The healthcare debate has moved to a more intense level in Congress now that three House of Representatives and two Senate committees have passed their respective versions of a healthcare bill.

House representatives must now negotiate and pass a comprehensive House bill and so must the full Senate. Then, the two chambers must negotiate the final bill.  Although only one of the proposed bills (The Senate Finance Committee’s proposal) does not include the public option (a government administered healthcare insurance plan), there is still doubt that the final bill will include the public option.

Undoubtedly, the successful negotiation of a public option to be included in the final bill is the strongest challenge facing Congress and the White House.

President Obama and House Speaker Nancy Pelosi are stern supporters of the public option. This is the area that attracts the most opposition, not only from moderate Democrats and Republicans; but from powerful interest groups led by the powerful private-insurance group. On the other hand, according to a recent poll, the majority of Americans (65 percent) support the public option.

Regardless of the pressure being applied to Congress from interest groups, it is important that members be mindful that they represent the American people, and not these groups. This may be idealistic, since most members of Congress are dependent on various interest groups for funding their election and re-election campaigns. But, hopefully as America seeks change, more congressional representatives will emerge that put the people’s interest first.

It has been reiterated in various forums and media that a final healthcare bill without a public option would not meet the objective of offering health insurance to millions of Americans who currently have none.

The proposed bills, especially those passed last week by the Senate Finance Committee, really help those who already have insurance, but do not open a way for the estimated 46 million without insurance to afford it. This includes a large percentage of African Americans (21 percent) and Hispanics (32 percent). A survey conducted by the National Weekly in South Florida earlier this year also indicated that 20 percent of Caribbean-Americans had no health insurance. The reason most of these minorities have no health insurance is that they cannot afford the high premiums set by the private insurance companies. It is imperative that the reforms offer them an affordable alternative.

One argument being offered by opponents to the public option is that those who cannot afford private insurance should apply for Medicaid. This is a most ridiculous argument. Because of the high cost of administering the Medicaid program, geared to assisting poor Americans, many people are denied coverage. There are confusing rules that restrict even people at or below the national poverty level from getting Medicaid. Without the inclusion of a public option in the final healthcare bill, at least some of the restrictions that prevent low-income Americans from getting Medicaid should be eased.

However, it is understood that the bills proposed by the House and the Senate do not address reforms to Medicaid. Without changes that make Medicaid more accessible, or a public option to offer affordable alternatives to private insurance, millions of Americans will remain uninsured and the cost of healthcare in America will increase as the uninsured continue to crowd emergency rooms at the nation’s hospitals.

It is hoped that the healthcare advertising campaign that targets regions of the country with large minority populations will place pressure on relevant Congressional representatives to vote for the public option. However, it is questionable whether this campaign can exert the type of influence to counter the campaign of the powerful insurance lobby. 

Interestingly, several congressional representatives seeking re-election in constituencies with large percentages of Black and Hispanic voters are involved in tight races and will be dependent on the minority vote to be re-elected next year.

It is hoped that it is the preponderance of the will of the people, not the urge to meet selfish, individual, political objectives that guides the conscience of Congressional representatives partaking in the healthcare debate.

Without the public option, true health insurance reform will be elusive, and more Americans, than the current estimated 62 percent, will file bankruptcy because of incurring high medical bills. Every Congressional representative in Florida, and the nation, must be cognizant that the majority of Americans, neither old enough for Medicare, poor enough for Medicaid, or are veterans or federal government employees, need an insurance plan that is an alternative to expensive private insurance plans.

Naturally, private insurers and their supporters see the public option as a threat. because it represents a more affordable, effective and equitable system for delivering healthcare than private insurance. But, every conscientious congressional representative, hopefully these are in the majority, must vote without fear of repercussion from the private insurance lobby, and in the interest of the people

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