By NYCeve (Eve Gittelson)

Sixteen years ago, President Clinton stood before a joint session of Congress and spoke about making healthcare available to all Americans. That speech was not just about healthcare, it was about our country and its core set of values. I remember as he held aloft a card and said that the little document would be a gift of life and certainty to all Americans. I breathed a deep sigh of relief, thinking how comforting, I’ll never have to worry about being uninsured or not having access to healthcare.

Alas, it was a short lived dream.

Even in those days, premiums were skyrocketing and there was always the possibility that each renewal might be the end of the road. Our healthcare lives were littered with worry, fear, anxiety and ever present bills. Back then, healthcare was a privilege, not a right, and it still is.

It was difficult in those days, but the system was still chugging along in some fashion. Back then, I had some surgery, and the day I entered the hospital, I was asked to write a check for $3500.00. I remember that moment like it was yesterday.Here I was going into a major American hospital to get help, but before I could access that care, I was required to make a large payment. I wondered, what happens to people who don’t have the financial wherewithal?

President Clinton didn’t lose the battle for Health Care Reform because he was over-reaching or because Hillary Clinton attempted to grab too much power, or cloak the legislation in a veneer of secrecy. We lost sixteen years ago due to a lack of political ambition and corporate greed—just like today. The American people lost because of lies, fears and manipulation.

Like all Americans, Paul Krugman is anticipating which road President Obama will take tonight. He is very clear, that without a public option, we’re still in the 1993 mindset.  Americans fearing each premium renewal and wondering—always wondering, will this be the year that I just can’t afford it any longer? Will this be the year the healthcare of my family gets the ax.

But what is one to make of the practical, political argument from the likes of Ezra Klein, who argue that any public plan actually20included in legislation probably wouldn’t make that much difference, and that reform is worth having even without such a plan?

There are three reasons to be suspicious of that argument.

The first is that I suspect that Ezra and others understate the extent to which even a public plan with limited bargaining power will help hold down overall costs. Private insurers do pay providers more than Medicare does — but that’s only part of the reason Medicare has lower costs. There’s also the huge overhead of the private insurers, much of which involves marketing and attempts to cherry-pick clients — and even with community rating, some of that will still go on. A public option would probably be able to attract clients with much less of that.

Second, a public option would probably provide the only real competition in many markets.

Third — and this is where I am getting a very bad feeling about the idea of throwing in the towel on the public option — is the politics. Remember, to make reform work we have to have an individual mandate. And everything I see says that there will be a major backlash against the idea of forcing people to buy insurance from the existing companies. That backlash was part of what got Obama the nomination! Having the public option offers a defense against that backlash.

What worries me is not so much that the backlash would stop reform from passing, as that it would store up trouble for the not-too- distant future. Imagine that reform passes, but that premiums shoot up (or even keep rising at the rates of the past decade.) Then you could all too easily have many people blaming Obama et al for forcing them into this increasingly unaffordable system. …

Let me add a sort of larger point: aside from the essentially circular political arguments — centrist Democrats insisting that the public option must be dropped to get the votes of centrist Democrats — the argument against the public option boils down to the fact that it’s bad because it is, horrors, a government program. And sooner or later Democrats have to take a stand against Reaganism — against the presumption that if the government does it, it’s bad.

The public option is also a reaffirmation from democrats that affordable healthcare is a right which citizens of the richest country on the planet can no longer be denied.

Worry, anxiety, and  fear is what we all experience from a dreaded medical diagnosis.  Never again should these toxic emotions arise from not having access to healthcare in the first place.