There are no two ways about it. What Speaker Nancy Pelosi's doing in the House of Representatives is a big play, and very, very bold--indicative of her confidence in both the wisdom of the public option as a political and policy tool, and
in her ability to get results out of her 256 member caucus, despite the wide ideological chasm between its most liberal and most conservative members.
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Pelosi's pulling out all the stops to pass a health care reform bill with a public option that pays providers at rates slightly higher than Medicare--even if it means she has to squeak a bill out of the House with the barest majority. Since the beginning of the push to pass reform, the public option has been at the center of the fight, pitting Republicans, moderates, and major industry stakeholders against an extremely determined majority of Democrats, progressive interest groups, and the public at large. It has been an epic tug of war, and at times, the pro-public option side seemed on the verge of being yanked into the mud.
But in recent weeks, as the health insurance industry further disgraced itself by rolling out the big anti-reform guns, and liberal leaders in both the House and Senate made it clear that they view the public option as an essential component of reform--one that serves voters' interests, and saves money--even if the White House isn't willing to put its full weight behind the measure.
It's in that context that Pelosi is running thiis public option endgame.