We've got the public option...now what?

Wyden and Merkley are working to open up the exchanges (1.33 / 3)

This isn't a move without controversy. Opening the exchanges and, with them, the public option to large employers and to employees of large employers raises big concerns about cost-shifting within companies. There's a reason both businesses and labor eye it very warily.

That's not to say that it is a terrible idea or even a bad one. It does mean that figuring out how to make this work through some reinsurance is probably necessary so that risk doesn't get improperly distributed.

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by: Matt Singer @ Tue Oct 27, 2009 at 18:33:59 PM UTC

I think you missed the point of Klein's article... (1.33 / 3)

that you really cannot reform and preserve the same system at the same time. You've been a proponent all along of minimal disruption to existing systems, from your original statements to me that moving to single payer is too disruptive, and therefor unacceptable. Which means that your reform goals are going to be necessarily limited.

There are those of us who would rather shake up the system by destabilizing it and allowing people the choice to move to a better system.

And this whole discussion really points back to why ditching the whole current system in favor of building a new system that works from end-to-end is preferable to most progressives and single-payer supporters.

Rep. Weiner says it well. The current legislative approach makes a difficult system more complex and unwieldy. Which is antithetical to what reform should really be, which is to simplify and unify.

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by: JC @ Tue Oct 27, 2009 at 19:41:09 PM UTC

[ Parent ]

But building a new system on day one really isn't (1.33 / 3)

preferable to most Americans.

I'm not opposing the Wyden or Merkley amendments at this point. I don't think I've said that they should be opposed. I'm saying that some of the opposition comes from genuinely progressive quarters.

Of course, I realize that sometimes I'm alone in comments here in thinking that labor unions, which gave us the 40 hour work week, living wages, meaningful health benefits (for those that have them), and dignity in the workplace, are progressive institutions.

There's no doubt in my mind that allowing more people to make the shift to the exchanges and, as a result, to the public option would strengthen the public option and turn it into a more meaningful competitor. This would also do a lot to create a much stronger opportunity down the line for single-payer or near-single-payer if you believe, as I do, that the public option will favorably compete with the private sector.

But to make that work, we've got to figure out how to reinsure risk pools so that this system doesn't trap sicker and older individuals in bankrupting ERISA plans. This isn't a bullshit complaint. It is a real concern.

So let's address the concerns, please, rather than telling me that I don't understand. Burning down the world to recreate it anew is often enticing. But it is also really fucking hard. More thought, fewer pitchforks.

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by: Matt Singer @ Tue Oct 27, 2009 at 20:08:28 PM UTC

[ Parent ]

The move to single payer (1.33 / 3)

was a 15-year phased move, not a "day one" nuclear bomb. We've had that argument many times over. And I don't carry a pitchfork to my single payer rallies.

Likewise this new system, however it shakes out, most likely won't do anything for 4 years. During which time 45,000 people per year will die prematurely from lack of insurance. And the naysayers and the voters will look at the do-nothing in the near-term nature of the current bills and vote accordingly at the polls (politician: "but by 2019, we'll have 94% coverage...". Voter: "I'll be dead by then".).

Some people say you have to tackle costs first. You're trying to figure out how to reinsure risk pools. My concern is that people--tax paying citizens, mostly--don't die needless deaths from being uninsured. Obama has hinted that something needs to be done about this immediately, but I have yet to see a mechanism or a discussion about this emerge.

And I didn't tell you you didn't understand. I'm sure you understand most of this well enough. I said you missed the point of Klein's article, which was to 1) to tell Weiner he was right, and 2) to tell him that he was confused. Going along with the theme of Klein's blog, I'd say Klein's suppositions about Weiner were likewise mutually exclusive. A confused person isn't often right.

Well, I don't know about you or anybody else, but I have found Rep. Weiner to be one of the clearest, most well-spoken and informed proponents of single payer (and willing to compromise for a strong public option). He lays out the conundrum of of trying to construct policy with mutually exclusive goals. Something is going to fail. You've picked up on one such failure. There are many others.

This is the argument that I am hearing from you, correct me if I'm wrong (you're a little unclear). If you preserve risk pools within employee-based insurance, you prevent enough people from moving to a public option and creating the needed scale to make it work. Conversely, if you do not prevent transfer, employers will get stuck with sicker, and more expensive employees, and they'll lower benefits? Or, are you talking about beefing up state plans like Montana's MCHA? If you want to debate this, why don't you lay out your arguments more clearly, and not shroud them in a bunch of other flak?

But as to your argument about unions being progressive institutions, if you mean that preservation of union-gained health benefits means we can't move to a single-payer system, or a strong public option, then I think you've got it wrong. Unions are more concerned (or should be) with the welfare of their members--be it already won benefits (or transitioning to a public option with equal benefits), or building a strong single payer health care system whereby American companies can compete in a global market where all of our competitors have some form of single-payer health care. Employer-mandated and/or provided health insurance is an anachronism whose time has come. Replace it within something as robust and the unions will follow.

In any case, I've been a member of several unions in the past, and worked for unions, so I'd appreciate a little less condescension about your not so seeming superior solitary understanding of unions here.

Methinks that if you think that unions and progressives are at odds here, that you need to spend some time working with unions to get them on the same page. Unions are weak right now, and will remain weak as long as they are divided on health care. And this the republicans love. Republicans have worked long and hard to weaken the unions and/or to drive them to the right. And with this tactic, they seemed to have driven people like you with them.

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by: JC @ Tue Oct 27, 2009 at 21:18:28 PM UTC

[ Parent ]

So I guess we got Tim Adams (4.00 / 1)

and his alter ego "justice" troll rating Matt's and my comments out of existence here. I don't believe that anything either of us wrote was trolling, so I guess it is up to the owners of this site to sort it out to see where we go from here..

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by: JC @ Wed Oct 28, 2009 at 01:45:46 AM UTC

working on it... (0.00 / 0)

I banned Tim and his IP address, and am trying rescue the comments...

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by: Jay Stevens @ Wed Oct 28, 2009 at 13:56:41 PM UTC

[ Parent ]

Actually, JC (0.00 / 0)

It was almost every comment for about 4 posts.  He was having a temper tantrum.  He left a comment that was little more than "HAHAHA", and it got troll rated out as it should have.  So he retaliated.  Apparently, problem solved.

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by: Rob Kailey @ Wed Oct 28, 2009 at 14:31:49 PM UTC

[ Parent ]

Rescued... (0.00 / 0)

...I think I got 'em all...

Dude signed up with an alternate account so he could essentially go through and randomly delete comments. I changed the rating policy so that won't happen again.

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by: Jay Stevens @ Wed Oct 28, 2009 at 16:20:41 PM UTC

[ Parent ]

Thanks Jay. (0.00 / 0)

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by: JC @ Wed Oct 28, 2009 at 18:07:32 PM UTC

[ Parent ]

I thank you as well, Jay (0.00 / 0)

However, don't you think you should tell us all what the new rating or moderation policy is?

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by: Rob Kailey @ Wed Oct 28, 2009 at 23:18:41 PM UTC

[ Parent ]