I may not be competent to weigh the importance of the various wonkish details of the health care reform package being debated in the Senate, but I'm pretty comfortable talking about this.
Ezra believes that if the votes aren't there for a decent public option then the horse trading should be around getting something good in return for giving up the public option rather than negotiating the terms of the public option. That would make sense if the public option were just another feature of the health care bill. But it is not. It is the central demand of the liberal base of the Democratic Party in this rube goldberg health care plan and has long since gone way beyond a policy to become a symbol.
Perhaps that is wrong on policy grounds. People will argue about that forever. But that doesn't change the fact that it is no longer a matter of policy but rather a matter of political power. And to that extent it cannot be "bargained away" for something like better subsidies, even if it made sense. "Bargaining away" the Public Option is also the bargaining away of liberal influence and strength.
Indeed, since the political establishment and the media have been declaring it dead for the past six months, the fact that it is still in the bill is a testament to liberal strength. And that is why Republicans and corporate centrists are so desperate to destroy anything that's called a "Public Option" no matter how many compromises are made to accomodate them. And it's why the liberals are so adamant about keeping it alive.
Again, as a matter of policy I don't know that the public option actually means much anymore. But as a matter of politics, it's very important. Powerful people, from outside and inside the Party are desperate that the liberals are not seen to win this battle. It changes the balance of power in ways that extend far beyond the health care debate and they know it.
Update: Bowers talks about the necessity of passing a final bill here, and a commenter uses this post to refute it. I don't actually think it does.
The "Public Option" is a symbol of liberal power, and losing it will be a serious loss. However, expecting that Democrats would vote against a final health care bill because it didn't have one was always dicey in my view. If, in the end this bill doesn't have a public option, I have little doubt that most pols are going to make a very serious gut check, as Bowers does, and ask themselves whether or not the public loss of this liberal power is worth tanking health care reform over. I don't know how that will come out.
What's really kept this symbol of liberal power alive is public opinion, in my view, rather than an institutional belief in the serious intention among progressives to tank the bill. It's the people who have the liberals' back on this one and that actually scares politicians. They aren't scared that liberal pols are going to vote against health care reform. They're scared of voters.