Opting Out and Chillin'
By John Amato Friday Oct 09, 2009 1:00pmSo we've had a new letter being sent to the White House by 30 U.S. Senators saying that they want a public option. And Specter and Difi signed on to it. No, really.
Taking a page from the strong House Progressive Block pushing a robust public option, Roll Call reports that thirty Senate Dems have written to Harry Reid, demanding a public option...This is a key development as the negotiations between Reid, Baucus, Dodd and the White House to merge the Senate HELP and Finance bills begin.
Moving parts and trial balloons are flying all over the place. We are speculating at this point because we aren't at the negotiating table, but the newest one is to include a public option in the Senate bill, but allow states to opt out if they don't like it.
Paul Krugman kind of likes the idea.
So the new idea seems to be a public option offered at a national level, but with states having the right to opt out — that is, make it not available to their own residents. At first blush, that sounds good.
It’s true that the states most likely to opt out will probably be small states that really need the competition. But many states, with probably a majority of the population, would opt in. And if the public option works well, there will soon be pressure on politicians in the others to do the same.
Howard Dean also thinks it's a good idea. Dean: If I Were A Senator I'd Vote For Opt-Out Public Option
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.
"I would like to see that come out of the Senate because it is a real public plan," he said of the opt-out compromise. "Then they can negotiate it [with the House] in conference committee... And if this passes I won't say it is not reform because it is reform."
"If this is what it takes to get 60 votes I say go for it," said Dean
I'm still digesting this, but the fact that the public option is still being talked about in such an intense way suggests that all our (blogosphere, activists, liberals in Congress, etc..) efforts have been really helping and I feel more positive than I did before. It's just a feeling at this point, of course...
I've been talking to Digby and other activists about the problem Obama faces because his plan won't hit the streets for anther 3-4 years and America wouldn't see any tangible evidence that the health care reform had a positive affect on their lives. It is a big problem because a lot of people can't afford to wait the necessary time it would take to implement a massive project like health reform.
Digby remembers something Howard Dean said and this makes a ton of sense.
Dean has been talking about this problem too, and his solution is even better:
To address that problem, Dean said Democrats need to do something that will have tangible results by next summer. His proposal: opening up Medicare to people over the age of 50 so that a "certain mass" of people will already have benefited from health reform by the elections. "You need to have people sign up for this program by July 2010," Dean said.
I've heard this before but it never seems to go anywhere. I'd be first in line to sign up for that plan. Even if it is eventually phased out, it would be worth doing right now. The people my age -- and they are a huge group -- are in real trouble with the current economic mess. They've lost their retirement nest eggs, their property values are in the dirt and their health care costs are insane. This would be very, very helpful.
This is a great idea.
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If that gets the PO into the senate version of the bill - all the better for what will eventually come in the final bill.
Opt-out sounds like a cop-out. But I agree with Dean.
Let the nuts on the right say their state will opt out ... how many of them said they'd refuse the stimulus money? and how many really did? and how many were overridden by their state legislatures. Anyway, it becomes a win/win. The blue states will get their public option and if any red state decides to not accept it, they'll pay for it in the polls in the end.
You may be right, and I just didn't think that far ahead.
The Red states will be the ones opting out - and probably a few of the middle west Blue dog states. But if the constituents want PO they can hammer that home locally. And I'm willing to bet they do - and quickly.
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"Schumer's plan, like other public-option proposals, would create a government-run insurance company."
Sorry . . To quote . . .
"They owe us for the suffering we now endure financially, emotionally and politically. They owe us for not only gaming the system with frauds such as derivatives but also for fooling us into paying for a war we did not need and plainly could not afford.
Just to make sure all this does not offend the sensibilities of the "no new taxes" crowd, it won't be a tax, it will be reparations.
That's right, you owe us."
Anyone disagree with that?
Schumer said that?!?
Reparations sounds spot-on appropriate.
reparations? I can't remember.
Beck.
going on Mick's Ignore List.
whatever. ;o}
If this happens, perhaps not as many states will opt out as we suspect because the local politicians have not been bought off the way the DC pols have and they may feel the pressure of their constituents more acutely.
Kind of like the idea of not accepting stimulus funds - that one blew up in a few faces and won't soon be forgotten.
You might be right.
I'm thinking any politician who wants wo get elected would have the pressure of his/her voters (The one thing they fear more than no money is no votes)
Let's say you live in a state that currently has a fairly progressive state legislature and opts into the plan. Four years from now, things have change and you wind up with some real assholes in your state government. Can they then say, "nope... we're out of this deal"?
Even in California, we still own pitchforks.
"who are worried about the effect a government-run insurance provider would have on private markets"
First of all let's distinguish the true difference between Private Markets and PRIVATE ENTERPRISE. Doctors in Seattle are attempting to go private enterprise (private practice) with flat rate no limit primary care (and affordable catastrophic) but we never hear ONE GOD DAMN THING about ideas like this in the media.
Whats with that?
"ideas like this in the media"
I'm thinking "medium" as a single source - media implies plural.
Giant Corporations already consider the United States their own "Private Market" how does that help people escape the grasp of these soul and money sucking monsters?
The Seattle Physicians group for example knows. . hey we don't need this! We don't need to take this crap to practice ethical medicine.
You think people are going to rush out to buy Corporate Health Packages with options like this available? Hell no they won't.
Is "anal retentive" hyphenated or not? :)
was trying the same thing and the New York insurance commission went after him.
http://www.nypost.com/p/news/regional/state_s...
This is what we are up against.
buy into Medicare @ age 50. I'm 48 and self-employed. 17 years until eligible for Medicare. Would be awesome if we were allowed to buy in for a reasonable price.
Isn't this the issue? Whats reasonable? Whats reasonable to people who barely break even each week come paycheck time. Whats reasonable to people who can't get work or can't work? Whats reasonable to people who lost their equity or pensions or savings which had been set aside to cover health issues?
Threatened him with primary-ing if he didn't fight for public option. Promised him that there was no way I and others would forget this, even if his next election is 5 years away. Health care is just that important.
Told him I was embarrassed that BURRIS signed and he hadn't. Once again shown up by his jr. senator.
I expect no reply. Durbin only writes back when I pat his back.
From what I have read about Canada's transition to single payer, they did it following a gradual escalation. In which the success of the pioneering provinces forced the people opposed to the change in other provinces to move out of the way, since they could not deny the success of the single payer approach.
If anything, this may allow some of the more progressive states to move forward, without having to wait for parts of redneckistan to get their act together.
The provinces, one by one, adopted single payer when they realized the benefits of such a system.
Here's a little history of what we went through up here:
http://www.laphamsquarterly.org/roundtable/ro...
Our state government and several in the south will op-out on purely bullshit GOP pandering partionship. This is not a good idea as the area's that need heathcare reform the most will be denyed it because GOP cry babies don't want to hurt there friends and don't want to give Obama credit.
they allowed the INDIVIDUALS to opt in? I'm stuck in the redneckistan-lite state of Florida, and it could go either way. I would love to know there was an option for me to buy in if I really wanted to.
From July 30:
Damn.
The state government makes the choice for the whole state is what this sounds like. If that's the case we will be screwed hear in GA. The GOP know that Obama and the dems are gaining popularity here and are trying to isolate us with fear and bullshit, they don't want to lose there past ability to get elected solely by have a (R) by there name
to establish residency in another state? Maybe a mass exodus would get their attention. Fuckheads(R).
...the public option is DEAD. It's just a liberal obsession. Chris Matthews said so!
Also, we're still a center-right country. What? We ARE! LA LA LA LA!!! I CAN'T HEAR YOU!!!
considering most Americans can count on immediate bankruptcy in the case of requiring medical treatments. Where's the variety of plans in this encouraging flexibility in payment options according to income and such?
Catastrophic medical should be covered for everyone. Nobody (not even the wealthy) should be bankrupted by an illness or injury.
It just isn't right.
And if you want to have your monthly check-ups and such covered you can buy from the private market . . . with a bare-bones government option priced according to income. The young and healthy, however, can opt to pay out of pocket for the small expenses if they want to. But the catastrophic stuff is taken care of for everyone!
This is the way the "Exchanges" will work.
Everyone will be MANDATED to buy health insurance with a minimum level of coverage by a date certain. Obviously if you want a "Cadillac Plan" you can just call Blue Cross and pay the big bucks if you choose.
For everyone else, especially those 50,000,000 Americans who have been going without insurance for the simple reason that either their employer doesn't offer it as a "benefit" OR they cannot afford the premiums AND pay the mortgage/rent, utilities, food, car payment, car insurance etc., their only "affordable" option will be the "Exchange".
They will have to go to the "Exchange" and tell the "Connector person" what last years income was according to their federal tax return. The "Connector" will TELL THEM what their options are and the various premiums. Should the person qualify, IF there is a Public Option, they may get to choose that. My understanding is that the programs in the "Exchange" will be partly subsidized by the Federal government and these dollars will go directly to the private for-profit insurance corporations working within the Exchange. This is why they are salivating and waiting for this bill to pass. They will be getting our money in the form of premiums that are MANDATED and they will also be getting our tax dollars in the form of subsidies.
But if the lowest premium quoted to the person is unaffordable (and this is exactly what is happening in Massachusetts...people are opting out to pay the fine in droves), then the person will face the fine/penalty which I believe is actually a TAX...since the IRS will be the agency responsible for collecting it.
The buzz I am hearing is that many Americans are considering the possibility of forming non-profit catastrophic health insurance groups nationally so at least they would have coverage in the event of something really expensive happening. The premiums would be inexpensive and it would be done as a protest. Everyone would opt to pay the fine to avoid lining the pockets of the rotten health insurance corporations, since having only catastrophic insurance will NOT BE APPROVED WITHIN THE MANDATE.
I would seriously consider doing this.
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"Moving parts and trial balloons are flying all over the place..."
Jesus H. Krist, it's October. WTF have these clowns been playing at for the past six months?
"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."
Howard Dean should know better.
I just attended a meeting today on health care with Rep. John Olver.
The Public Option in the House, whether you want to call it "strong" or "robust" will ONLY be open to certain individuals who are currently UNINSURED and who fall into a particular category of income that is anywhere from 150-400% of the National Poverty Level.
We are talking about no more than 17,000,000 of the approximately 50,000,000 Americans who are currently uninsured.
What Howard Dean is falsely suggesting is that if a Public Option is incorporated into any legislation that EVERY American will be eligible to participate. This is NOT true and he should know better.
What he is actually supporting is "Medicare for All" which is "off the table" and he certainly knows this.
The idea of anyone who is 50 or older being allowed to dump their for-profit policies and opt into Medicare is a fantastic idea and I would be the first in line to sign up if that happened.
But the reality is that even when the H.E.L.P. bill is combined with the Baucus bill, even if they end up with a Public Option, it will be NOTHING like what Howard Dean is suggesting.
Same for H.R. 3200.
And once the entire mess of fines/penalties/mandates/"Exchanges" and possibly a Public Option are formulated into one FINAL bill for Obama to sign...I seriously doubt that that great idea of "Medicare for 50 and over" will be there.
It's time for everyone to do a reality check, and that includes Howard Dean.
The fact that the programs won't start for three or four years is a huge problem for individuals, but I'm not sure Obama is one of them. Changes of this magnitude are likely to have difficulties early on. If the reforms are rushed into place, those difficulties may appear just in time to create problems for Obama in 2012. That's why I think the three to four year delay is designed to help Obama (and all the people who will die, suffer, or face financial ruin in the interim are nothing more than the cost of Obama's political ambitions). If reform is passed now, Obama can run on his triumph without worrying about ironing out the all but inevitable birth pains that any major reform is likely to suffer. Then, safely re-elected, Obama can address those problems without facing any personal political danger.
Personally, I can't wait three to four years, but I don't really believe that helping people is the highest priority for Obama and most other Senate health care reformers. For the majority of these politicians, getting re-elected is the primary goal -- once that's accomplished, then helping people can become a priority. Right now, it is more important for Obama to pass reform than it is to provide affordable coverage to anyone.
Take some time.
and look what we got.
The Shaft
Purchasing power of Americans has plummeted to next to nothing while the cost of living keeps getting higher. Not to forget a 900% increase in the incomes of the Rich.
Of course they do. But how the changes are introduced can tell us a lot about priorities. If things are timed to allow Obama to run on a triumph that hasn't even begun to help people, then it seems reasonable to be suspicious of his priorities.
On the other hand, if helping people is the priority (and it ought to be the ONLY priority in health care reform -- and helping in this case is not limited to providing coverage, it includes lowering and managing costs, improving care, eliminating wasteful care, etc.) then it is not enough to pass reforms and ignore all the suffering that will take place before the reforms go into effect. People who want to allow individuals to join Medicare while waiting for reforms to take effect are demonstrating that their priority is to help people. Those who propose a timetable that allows countless people to die, suffer, or face financial ruin in the interim may have other priorities in mind. So far, the plans for implementation that I've read about, sound suspiciously like they're designed to help and protect politicians first. That shouldn't be acceptable.
Tell us about how you pay for your Medical Care for once. Let's talk about that.
some Republicans to save enough face to vote for it and certainly takes the wind out of the sails of the States Rights crowd. Somebody's been doing some thinking.
If this is how we get the toe in the door then so be it.
We are talking about just one of the bills. If this gets it into the senate version it will make the fianl version better.
All the hand wringing should be about the final bill, or am I missing something? Just a week or two ago all the concern trolls had all but decided there was never going to be any public option. . .
If you want ot be taken seriously you have to try to sound a little more level headed and serious. Save the GBCW's for the final bill.
Are you effing kidding me? I live in Texas. Think Rick Perry is NOT going to turn it down? Shit.
The knuckle dragging young-earthers in the AZ legislature will be fighting over first place in the line to turn down health care.
Dinosaur-riding Jesus didn't have no healthcare and all that...
From June 26:
Let the conservative states opt out. Great. The people in those states aren't total fools, anyway not all of them, and when they see how people in the rest of the country are benefiting, they'll vote out their elected state officials and vote in more progressive (or less regressive) officials.
This state option is handing a loaded gun to the Republican officials (like Jindal), and helping them point it at their own heads with local voters there to pull the trigger. I like it.
My thinking exactly. Let the repigs screw themselves for once.
Bad legislation is not a victory, and Obama does not have the balls to veto a bad bill.
ANY legislation that could wind it's way through this corrupt congress will be a bailout for insurers - it couldn't pass if it wasn't.
ANY bill passed will be seen as a victory by politicos and most likely by insurers, who have written most of the Senate's bill and will dodge any real bullets with 1,000 pages of fine print protecting their profits.
HR 676 is only 27 pages and does everything we need.
I think the Opt in version may be the way to start a national public option or even Medicare for all. As others have pointed out, the Opt in gives the Repugs a States Rights option - can they really vote against what their party has stood for for the last 60 years? It's a true option - each state has the choice to opt in or out. I don't think that a true public option is going to pass this year, but if we can at least get it started, get our foot in the door, once the public sees how well it works for others, then they'll want it for themselves. The Canadian model of implementation proves this. Once those in the provinces that didn't join at first saw how good it worked for the others, they all joined in. I think this may be the way to start the ball rolling - it's not perfect, it's not what we want, but it may just be the way to get it started. And getting it started is better than nothing.
and few dems give a shit if you live or die! They just want the money and the easy pay check with all the good benefits.
republicanism is a mental illness!
Can I be next in line please
GOP is snookered with this one.
No one is talking about the fact that the much vaunted Public Option will be available to only about 5% of the general population. They could just raise the Medicaid requirements.
But they're all pretending this is going to be wonderful for everyone.
They talk about controlling costs - what about those of us that can't afford to use the insurance we have now? Somewhere in the vicinity of 70% of those that filed bankruptcy for medical reasons were insured.
This is one giant snow job.
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So why is he not the head of Dept of H&HS, or a chief advisor on health issues in Obama's cabinet? What a screw up not to include him. Rahm is a closet Rethug.
I don't want a Public OPTION. I want a PUBLIC PLAN with a PRIVATE OPTION.
Single payer for everyone, birth to grave. But if you want to, you can Opt Out of the Public plan. If you opt out, you can get insurance if you want, but it's privately provided, you pay all the costs and the insurance companies are totally unregulated. And you can't sue your insurance company or doctors for anything because they aren't regulated.
Hell, let the people opting out not pay their share of taxes for universal care. Uber rich people will opt out so they get a tax savings...but then when the insurance companies start dropping them, and they can't sue anyone, well too bad. Let the market take care of them.
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