Robert Reich
Robert Reich - 
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Kai Ryssdal: Behind the closed doors of the Senate Finance Committee today... beer. Actually, raising beer taxes. Another 15 cents a six-pack, if that's of particular interest to you. Congress is trying to find ways to pay for health care reform. Exactly what kind of reform we're going to get is still in the works. There's been a lot of talk about some kind of public-private partnership. But commentator Robert Reich wonders whether there's been too much talk.

ROBERT REICH: I understand politics is the art of compromise, but at the rate we're going with health care, politicians may be giving away the store.

Right now, private insurers spend big bucks marketing policies to healthier and younger people while avoiding sicker and older people, rejecting those with pre-existing conditions, and contesting many claims.

That's why many experts have long advocated a so-called "single-payer" system that would instead focus on helping sick people and preventing others from becoming sick. And use its vast bargaining power to negotiate lower prices from drug companies and hospitals.

On the campaign trail, Barack Obama pushed a reasonable compromise -- a universal health system that included a public insurance plan resembling Medicare, which members of the public could choose if they wanted. This optional public plan could at least negotiate low prices and pressure private insurers to better serve the public.

But the Senate is taking this Medicare-like option off the table, courtesy of heavy lobbying by insurance and drug companies. And the White House is signaling it's open to other approaches.

Yet other approaches being considered by the Senate would essentially gut the public plan. One would break it into pieces run by regional third-party administrators, thereby guaranteeing that none would have much bargaining leverage to get low prices.

Another would put the public plan under state governments, further eroding it. Big pharma and big insurance already get just about whatever they want from state officials.

A third would require that a public plan adhere to private-insurance rules. But if they're rules private insurers have wangled, the public plan can't possibly push insurers to do better, or get good deals from drug companies and medical providers.

Maybe the House will come up with a real Medicare-like public option and Senate democrats will pass it under a reconciliation bill needing just 51 votes. But this won't happen unless there's huge pressure from the White House and the public.

Right now we're on the way to a universal health-care bill that politicians will claim is a big step forward when it's really, at most, a step sideways.

RYSSDAL: Robert Reich is a professor of public policy at the University of California, Berkeley.