As President Obama signals the urgency of healthcare reform at today's summit, experts and commentators are weighing in on the need for a meaningful public option to rein in soaring health care costs and end double-digit rate hikes. Among the most eloquent of the commentators is Roger Cohen in this superb op-ed in yesterday's New York Times:

"Crunch time has come on a question central to the nation's future, where an acknowledgment is needed that, when it comes to health, we’re all in this together. Pooling the risk among everybody is the most efficient way to forge a healthier society. That's what other developed societies do. And they don't have 30 million plus uninsured."

It's clear to such commentators that a public option with teeth and broad coverage is the only way to lower costs and keep health care affordable. So why isn't Congress and the White House responding in kind?

Bill Budowsky at The Hill put it this way: "It is sad and ridiculous that with a Democratic president who supports the public option, and with a historically large Democratic majority in the Senate, and with a near-80-vote Democratic majority in the House, and with the public option supported by a strong majority of voters, and with the public option supported by more than 70 percent of independent voters, and with the public option significantly lowering the deficit, and with the public option supported by four out of five congressional committees that have voted, and with the public option having passed the House, and with the public option supported on the record by a majority of senators, the public option cannot be passed."

If the President and Congress are willing to heed the degree of public support for the public health insurance option, reconciliation could be used to restore the option to the health care reform package.

Meanwhile, while the debate inches forward, the news story unfolding in California, about health insurer Anthem seeking to raise rates by a whopping 39 percent, should make clear to all of us that the Republican "policy" of leaving the market to regulate itself (i.e., leaving health insurers to their own devices) is a recipe for disaster. We have been there and done that, thanks very much, and we're still paying heavily for the consequences. Millions of Americans are still uninsured. The coverage that many others have is borderline dismal. And if we're talking about rate hikes of 39 percent this year, what's to come next year and the year after that?

Many Americans, young and old, are confronting the awful necessity of trying to reduce their healthcare coverage to rein in their own monthly costs. The knock-on effect is forcing insurers to raise rates, which in turn is increasing the shortfall and worsening the crisis, leaving fewer Americans with adequate coverage and more of them vulnerable to bankruptcy from emergency medical bills. In today's San Francisco Chronicle, WellPoint CEO Angela Braly explains that Anthem's rate increases in California "were needed to keep the company solvent as healthy, young people have dropped coverage to save money, leaving an older, sicker population that requires more care."

To offset this vicious cycle and increase the pool of insurers, we need a meaningful public option that regulates rate hikes. That system works effectively in Canada; why can't we "Canadianize" our own system, as Paul Krugman asked recently about our similarly deregulated and chaotic banking system, to emulate the smart thinking of our neighbors?

Cohen goes one step further: "Why not offer Medicare as a choice — a choice — to everyone? Aren't Republicans about choice?"

It's a terrific idea. What are Republicans and the White House afraid of? That we'll choose Medicare over more expensive private insurers and move incrementally toward national coverage?

And that would be a bad thing because . . .?  Follow me on Twitter @christophlane

March 12 Update: "The Public Option's Last Stand: A Matter of Will, Not Votes."

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