The intensity of debate on health insurance reform is building towards a climax as public and blogosphere pressure increases rapidly on the President and both Houses of Congress. In particular, Harry Reid is facing intense pressure, reportedly from the Administration, Nevada Democrats spurred on by blogosphere-generated telephone campaigns, progressive interest groups, and both progressive and conservative Democrats in the Senate, to do what they’d like him to. The point at issue is whether Harry Reid ought to include a public option in the Senate bill he is now shaping based on the products of the HELP and Finance committees. And if he ought to include one, then what kind of PO should he include?

The blogosphere and progressive interest groups, in particular, are doing their best to counter insurance company lobbying and to demand a “robust” or “strong PO” from Harry Reid. There’s something strange about this effort however. And it is that the people and groups doing the pressuring aren’t telling Harry what exactly they want in the way of a PO, even when they tell him that writing in a PO is a moral choice. As I’ve said in a previous diary, the PO is a general label for many, many variations. One person’s robust PO, is another person’s sell-out, or dog. Many folks are upbraiding Harry and threatening him with defeat in the next election either subtly or very directly. But very few are telling him exactly what he must write into the bill to assuage their forthcoming wrath. Apparently, they think Harry is a mind reader who knows automatically what a “robust” or “strong PO” is. Or perhaps they believe that if they remain vague about what they want, Harry will be so frightened that he will pass a stronger PO than anybody imagines he would ever consider?

I think it is more likely, however, that even if Harry is persuaded to support “a robust public option” by all the pressure he is receiving, he will simply impose his interpretation of what this means on reality, and then use his substantial stash of campaign funds to try to get re-elected by persuading the public that his notion of “robust” is what they meant all along. And what will progressives do then? Will they reject what he thinks is a robust PO and try to defeat his bill and punish him, or just fold their tents and go away?

I’m very curious to find out, because I can almost guarantee that without a clear message about what is acceptable, and what is not, what is “the moral choice” and what is not, in the way of a PO, we will, indeed, get something unacceptable from him, and all this work of ours to get a decent PO-based reform through Congress will have been wasted. For example, let’s say Harry thinks that a robust PO is one whose pricing is tied to Medicare, but he doesn’t think that the meaning of “robust” includes implementation within a year rather than in 2013. And further, let’s say that he doesn’t think “robustness” includes letting the PO use Medicare’s provider network, or letting everyone choose the PO in preference to employee-based insurance. And, finally, let’s say he thinks that letting States opt-out of the PO is perfectly consistent with “robustness.” What then? Will progressives still support Harry’s PO, or will they work to defeat it?

More generally, what is the progressive breaking point on PO legislation? What is a “non-robust PO”? What is an “immoral PO”? We don’t know the answers to these questions, and since no one has told him, neither does Harry Reid know what we mean by these things; which kind of makes the heavy pressure on him beside the point. Doesn’t it?

(Also posted at the Alllifeisproblemsolving blog where there may be more comments)