Everyone on the Sunday talk shows yesterday optined that the health care reform effort was moving closer to passage. 

“We’re entering the final stage, and everyone is maneuvering to get the best possible deal,” said Drew E. Altman, president of the nonpartisan Kaiser Family Foundation. “The odds of passing legislation are steadily moving up.”

The final bill will not be perfect, but I believe it will contain a public option of some kind.  The other big questions are financing  and affordability.  The reason I think the bill will have a public option is because a friend my husband  was talking to the other morning supports one.  He is not a political activist, tends to be conservative, and is a veteran.  He talked about the rise in premiums he had experienced and the fact that vets have now come to understand that they won’t lose their coverage under VA – or have to pay for it – but that others will gain  the kind of health care they have.  He thinks this is a good thing.  And the opinion polls show others are moving his way.

I think there will be an opt out provision for the states, but, unlike the stimulus funding, the governors will not be able to “refuse” to implement the reforms at all.  I think it will end up will a 3 to 5 year trial period after which a state could opt out or a similar period during which the insurance companies in a state would have to lower premiums or they would have to become part of the government provided health care.

There are a lot of details to negotiate.  Like how to pay for reform.  We will have to see if the President has, in the end, provided the weapon to defeat the bill .  Is his 900 Billion cap going to mean a bad bill or no bill?

Howard Dean has a great feature on his health care reform webpage.  The vote tracker allow one to sort for public option supporters.  Dean, like President Obama, is not supporting a particular bill, but iw helping to keep an eye on the votes in support of the public option.  His latest count is 218 house votes and 51 in the Senate.  We need to work on those undecideds in the House, but it appears that if all Democratic caucus members vote against the filibuster, the Senate can then pass a bill with a public option.  Go to his list and filter for undecided Democrats and if your Congressperson or Senator is on the list, give them a call.

Even John McCain now thinks Congress will pass a bill with some kind of public option.

“I think the Democrats have the votes, and in the House, Blue Dogs bark but never bite,” Mr. McCain said on CBS’s “Face the Nation,” using the nickname for conservative Democrats . “So I don’t think they have a problem over in the House side. In the Senate I think the Democrats are very aware that they don’t want a repeat of the Clinton failure in 1994. So I think it’s very likely they will get something through. But it’s not clear to me what it is.”

The Democrats need to forget the Republicans and get the votes in the party.  Even Senator Ben Nelson appears to be moving toward support of some type of public option.

The remaining big pitfall is abortion and whether the bill has a provision to pay for the procedure under the public option.  Right now, I have to say that will be a compromise point and reproductive choice will remain a choice only for those that can afford a choice.