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Paul Abrams

Paul Abrams

Posted: June 25, 2009 12:46 PM

An Offer on a "Public Option" Republicans Can't Refuse: Let States Determine Whether to Adopt It.


Lying, intransigent Republicans plus cowardly Senate Democrats is a witches' brew for stalemate on healthcare reform. The same posturing pompous politicians who celebrate the courage of the Iranian people asserting their public will against the mullahs shrivel into whining, doubting pusillanimity when they have to..to...to....vote to serve the clear choice of ~70% of the American people for a public option in healthcare.

By this time the President knows that Senate Republicans will pretend bipartisanship until the 11th hour, and then vote as their ayatollahs in the insurance and pharmaceutical industries tell them. They will use the public option, or the mere possibility of a public option, as the excuse. It will be framed as a "federal takeover of healthcare".

Democrats have two choices. Get a backbone transplant, or provide the Republicans an offer they cannot refuse (or, if they do, they get trounced in 2010). Since a backbone transplant may or may not 'take', here is the offer they can't refuse:

Define and provide funding for the public option as if the insurance and pharmaceutical ayatollahs had gone off to Argentina to work on family values, i.e., define and fund it as if the public plan would have smooth sailing. Then, make the inclusion of the public plan optional on a state-by-state basis, i.e., no federal mandate to offer it in any given state.

At that point, state politics will prevail. If Mark Sanford needs a public option to pay for his Viagra, then the South Carolina legislature will vote to allow the public option into the State, and Sanford--with a gleam in his eye--will sign the bill. If, on the other hand, Sanford's trip was his last tango, then perhaps it would be vetoed.

In Washington state it would become an instant ballot initiative, and the people could vote it up or down (no Viagra pun intended here). Federalism prevails.

It will be absolutely delicious to watch Governors Pawlenty, Palin, Perry and Barbour (the only difference between "P" and "B" is the latter is voiced, so he fits) squirm as this issue is pushed onto their states' agendas. Will they support including the public plan in their states' insurance plan options...or, will they be kneeling and bowing to their mullahs of moolah?

An additional little twist: whatever a state decides will be its insurance plan options should be the only options available to Members of Congress and Senate from that State. It will be downright delectable to watch these members do what Representative Inglis did on the $787B stimulus--vote against it with righteous indignation and then plead with his Governor to take it because "it may help"!

We can have our public plan, and have fun in 2010 to boot.

 
 
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06:52 AM on 06/26/2009
The private insurance industry has failed to efficiently make it possible to deliver universal healthcare to the citizens of the U.S. If they cannot justify their existence, they need to disappear. The government has a responsibility to protect the health and welfare of its citizens, and the private insurance industry has failed.

The issue of public option is one more corporate welfare measure designed to bailout the private insurance industry, by taking all of the toxic patients and placing the cost of delivering healthcare to them on taxpayers. Single payer healthcare is the solution, as evidenced by visiting any country of choice. Americans do not tolerate corporate welfare. It's time to eliminate healthcare insurance companies, once and for all.
02:49 AM on 06/26/2009
Lets clear something up, right now. The GOP doesn't totally believe in States'
rights.

They only believe in States rights when they feel totally confident the states
will follow their wishes.

For example, they believe in States rights to ban abortion, because they are confident
most states will be stricter than the federal government on abortions.

But, when it comes to restrictions on firearms they dont want the states to have the right to
make their own decisions on gun restrictions.

That's why they are angry with Judge Sotomayor:
she ruled that the 2nd amendment (thus far) has not been applied to the states,
by the Supreme Court; and she is correct-that is the current state of the law.
(DC is not a state)

thus at this time, states are free to make their own laws on firearms.
But republicans dont like it. They don't trust states to have that right.
But they trust states to have the right to regulate abortion.

The GOP cant have it both ways with State's rights, but they certainly would like
to have it both ways..
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HUFFPOST SUPER USER
marijam
Independent
06:47 PM on 06/25/2009
No. It has to be national. It's the only way that all states would be able to afford it.
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HUFFPOST BLOGGER
Paul Abrams
08:08 PM on 06/25/2009
The states aren't paying for it. Under the proposals, the public plan would be another insurance plan, competing with Blue Croos, for example, on price and coverage. It would reimburse at negotiated rates.

Those of us who favor it believe that its existence will bring down the costs of premiums (in this proposal, in states that have it).

see below some of my other comments, it explains what is going on.
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HUFFPOST PUNDIT
jsgaetano
Legum servi sumus ut liberi esse possimus
05:20 PM on 06/25/2009
You know what? I actually LIKE this idea.

This means all the liberal states will have health cares, and all the hardcore conservative states won't. And... the only way for them to EVER get free health care will be to start electing liberals into office.

And likewise, you will see businesses start to flee from Red States, since smart companies will prefer to dump all the expense involved in health care. Likewise, you will start seeing the smart people leave Red States for the health care.

Blue States win all around- we get health care, jobs, and "brain drain". Red States will be left with nothing... and the people who hold out will eventually vote the health care obstructionists out of office.
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jmpurser
See My micro-bio
05:55 PM on 06/25/2009
So we're going to start with a plan that saves absolutely nothing up front AND THEN make it optional by state to sign in?

Two strikes with one pitch. Brilliant.
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HUFFPOST BLOGGER
Paul Abrams
08:04 PM on 06/25/2009
I don't think you understand what the costs are. The entire system today is paying for all the healthcare dispensed, even to those without insurance because they use emergency rooms, cannot pay, and the amount that the insured pay is increased to make up for it. I.e., it is a zero-sum game.

The question is whether there is a more rational way to pay for it. The public plan does not have built into it the administrative costs the private plans have. Medicare is less than 5%.

To save money, one has to improve the delivery of healthcare. For example, 10% of medicare recipients consume 67% of the annual costs. That's an opportunity to improve their overall health, and reduce costs. This isn't the place to explain how that happens, but it can--and in pilot projects, it does.

The public plan is "merely" another insurance option to be offered in the states, or not if, under this proposal, a state says "no" to the public plan. The costs in that state will, in my estimate, go up, but if the state, in its wisdom, decides it doesn't care, or that it will be less expensive, they can do that.

This is NOT a system where the government will actually be dispensing health care, as it does in the military or the Veterans Administration. It is an insurance plan that will pay, like other insurance plans, for covered care, as Medicare does today.
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jmpurser
See My micro-bio
04:40 PM on 06/25/2009
Well, I thought I'd heard about every really screwed up way to health care reform. Thanks for adding to the miserable repertoire of ways politics can foul up a really simple proposition.
HUFFPOST SUPER USER
JRsNana
The most important things in life aren't things.
01:57 PM on 06/28/2009
If there was a "simple" proposition, we'd already freakin' have a public health care option! I love it. You come in here with NOTHING to offer but a bunch of negative comments (typical of the current GOP), and expect everyone to just cower in the corner and say "yessir Mr. GOP, we won't do anything without your approval". What is YOUR suggestion? Got one? I didn't think so.
HUFFPOST SUPER USER
JRsNana
The most important things in life aren't things.
12:55 PM on 06/25/2009
BRILLIANT! I say let's do it! I've been ruminating on this issue for weeks trying to figure out how we can get around the Republicans AND spineless Democrats. I hadn't come up with anything. You've hit on the perfect solution. Thanks. Now I can move on to ruminating on something else.
02:46 PM on 06/25/2009
Sorry, but leaving the implementation of a public health option to the states is a recipie for disaster and for the non-implementation of the option to the majority of people who really need it.

Some states will definitely sign on, others (mostly in the South, where I live) won't because of fearmongering about "socialism" and other right-wing boogeymen.

A nation-wide public health insurance option is the ONLY way that it will work. Giving the states the option of implementing it or not will only create a piecemeal system in which one's access to health insurance will depend on the state in which one lives.

Enough already with this "state's rights" crap. Let states work out LOCAL issues an have the Federal government deal with issues that affect ALL Americans.
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HUFFPOST BLOGGER
Paul Abrams
03:58 PM on 06/25/2009
You do not understand what the public plan is, or how it is proposed to work in any scenario. A public plan would be, say, like Medicare. If available nationally, any person or employer could choose to purchase (and pay premiums) into that plan. Or, they can choose other insurance plans available in their state.

If my proposal were adopted, then only states that had agreed to include this public plan would make it one of the options offered by insurance providers in their state. It would work precisely the same way as if the whole country had it.

It is not a matter of "implementation" by the states, but rather agreeing to its availablity to its citizens.

I wouldn'dt get too exercised about your state--like the stimulus, everyone (even those who opposed it) want to take it. My proposal changes the politics and, if some states decided not to offer it, lots of people would start moving elsewhere or kick out those who denied it to them.
12:53 PM on 06/25/2009
He// , they should have tried this in the first place, allow states to decide whether or not that this policy is they would like to adopt.
02:47 PM on 06/25/2009
Yes, and turn what is currently one battle being fought at the Federal level into 50 separate battles fought at the state level.

That is exactly how to NOT implement a successful system.
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jmpurser
See My micro-bio
05:10 PM on 06/25/2009
Well said.
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quidam56
12:52 PM on 06/25/2009
Too many American's are being ripped off by the politicians and the profit machines. The health care system spends $ 1.4 Million per day lobbying Congress, that sure could go a long way to help so many folks who need health care. I know exactly what the outcome is of the status quo. http://www.wisecountyissues.com/?p=62 It's called quality health care in Tennessee and Virginia.