A health care reform plan without government-run insurance is "D.O.A.," says one left-wing grassroots organizer up in arms about the possibility the Obama administration could abandon its efforts to build a "public option."

Jim Dean, chairman of progressive group Democracy for America, wrote supporters on Monday to tell them to fight any effort to remove a government-run health insurance plan in place of non-profit "cooperatives."

Suggesting insider Democrats and the insurance industry are behind the effort to kill a government-run plan, in his e-mail Dean assumed all Republicans in the House will oppose the health care reform with cooperatives, and with a loss of Democratic support, it would be dead on arrival. 

"Let's be clear: A health care bill without a public option is D.O.A. in the House. Period.
To pass any bill in the House they need at least 218 votes but 64 House Democrats have stood up and said they will not vote for a bill without a public option. That means a bill without a public option would only have 193 votes," he said.

On Sunday, Health and Human Services Secretary Kathleen Sebelius told CNN's "State of the Union" that a public option is "not the essential element" in reform legislation. 

"I think there will be a competitor to private insurers," Sebelius said, indicating that cooperatives could work as a substitute. "That's really the essential part, is you don't turn over the whole new marketplace to private insurance companies and trust them to do the right thing. We need some choices, we need some competition."

Sebelius extended comments from President Obama a day earlier, in which he told a town hall that a government-run health insurance program was never the most important part of a call for reform.

"The public option, whether we have it or we don't have it, is not the entirety of health care reform. This is just one sliver of it, one aspect of it," Obama told a town hall in Colorado.

"So we are working on a series of proposals to address the questions that you're raising. I believe that we can work them out. But those are specific questions as opposed to broad, philosophical questions about whether government ever has a role to play or not."

Several liberal supporters of any changes to the current bills being debated in Congress offered their criticism of a weekend suggestion by the administration that the sticky "public option" proposal could be removed from negotiations.

"Leaving private insurance companies the job of controlling the costs of health care is like making a pyromaniac the fire chief," said Rep. Anthony Weiner, D-N.Y., who advocates a government option from his post on the House Energy and Commerce Committee.

"Any bill without a public health insurance plan like Medicare is not health reform," said Rep. Barbara Lee, D-Calif., chairwoman of the Congressional Black Caucus. "Without a public option there will be no way to keep insurance companies honest and their rates down. A public health option that competes with private insurers will set standards that could help lower costs and improve access."

Howard Dean, a former presidential candidate and doctor who is a former Democratic Party chairman and a leading liberal in his party, said he doubts meaningful health care reform can take place without a direct government role.

"You can't really do health reform without it," Dean told NBC's "Today Show." "We shouldn't spend $60 billion a year subsidizing the insurance industry."

But while supporters of a government-run program insist that alternatives like cooperatives aren't enough, Sen. Kent Conrad, D-N.D., one of six negotiators trying to hammer out a bipartisan compromise measure on the Senate Finance Committee, told "FOX News Sunday" that a government-run insurance plan simply does not have the votes to pass. 

"The fact of the matter is there are not the votes in the United States Senate for the public option. There never have been," he said. "So to continue to chase that rabbit I think is just a wasted effort."

Pennsylvania Sen. Arlen Specter, the Republican-turned-Democrat who has faced some of the most energetic opposition toward a government-run plan, said Monday he's not ready to take it off the table. He added that he'd like to leave a private insurance option, but add choices.

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