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Rob Kailey is a working schmuck with no ties or affiliations to any governmental or political organizations, save those of sympathy.

The Difference Between MassCare and MaxCare

by: Matt Singer

Wed Mar 04, 2009 at 08:34:09 AM MST


Max Baucus has outlined an aggressive timeline to get a health care bill to the floor of the U.S. Senate -- his aim is to have one by early or mid-Summer. That's faster than what earlier speculation I had heard was shooting for.

In Mike Dennison's writeup this morning, he notes, correctly, that the Massachusetts plan that is similar to Max's plan has not controlled costs as much as it wanted to -- with attendant concerns for individuals, business owners, and taxpayers.

But there's a meaningful difference between Max Baucus's plan and the Massachusetts plan: Max Baucus's plan contains a public health insurance option. There should, of course, be a difference between the plans. Mitt Romney was Governor of Massachusetts when the plan passed. Barack Obama, who also supports a public health insurance option, is President of the United States.

Why is a public health insurance option so crucial? Bottom-line: it gives consumers an option besides the private insurance sector and, as such, keeps private insurance honest.

Jacob Hacker, a wickedly smart individual and fierce advocate of a public health insurance option, explains the need for a public health insurance option vis a vis constraining health care costs.

Basically, though, we need to get past what I'll call the Massachusetts plan (only private insurance) and the single-payer plan (only public insurance) and look at hybrids that combine the choice and competition of Massachusetts with the accountability and cost-containment of single-payer.

Fortunately, there is a plan out there with those features. It was drafted by our Senator.

Matt Singer :: The Difference Between MassCare and MaxCare
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"... our Senator," says Matt. "Unfortunately," say I. (0.00 / 0)
Sorry, Max -- as long as you keep saying "everything is on the table" and then go on to say "except for single-payer," you sure as hell won't get my support.

Do you want to be at the table or on the menu? (0.00 / 0)
And is single-payer so important that taking yourself out of the discussion on principle is the best answer?

How does that actually move us closer to your vision?

Decisions get made by the people who show up. I'm gonna show up.


[ Parent ]
At the table? (0.00 / 0)
Only if it's the little kids table in the back room on thanksgiving--out of sight out of mind with nobody paying attention to you.

Max may be doing what he thinks is the right thing, and his career legacy is on the ropes here. But as long as he turns a deaf ear to the concerns of the single-payer crowd, he's just spouting rhetoric with his "everything is on the table" claims.

Pete is right. Max needs to be pressured by Montanans to open up the discussion. And not supporting Max doesn't mean we're not "showing up." And showing up doesn't necessarily mean getting on the Max "me too" bandwagon.

There's a reason why he has been nicknamed "Senator Gumby" all of these years. And it ain't because he's a man of principle willing to stand up to monied lobbyists. Which way's the wind blowing today, Max?

And I still don't know why I should sit down and work with Max, when I don't believe that it will bring meaningful health care access any closer to my grasp. As long as he is going to involve the IRS to enforce a mandate, and subsidize coverage through tax credits, I'm going to be opposed to anything he does. Bottom line: as more and more people find out that the "cracks" in the new "quasi-universal" system of health care are going to be filled with financially vulnerable people, then the opposition will get a lot noisier.

If universal doesn't = ALL (with no exceptions), then I cannot get behind it.  


[ Parent ]
So you say you're at the table... (0.00 / 0)
but then say you don't know why you should sit down and work with Max.

Yelling, "My way or the highway!" while standing on the highway isn't a very effective tactic.

What table are you at and what are you doing?

I don't think I've ever told people they shouldn't support single-payer. My argument, made pretty thoroughly above, is that there's a meaningful difference between the Max plan and the Mass plan. Namely, Max's plan includes a public health insurance option. That's a huge difference. It's also something that single-payer advocates would appreciate, I would think.

A health reform bill moving with a public option is better than one moving without it, no? Or is your solution that we pass your plan or we pass nothing at all?


[ Parent ]
Matt, you know I'm not a "My way or the highway" (0.00 / 0)
sort of guy. But I take a principled stance on health care reform. And If Max doesn't show any inclination to work with some principles, then I'm going to work against him. I just don't know why I should spend hundreds of hours helping Max to pass a plan that isn't going to solve my, and many other millions of people's, problems.

Look, I know quite a few people who work with and around Max. And I've been communicating my concerns to them, and will continue to do so. But I'd rather work with people who have a similar starting point as I do--a principled one--and give them the support they need to provide some political traction against what I see as another "Baucus approach" [read: senator Gumby] to solving problems.

I just don't trust him to not continually cave in to the right wing in his quest for 80 mythical votes. His desire to get 21 or 22 republicans (plus however many democrats he loses) on board will water his plan down. You tell me what sort of plan those 22 republicans will support, then you'll see what Baucus' proposal will end up lookin like. Wanna work for that? I don't.

Yes, of course I applaud Max for having included a public option. That's a big step. I just happen to think he's going to blow that public option with his idea of using the IRS to enforce a mandate, and using tax credits for subsidies, and an as yet unknown enforcement penalty.

If Max would drop the IRS out of the picture, and go with auto enrollment with no mandate or penalties, then I'd probably work to improve his ideas, instead of continually railing against him. Bringing the IRS into the mix is a guarantee that millions of people will not be able to participate in his public plan. And that just isn't right.  


[ Parent ]
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