For my first and last sports analogy — you can’t score if you don’t get on base. 

Reform is a process.  I think many of us would be surprised by the narrow focus of the Social Security Act when originally enacted.  

If the emphasis on the public option defeats the broader reform bill, then that is a bigger tragedy.

I believe that a public option is necessary because insurance companies will now refuse to insure the currently uninsured at a reasonable cost because of the other reform measures that circumscribe an insurance company’s ability to deny coverage to existing policy holders.  

But first we need:

a law that eliminates pre-existing condition exclusions, prevents “dropping” coverage when an insured person gets sick, and eliminates life-time maximums.

a “best practices” safe harbor so doctors aren’t forced into costly, defensive medicine practices.  We need computerized record keeping to reduce costly, tragic mistakes from insufficient information.

If, within a year after bill passage, there is a spike in health care premiums, even the GOP and Blue Dog Democrats will want a public option because their constituents will demand it.

There are two other reasons to wait a year: 

one, the cost of creating a public option may be more than our economy can handle right now.  Do I know for sure?  No.  No one can know for sure.

two, we need to see how identifiable changes affect the system.  The law of unintended consequences may yield a different set of problems or a different set of options when we see how the reforms actually affect the economy.  And we need some room for tinkering.

I applaud those who recognize that a public option is necessary.  But, please, don’t hold up the other reforms that the nation needs.