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KQµårk 死神 On October - 7 - 2009

healthcare 03First let me unequivocally say I would prefer single payer over all and a robust public option for the entire country at least.

However the one public option compromise I think I can live with was reported by Sam Stein today.  Some Senate Democrats are suggesting that they would add a public option to a healthcare bill where states could opt out.  The details are still being worked out but the following passage talks about how the plan is progressing.

“Senate Democrats have begun discussions on a compromise approach to health care reform that would establish a robust, national public option for insurance coverage but give individual states the right to opt out of the program…

…How such a system would work is still being debated, according to those with knowledge of the proposal. But theoretically, the “opt-out” approach would start with everyone having access to a public plan. What kind of public plan isn’t yet clear. States would then have the right to vote — either by referendum, legislature, or simply a gubernatorial decree — to make the option unavailable in their health care exchanges.

For conservative Democrats — especially those from states with major private health insurance industry interests — this concession could be key, allowing them to punt a vote on a public plan to local governments. For
progressives, it would not be the hardest pill to swallow.

“It is clearly much better than triggers and [Carper’s] opt-ins,” said Richard Kirsch, executive director of the group Health Care For Americans Now. “A trigger option is a way to kill the public option and these opt ins are not effective because it leaves it up to state legislatures to set it up…”

Another Democrat working on reform legislation added, “If everyone gets a plan, and states have to affirmatively vote, preferably by referendum, to opt out. I really don’t see a lot of states opting out, for one. And, for two, you get your national [public plan] available everywhere. If a few holes start appearing, it’s not nearly as fatal as if you went with the Carper plan, which after a few years might mean 10 or 20 [state-based] public options. If you go the other way, you’ll probably have like 47 states. It’s a big difference.””

Triggers and co-ops are bullshit compromises because they would not reduce costs but this is different.  While it challenges my ideals to leave millions of Americans without access to public healthcare, my pragmatic side is open to this compromise, especially if this makes the public option more robust.  I think it’s a compromise I can live with because the vast majority of states will keep  the public plan.

statepopredblue512Putting my cynical political hat on, this type of compromise defines the divided country we live in today.  If it takes a bill that literally creates two Americans to define what kind of country we are it could transform American thought.  Mostly Southern states would opt out and the competitive advantage for jobs they have been getting for decades with lower taxes and cost of living could be turned on it’s head especially with small and medium sized businesses that are being decimated by healthcare costs.  The populous in states dominated by right wing politicians who opt out of public healthcare for ideological reasons could eventually be pushed out by people who do not want to pay insane healthcare insurance rates.  It would be a political experiment of monumental proportions in any case.

Written by KQµårk 死神

My PlanetPOV contact is [email protected] Proud Dem whose favorite hobby is cat herding. The GOP is not a political party, it's a personality disorder. Cancer, Heart Failure and Bush Survivor.

9 Responses so far.

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  1. KQuark says:

    It’s seems Dr. Dean would accept this compromise at this time too.

    “”If I were a member of the U.S Senate I wouldn’t vote for the [Senate Finance Committee] bill but I would vote for this,” Dean said, “not because it is necessarily the right thing to do but because it gets us to a better conversation about what we need to do.”

    In a brief telephone interview, Dean stressed repeatedly that his preference remained, far and away, a national public option that was available to anyone — regardless of state — from the day of its conception. But in a wholly political context, he acknowledged, adding the opt-out option to the bill might be the best and only way to get something through the Senate.”

    Read more at: http://www.huffingtonpost.com/2009/10/08/dean-if-i-were-a-senator_n_314118.html

  2. AdLib says:

    The polls show about 2/3 of the country wanting a public option so I don’t think what’s going on in the Senate reflects America, it reflects the Senators bought and paid for by the insurance industry and Republicans wanting America and Obama to fail.

    Ultimately, this state opt-out plan is fine for advancing the Senate bill but it will change in reconciliation, the House Progressives won’t sign off on a bill that doesn’t have a national public plan.

    I’m fine with this too and as you describe, if it became law, all of these Republican, southern states would be slammed economically…which wouldn’t be the worst thing except that it is the poorest in those states that would be hurt the most.

    • KQuark says:

      BTW some other Dems are talking about a state level public opt where states would have full control of the public option but it would limit the bargaining power of states, especially small states. I think the nationwide public plan with a state opt out is much better than the disaster that would create.

      But we do need to make sure states have a right to vote for single payer if they wish like in the house bill. That would be huge boons for large more progressive states like CA, NY and IL.

    • KQuark says:

      Hey Adlib good to see you posting. I hope you are feeling better.

      The real goal of this is to get a bill through the Senate with a public option to build up momentum. If it’s an easy sell to get the whole 60 vote bullshit the first time I’m all for it. I’ve seen momentum growing for the public option in the last couple of weeks because the Baucus bill has properly become so politically impalpable for many in congress.

      Like I said my feelings on the compromise are cynical in nature. I’ve posted several times to trolls if you don’t want public healthcare you can be suckers and keep on buying profitcare insurance but I want to be able to buy into government run healthcare. In a way a state opt out would do just that with states where people still vote against their self interests. If it did not hurt working class folks and Democrats in those states I would not mind. Hell I would say all trolls can opt out of public healthcare for the rest of their lives to live with their sick ideology.

      The wonk inside of me would say that if it was a choice between a robust public option where states can opt out our a watered down public option I would take the opt out because at least people would have a real choice.

      But you are right about progressives in the house they will go for the opt out, at least at first.

      • AdLib says:

        Thanks, glad to be back.

        I also heard that some Dems in the Senate are pressing for an approach that any Dems who side with the Repubs on the filibuster would be stripped of their Chairmanships.

        That’s the way to whip these Blue Dogs in line. If they vote with Repubs to try and kill Health Care Reform, they should lose their chairmanships.

        Because, if the Dems don’t pass reform with a public option that makes a difference, they will lose in 2010 and 2012 and no Dems will be Chairmen in a GOP Congress.

    • Kalima says:

      You there, hi there!

  3. Kalima says:

    I really don’t understand the adversity to the pubic option. These people against it seem like communists to me, and they belittle your President and call him a socialist. Hilarious!

    • KQuark says:

      Even though I’m from the northeast that is much more progressive I’ve lived down south for 18 years so I see there really are two Americas in many ways. Most of America is not afraid of a public healthcare system but there are large swaths of this country in the southeast and other parts of America that fear any progress. It’s totally unreasonable but it exists.

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