Cohn looks way past this week's tussle over the public option and even beyond the health care debate that's dominated the first year of President Obama's tenure. He frames the public option fight and defeat within the broader sweep of liberalism and America's feelings about big government programs. Even if Democrats lost the public option, Cohn argues, they won an expanded share of American ideology--not to mention health care reform legislation they should be proud of.
Disappointed progressives may be wondering whether their efforts were a waste. They most decidedly were not. The campaign for the public option pushed the entire debate to the left--and, to use a military metaphor, it diverted enemy fire away from the rest of the bill. If Lieberman and his allies didn't have the public option to attack, they would have tried to gut the subsidies, the exchanges, or some other key element. They would have hacked away at the bill, until it left more people uninsured and more people under-insured. The public option is the reason that didn't happen.
And if public option supporters lost in the Congress, they won in the country as a whole. The underlying political problem for liberals remains what it has been for a generation: profound and widespread distrust of government. But polls consistently showed voters thought the public option advocates were right--that, at least when it comes to health insurance, government can be trusted. It was a small victory, but it's on top of such small victories that political movements are built. Someday in the future, that movement may be powerful enough to win more sweeping changes. Who knows, maybe those changes will include a government-run insurance plan.