A fighter for real health reform loses with grace, grit, and compassion for all who languish outside the health care system.

Senator Jay Rockefeller (D-West Virginia) has long been one of my heroes. In 1994 I testified before a full hearing of the Senate Finance Committee, the same committee now marking up the bill to introduce health reform. Sen. Rockefeller is one of the few members who were on the committee in ’94 and are still on it now.
It was a hearing on “end-of-life issues,” ostensibly from a financial viewpoint but actually much more.

In my testimony I talked about my mother’s death, and then in the question period Sen. Rockefeller talked movingly about his mother’s death. While she was dying, he and his family were confused and surprised that no one talked to them about what was going on. He must have been thinking, as I was, if a U.S. senator named Rockefeller can’t get the system to respond to him, who can?

But, like Ted Kennedy before him, he is a son of privilege who cares deeply for those who have none. And that is why he introduced and defended an amendment to the current bill that would give Americans of all ages the option—just the option—to buy health insurance resembling the insurance he himself gets from the government, and to do that at an affordable price. This would put pressure on insurance companies to keep their prices low, the only realistic way to control health care costs.

In his opening statement, he not only used but highlighted the word “rapacious” to describe health insurance companies. He quoted the testimony of Wendell Potter, a former top 20-year Cigna executive for, to a House committee. Potter said that if Congress should fail to provide a public insurance option to compete with the private insurers, the bill to be sent to the president should be called “The Insurance Industry Profit Protection and Enhancement Act.”

Under this bill, Sen. Rockefeller noted, “nearly half a trillion dollars of subsidies would go directly into the pockets of insurance companies.”

President Obama has already indicated clearly his intention to sign such a bill. He talked about the public option and said he preferred it, but he did not fight for it, and he won’t fight for it now. Will the bill he eventually signs be better than nothing? Maybe. Will it be a huge new boon for private insurance companies? No doubt. Will it be affordable to the American people in the long run without a tax increase? No way.

Senator Rockefeller went on to talk about the “nine million” people who are turned down for care by insurers who “incent” their employees to deny care. “They’re getting away with banditry, and they revel in it.” He defended the public option as the only way to introduce competition in a marketplace where in most states one or two insurance companies completely control the market; for this reason he thought that Adam Smith would like it. “I don’t understand why we wouldn’t want to do this.”

And he went on to say, “The people that I represent need this. They need this, because they’re helpless in front of the insurance companies . . . They can’t even analyze what they’re having to pay . . . I don’t want to see people treated like that by this bill, where more than half the cost of the bill goes to subsidizing private insurance.”

Sen. Charles Schumer of New York and others pointed out that the same Republican and conservative Democrat senators who reject the public option accept its equivalent, Medicare—for people over 65. Sen. Chuck Grassley (R-Iowa) intoned, “Medicare is part of the social fabric of America,” implying that it is untouchable, which it is, and that opposing it is un-American.

Senator Grassley, how did Medicare become part of the social fabric of America? It didn’t exist when I started college, and it was opposed bitterly by Republicans, by the American Medical Association, and of course by insurance companies. It passed before I graduated, and soon they all got used to it. Now it’s a part of the social fabric.

In his impassioned closing statement, Sen. Rockefeller acknowledged, “The public option was dead, it was a non-starter. We just finished close to five hours of discussion . . . I don’t buy it when someone says, I have to have a health care bill in front of me . . . What is wrong with giving people a choice? . . . This is about people. And you’ve got to see people in your mind when you push the button that does your vote. You’ve got to see people in your mind. Insurance companies can take care of themselves, they always have, they always will . . .

“I’m just telling you this,” Sen. Rockefeller concluded, gently pounding the table with his fist, “the public option is on the march.” Polls show that 65 percent of Americans support that option. “It’s a very serious decision. It’s a moral decision, it’s an ethical decision, it’s a human decision, it’s a health care decision. It’s writ large in our legacies. I urge my colleagues to support the amendment.”

When they did push their buttons, the amendment was crushed, 15 to 8. If, as is likely, the bill passes on the Senate floor, it will be passed with minor changes by the House, and will be signed by the president. It will indeed be a huge boon to insurance company profits, by pouring taxpayer money into their coffers to cover large numbers of the uninsured.

Covering those people is the right thing to do, but doing it this way incurs great new financial burdens that the country at this moment can ill afford. The notion that cost savings will magically fund all those added public expenses is fanciful. How long will Americans tolerate more charitable expenses that they have no visible way to meet? The public option would have funded this new mandate, but for now the public option is dead.