Nelson’s problem, he told CQ, is that the public plan would be too attractive and would hurt the private insurance plans. “At the end of the day, the public plan wins the game,” Nelson said. Including a public option in a health plan, he said, was a “deal breaker.”
So, the immediate reaction from liberal pundits and bloggers is that Ben Nelson is clearly the insurance companies' bitch. If harm to their private plans is a 'deal breaker,' it means that their profits are his key motivation.
I think it's slightly more complicated than that. Nelson is most likely right: A public plan (positing that it is well funded and well constructed) is likely to outperform what the insurance companies can provide with their strict adherence to the bottom line and their relative size.
But what Nelson is really doing here is puncturing a convenient fiction that the left brings to the debate: That by introducing a public plan but preserving consumer choice, the magic of market forces and competition will keep both the public plan and private plans lean and cost effective. The reality that Nelson points out is that if we actually do the public plan right, it will simply replace the ubiquitous private plans, effectively socializing health care (and, importantly to Ben Nelson--whose"(D)" stands for "Douchenozzle"--harming the profits of the insurance industry).
Nelson is just honestly pointing out that we face a more clear cut choice than "third-way" dems like to admit: We should either muddle on with private industry failing to provide adequate health care insurance, or we should just go ahead and socialize it all.
Nelson is on the wrong side of that debate, but at least he calls it like he sees it.