Senate Dems. moving the goal posts on the public option
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When in a public option not really a public option?
When the definition is ‘dumbed down’ to the point where virtually anyone can support it, particularly the Senate Democrats who are desperately looking to claim victory on a public option without actually having to pass one.
Travel with me back to the early months of 2009 when a public option was defined as either a ‘Medicare-for-all’ approach or a ‘start from scratch’ program that would have the newly minted public program negotiating with health providers to set the payment rates that would apply to the plan. The debate was not about whether there should be a legitimate public insurance plan for Americans, but rather whether Medicare rates would apply or some larger sum would be paid to health care providers pursuant to independent negotiations.
These were the heady days of a new, presumably progressive Administration that would move in concert with the progressive leadership in both houses of Congress to drive through a public insurance option that would actually provide Americans with relief from the control too long exercised over their lives by the for-profit insurance companies.
Those days seem a lifetime away.
While the House Democrats appear to have the votes necessary to pass legislation which includes a plan meeting much of the original intent of a public insurance program, the Senate is a very different story.
With no ability to gather enough Democratic votes to make a true public option reality, Senate Democrats are now busy moving the goalposts and changing the definition of success until they produce a public option so unrecognizable that Ronald Reagan would vote for it.
“It’s a tried-and-true legislative strategy for getting everyone to ‘yes,’ ” said a Democratic strategist familiar with congressional leadership strategy. “Narrow your differences by broadening the definition of what constitutes success.”
If you have any doubt as to what the Democrats have in mind, just tune into what Sen. Harry Reid, Democratic Majority Leader, has been telling us. In vague, mysterious pronouncements, Reid suggests that the public option is “in the eye of the beholder” or that the words ‘public option’ is a “relative term.”
Relative to what? If you failed to understand that these words are code for “we’ll see what we can get away with and call it a public option”, you would be left to scratch your head, wondering what in the world Reid is talking about.
So, then, what exactly does pass for a public option these days?
First we had Republican Senator Olympia Snowe’s notion of a “trigger” mechanism that would bring a public option into existence sometime in the future should the private insurance companies fail to behave themselves. The idea generated a bit of interest for a short while until it appeared clear that the votes wouldn’t be there. Now, the concept is kicking around somewhere in the background as new ideas, with even less impact, come for the fore.
The flavor of the week comes from Sen. Tom Carper, the latest Dem. to insert himself into the center of the debate. Carper’s idea is to allow each state the option to create a public government insurance program either by starting up a new plan, on a state level, or allowing anyone in the state to join the existing state employees health program.
While the state governments have always been free to do this, the Carper plan would have the federal government provide start-up money to states who ‘opt-in’ so long as the federal government deems the state’s plan to be competing on a level playing field with private insurers and can prove that their plan is actuarially sound.
This idea has gained the interest of the more conservative Democrats, like Sen. Ben Nelson, but failed to fully satisfy the more progressive members of the Democratic caucus.
What have the progressives suggested?
Rather than allowing the states to opt-in and accept some federal money to launch their own public insurance program, the Senate progressives are proposing an ‘opt-out’ plan where the federal government would set up the public insurance plan but each state would have the right to opt-out of the plan and leave things as they are.
The bottom line on this is that the debate has left the realm of a public insurance option available to all Americans and has shifted to a discussion over whether states, operating their own programs in lieu of the federal government, opt-in or opt-out.
Either way, if you happen to live in a state where your government has ideological problems with a public option, you aren’t going to get it.
Still, the Senate Democrats wish us to believe that this idea will, somehow, constitute a public insurance option. Sen. Dick Durbin, an early and vocal supporter of a ‘real’ public option, has indicated that he would be “inclined positively” to view the inclusion of the Carper proposal as fulfilling the promise of a public option. Word is that a large number of Senate Dems. are also preparing to support this approach and declare victory.
Maybe it is a victory – if you happen to live in a more progressive state prepared to create their own public plan or opt into a federal public plan. But if you happen to live in a less progressive state, say, one with a Republican governor, I’m afraid your choices will be to accept things the way they are or pack up and move to New York.
Is this really a public insurance option for all Americans?
To quote the words of Barack Obama when comparing John McCain’s policies to those of the Bush administration, “You can wrap up an old fish in a piece of paper and call it change. It’s still going to stink after eight years.”
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Rick I’ve been giving this issue some thought over the past few days, which of these compromises I could live with. More and more I’m coming down on the side of “opt out”. In the first place why should we in the blue states have to wait just because people in the red states keep voting against their own interests? Secondly, the opt out compromise could prove to be windfall for the Dems. As insurance rates continue to climb and more people find themselves without coverage in the red states let the GOP governors justify before the electorate why they refuse to allow their states to enroll in “Obama’s socialist takeover of health care”.
maybe. but you have to admit this is a long way from a real public option and is pretty unfair. If you happen to live in Tennessee, and you want to participate, is it fair that you don’t get too because people voted for a republican government.
In response to another comment. See in context »While I understand that this could be helpful on a political note, don’t you think it kind of sucks to play politics with people’s health and lives? Aren’t you kind of doing what you dislike the GOP for doing? You’ll be happy in New York where the plan would be adopted but others will be suffering in other states, This isn’t right. Period.
Of course it’s unfair Rick but it’s not of my doing. But by that rational isn’t it just as unfair to expect the citizens of NY to wait simply because the “god-guns-gays” crowd are more interested in bringing down this black president instead of fixing our health care problems? Fairness is a two edged sword Rick, it cuts both ways. I see no reason why the rest of the nation should be held hostage by the haters.
In response to another comment. See in context »It strikes me that the inequity of some state governors saying “no” to a public option would last only one election cycle … How easy would it be for anyone running against an incumbent to say “cheaper, better”? If this version of health insurance reform happens, I’ll view it (caveats aside) as early adopters vs the laggards. Isn’t it always thus with innovation?
Maybe. But if there is even one person in a red state who wants this coverage while the rest of his state may not, shouldn’t he or she be entitled to it if people in New York are entitled to it?
In response to another comment. See in context »Is there some way to allow individuals in “NO” states to opt into the public option pool of another state? What but a “YES” state’s own regulations would keep it from including any out-of-state individual from jumping into the pool? Opening insurance to across-state-lines subscriptions would facilitate this kind of activity, wouldn’t it?
In response to another comment. See in context »Kind of a different issue on the crossing state lines thing. More than likely, states would effectuate such a plan by opening their state employees health care program to other state residents. This would become pretty unmanageable if the states were to allow residents from other states to participate. It would also go against the purpose of the federal law. So, I think it is highly unlikely that a resident in Kentucky could sign up in California. Also keep in mind that most coverage programs only involve providers in the state where the coverage originates with the exception of emergencies which occur when you are out of state. Thus, that fellow in Kentucky who gets coverage in California would have to travel to California whenever he wants to see a doctor, unless it is an emergency.
In response to another comment. See in context »Guys, in every single comment here there are two presumptions. (1) The federal liberal plan is better than any other plan, and (2) The federal government has some sort of right to trump all state laws, regardless of the fact that a majority of the people in a particular state may not want it.
These are the hallmarks of liberal nanny-state arrogance imposing what they “know” is best on the rest of us. Those of us who disagree are simply ignorant rubes who should listen to their betters.
This country was founded on a limited federal government with a finite set of enumerated powers. All powers not specifically set forth in the Constitution were left to the states. The reason for this is that the Framers believed that liberty and freedom were maximized if people governed themselves primarily at the state and local level. The idea is that we have 50 democratic laboratories where people decide what laws they should live under. This, by definition, will mean more people will be living under laws that they deem fair and just.
When Nancy Pelosi wants to impose San Francisco values on the rest of us, you can see how well that is being received. Each state is designed to be a reflection of the values of its citizens. You don’t have to like the way Mississippi conducts itself and I don’t have to like California’s way of doing business, but each of those states is best run by its own people. You are not supposed to like the way a lot of states operate. But you are free to go to whichever one you do like. To impose a one-size fits all federal health care plan is not only unconstitutional, it is undemocratic. The ability to allow the states to make their own laws is like a pressure valve. The more you limit personal freedom and liberty from Washington, the more the people will become disgruntled at their powerlessness and you begin to sow the seeds of widespread discontent, which can lead to something much more dangerous.
“The idea is that we have 50 democratic laboratories where people decide what laws they should live under. This, by definition, will mean more people will be living under laws that they deem fair and just.”
Not exactly true, especially since ratification of the 14th. You’re repeated clinging to the 10th just doesn’t stand up to historical muster. Also your repeated stating that if it’s not in the Constitution the fed is prohibiting in engaging in certain activities doesn’t hold up either.
In response to another comment. See in context »Bill – again, you are trying to insert your interpretation of what the founders intended as the final word. You look pretty young to me, so I’m guessing you were not there.
For starters, there is little evidence to reveal that founders intended the states to operate as 50 democratic laboratories. While I have always liked and supported that approach, we should not credit the concept where it does not belong.
I do agree that the nation was founded on the idea of limited federal government, however we know a few things about this, historically. First, not all the founders and early leaders of the nation saw it this way nor interpreted the Constitution this way. Some did…some didn’t. Secondly, as the experiment has progressed, we have found that this doesn’t always serve the best interests of the people and that there is, according to numerous incarnations of the Supreme Court, room in the Constitution to allow variances from a concept that was never intended as an “off limits” rule.
I know we would disagree on whether the Constitution was created to be a static “bible” of American democracy or a living, breathing instrument. I suspect you would see it more as the first while I the second. Either way, there have been times in our history where the federal approach has better served the people. Could there be social security on a state by state basis? Unlikely. Yet this federal program has greatly improved the lives of our elderly, a responsibility any great nation should honor. Doesn’t health care fall into that category? Clearly, the founders did not intend health care to be a right – it is a privilege. But what is wrong with a wealthy nation using its collective power and wealth to improve the lives of its citizens.
With all respect, I think the problem you run into is your focus on ideology blinds to the needs of the humans you believe you are protecting. I respect the fact that you believe that you are protecting the rights of the individual – and I believe you are sincere. But it doesn’t necessarily follow that protecting individual rights is inconsistent with providing other benefits to Americans.
All that said, you’ve kind of gone off point. Tell us why you think a real public option is such a bad thing for Americans?
In response to another comment. See in context »You’ve made it sound as if the Dems were making up this “option” thing from scratch, when you know that we have all the rest of the developed world, and a U.S. state or two as well, to refer to for what works and what doesn’t in health care and health insurance.
What I see is that Washington has left it to the states to do as they will for decades now. And still tens of thousands of our citizens are dying because of lack of health insurance. I know that can’t be okay with you, even if they are dying Constitutionally. The people are weeping, Mr Dupray …
In response to another comment. See in context »Brian, we already went round and round with this in another post. I said then that you (respectfully) have no frickin’ idea what you are talking about. You have cited no authority for your 14th Amendment argument. I am not going to argue the Constitution with you if you cannot come up with a Constitutional argument.
I have laid out in several comments and posts exactly why a piece of legislation is Constitutional or not. My argument is always based on the language of the Constitution and the jurisprudence behind it.
If you would like to do the same, I would be happy to discuss it with you.
You have done exactly that. But as I have noted in some of your other posts, you lay out your Constitutional arguments as “givens” when you and I both no that there is no such thing. I do wish you would more honestly present your arguments as one side of the argument. You might have more influence over people like Brian if you didn’t try to fool them into believing that your statements of Con. Law are absolutely the only interpretation when you know otherwise.
In response to another comment. See in context »“You might have more influence over people like Brian”
Don’t bet the vacation home on that one Rick!
In response to another comment. See in context »In the last post we went over this I sited several legal cases where the SC ruled against your understanding of the 10th. Not surprisingly you chose to ignore it. Bottom line, you’re wrong, and if think this is any court is going to rule against the fed establishing a national health care program I suggest (respectfully of course) you demand a refund on your law school tuition.
In response to another comment. See in context »[...] Senate Dems. moving the goal posts on the public option [...]
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