I mentioned earlier in the week how the public option fight changed the progressive movement. You had a popular, compromise measure that the public supported, where advocates did everything right, getting their pledges and using allies to make demands, and none of it mattered. It bred cynicism for future fights.
Underneath all that was a belief that the public option’s fate represented a sellout, that forces inside Washington cut a deal, whether with the hospital industry or the insurance industry or whoever, to get rid of the public option at the last minute. Tom Daschle confirmed this in a book all the way back in 2010, which he then had to walk back. And other reports have made similar claims, though nobody could nail it down.
Now, Richard Kirsch, who was the head for Health Care for America Now, the labor-backed coalition trying to pass the Affordable Care Act in 2010, admitted that the public option was traded away in the midst of the fight.
The book is Fighting For Our Health, by Richard Kirsch, who directed the advocacy group Health Care for America Now during the push for reform. HCAN is a well financed umbrella group backed by scores of liberal groups, unions, and other reformers — making Kirsch a close witness to the entire saga. He confirms that the White House treated the public option like a bargaining chip with powerful industry players, and believes that when his group became most critical of the bill mid-way through the fight, that top White House aides sought to have him canned.
“The White House had negotiated a number of deals with the health industry, designed to win their support for reform, including agreeing to oppose a robust public option, which would have the greatest clout to control how much providers got paid,” writes Kirsch, largely confirming what has become an open secret in Washington.
I think this sellout exposed Democrats and separated them from the progressive movement like nothing else has. Anyway, I like to think that…
At the Slackwire, JW Mason generalizes the idea, offering progressives a useful counterpoint to neoliberal market ideas.
[W]hen public funds are used to reduce tuition at a public university, they don’t just lower costs for students at that particular university. They also lower costs at unsubsidized universities by forcing them to hold down tuition to compete. So while each dollar spent on grants to students reduces final tuition costs less than one for one, each dollar spent on subsidies to public institutions reduces tuition costs by more. 
The same logic applies to public subsidies for any good or service where producers enjoy significant monopoly power: Direct provision of public goods has market forces on its side, while subsidies for private purchases work against the market. Call it progressive supply-side policy. Call it the general case for public options. The fundamental point is that, in the presence of inelastic supply curves, demand-side subsidies face a headwind of adverse price effects, while direct public provision gets a tail wind of favorable price effects. And these effects can be quite large.
This suggests why public universities are superior to public educational loans, public elementary schools are superior to vouchers, and public employment is better than the EITC. It is often the case that tax incentives simply funnel money to producers that enjoy monopoly power.