans actually buttress this assertion when they argue that private insurers cannot compete with a public plan. If the public plan attracts millions of insured individuals from private insurance, then there is a greater chance that premium payments can sustain it.

If the public option does not win support, voters needs to consider whether other aspects of healthcare reform should advance without it. I wonder, for example, whether it is wise or fair to mandate coverage without a viable alternative that reduces the overall cost of health insurance.

What Voters Need to Hear About the Status Quo
If voters are truly worried about fiscal policy, they need to consider the budgetary impact of the status quo. Federal and state governments heavily subsidize "private" employer-sponsored health plans by not treating the benefits to employees as income and allowing employers to deduct contributions as business expenses.

The subsidization of employer health plans, which is the largest of all federal "tax expenditures," substantially reduces tax revenue collected by federal and state governments. The "tax break" is also regressive because a greater percentage of higher income earners have employer-sponsored health plans than low-income workers.

Presently, universal, public plans are available for the elderly (Medicare), the extremely poor (Medicaid), and children in certain households (SCHIP). The government also substantially funds healthcare for workers -- largely those in big companies. I would love to hear a justification for covering or assisting these groups but denying coverage for the 47 million uninsured Americans, who include millions of workers and their children.