According to "progressives", Republicans must completely block all "healthcare reform" if you don't want to see a government takeover.

How should one view a politician who says or does one thing, to mislead the public, but privately knows it will lead to the opposite? In short, what does it mean when you have to deceive people to enact your desired policies? Isn't "democracy" supposed to be about representing the people, rather than manipulating them?

Via Dr. Reynolds, and the Prospect front page: a pair of articles written by and for "progressives" which outline the game plan:

"Chill out, progressives. To get health-care reform through the Senate, the public option is almost certainly going to have to be dropped."

1. According to Prospect's Adam Serwer, the point of the "progessive" movement is, essentially, to enact otherwise unacceptable left-leaning policies by stealth: "The point is that progressive policy initiatives often begin as narrowly as politically possible, but grow into being much more expansive and effective than their opponents ever wanted" — or, I might add, they grow into something even their run-of-the-mill Democrat supporters would have rejected up front. This is, again, good in their eyes.

2. So while claiming the purpose was to "increase competition", the real purpose of the "public option", Prospect's Paul Starr admits, was actually to enact stealth medical price controls:

The original idea for the public plan, however, called for it to drive down costs below those of private insurers by another means -- paying doctors and hospitals at Medicare rates, which run 20 percent to 30 percent less than what private insurers pay. Modified versions of that proposal call for the new public option to start out by paying providers at Medicare rates plus 10 percent.

The problem is that price controls simply don't work: because they can't really change the underlying cost of something (which is what insurers are essentially paying) price controls produce (often simultaneously) shortages and gluts. (Look at rent control in New York, for example: a shortage of available rental housing, yet blocks and blocks of empty apartment buildings. Or plummeting physician availability in Canada, while trained Canadian physicians leave the country or go into other professions.)

Note how one limit is proposed up front (medicare PLUS 10 percent) with unspoken plans to change it to something far different later. Again, this is kind of chicanery is good because the public would object if they knew.

3. Starr continues by noting (emphasis added) that instead of "more competition", a secondary point of the public option was to starve the insurance companies out of the market: "Either way, however, this proposal meets the united opposition not just of the insurers, but of the providers as well because it would result in a massive reduction in revenue for them."

4. However widespread opposition is "not a problem" because all they have to do is put in some kind of "reform", and then fundamentally change it later, under the guise of a "budget reconciliation", requiring less than the Constitutional 60% to pass new legislation:

[T]here is a tactical rationale for separating the public option from the rest of the legislation. The exchanges and other insurance-market reforms should be passed as ordinary legislation, which in the Senate requires 60 votes (because of what has now become the routine, unconscionable use of the filibuster). Shorn of the public option, the legislation is more likely to pass that hurdle.

But at some later time, the public option could be added as part of budget reconciliation, which would then require only 50 votes in the Senate. To be part of reconciliation, a proposal would have to show budgetary impact. And a public plan paying Medicare rates or Medicare rates plus 10 percent could pass that hurdle.

So my advice to progressives is to chill, at least on this matter.

Serwer agrees:

.... progressive policy initiatives often begin as narrowly as politically possible, but grow into being much more expansive and effective than their opponents ever wanted. The same is going to be true of health-care reform, if it passes, and particularly if Democrats follow Mark Schmitt's advice and use the reconciliation process in subsequent years to ensure inclusion of some of the more controversial elements of the plan. But none of this can happen if nothing passes -- and make no mistake, Republicans aren't trying to kill end of life counseling. They're not trying to kill the public plan. They're trying to kill reform itself, because they know that even if reform falls far short of liberal expectations today, someday it won't.

(Gee, I thought Republicans were just wrongly "scaring people" about a slippery slope.)

5. So, instead, they'll pass something like a bill creating "health care exchanges" (boy, doesn't that sound free-market-y? who's going to be be against "exchanges"?) or some other set of "reforms", and use that as a back door to the "public option", which, they noted above, is itself another back door to price controls and removing the insurers from the market: "The public option as ... is a separable proposal that could be enacted after the exchanges, insurance-market reforms, and subsidies are passed."

Cunning, eh? I certainly don't think this way, but the rationale is that that this is good because they certainly know better than others. Voters are, I suppose, too stupid to know what's good for them, so, hey, the end (government-controlled healthcare) certainly justifies the means (layer upon layer of deception).

Intrinsic dishonesty aside, the concern for readers should be that government control doesn't create, as the Prospect insists, a "a fairer and more efficient market" for anything. Especially that "efficient" part, and usually not "fairer" either: the perks still go to those with wealth (and our "rulers") while the baseline declines for the rest of us.

Update: If it's a "lie" that the "public option" is supposed to lead to socialized medicine, the people of Boulder sure haven't gotten the memo:

Now I realize this isn't the most exciting video in the world, but if you had any doubt about whether or not the public option is a trojan horse for socialized medicine, here's a video of a crowd in Boulder chanting, "What do we want? SINGLE PAYER. What will we settle for? PUBLIC OPTION." Obama's liberal supporters sure seem to think it's a step in that direction.

They're "in" on the, um, tactic, apparently.