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Even though it faces an uphill battle in the Senate, look for U.S. Sen. Harry Reid's, D-Nevada, flexible public option to become part of a universal health care bill. That's because Reid's 'flex-pub' fits the federalist system of governance
(local-state-federal) practiced by the United States in that it enables states to 'opt-out' of the public option, provided they have a state-level plan for universal care and/or are complying with other federal requirements for universal health care coverage.
And, when one thinks about it, politically and operationally, a flex-public option makes a great deal of sense.
Politically, it enables a state to manage and resolve the problem of uninsured residents in its state on its own, without that state participating in a federal public health plan.
Operationally, the flex-pub accommodates the broad diversity that exists in the nation, and allows states to adapt a program to meet their unique needs. For example, New York state's health insurance needs differ markedly, in terms of case load and per person costs, from Montana's.
Further, as a colleague in public policy frequently says, "The states are great laboratories." There's much that the states and the federal government can learn from state-level administered plans in Massachusetts, and Minnesota. The states can learn about each other's 'best practices' regarding their efforts to achieve 100% insurance coverage. Lessons from these state-level laboratories will undoubtedly lead to more-efficient, less-costly public health insurance programs.
Fiscal Analysis: One can see how, politically, a flexible public option could find favor in the House/Senate conference committee: it's an appealing compromise, given the nation's ideological diversity (and divide) over how best to get to 100% coverage of its citizens.
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Reader Comments (Page 1 of 1)
10-27-2009 @ 6:06PM
Bill Thomas said...
A Two-Tier system is the practical solution. In sum, FUND BASIC HEALTH CARE WITH FEDERAL MATCHING GRANTS to more Federally Qualified Health Centers. No new insurance plan needed. Its key: competition with private insurance and among non-profit applicants. Truly, it is our Public Option.
Matching funds will come from states current programs, charities, unions, etc. Put on a sliding scale co-pay and write $5 generic prescriptions. Start a “Healthy Lifestyles” tax on junk food, tobacco, and liquor and $1/gal of gas. 50cents of hourly wages pays for part. Since many politicians have promised “no rise in taxes“, give a $500/yr refund from the gas tax that non-filers won’t get , including illegal aliens. Then, anyone can seek care.
Non-profit hospitals, clinics, and for-profit providers (who agree to terms) COMPETE FOR GRANTS, as could cities and states which opt-in. Mandates are minimal. For example, Catholic hospitals wouldn’t need to give end of life counseling or birth control, but Planned Parenthood clinics could. Doctors and clinic managers make decisions on a “Space Available” system, not by a for-profit insurance company. Normally, BHC doesn’t cover extreme cases, but add a “ Miracle Lottery” to give hope. Oregon recently used a lottery for HC insurance. There is no perfect plan, but this costs maybe $1000 per person, not $7000 per year as our “fee-for-service” private insurance system. Finally, many of the 47million UI can’t fill out paperwork. Some can‘t read and write, they are mentally ill, or too sick. They are lucky to have a ride, let alone afford care. Don’t make anyone buy insurance.
10-28-2009 @ 5:34AM
harry said...
let me see if i have this right.....a state can opt out but will have to pay anyway.... huhh---dahhh dump reid,pelosi and all their marxist friends.
10-28-2009 @ 8:40AM
Customlawnil said...
Notta good idea at all. If you think the government can effectively administer something this complicated you should seek professional help.
10-29-2009 @ 6:22PM
Byron Thomas said...
""If you think the government can effectively administer something this complicated you should seek professional help.""
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I agree with your reference to Reids plan. However, did you take a minute to read my plan? The FQHC's are one of the most popular and efficient Gov't programs, with strong Bipartisan support. They might even be able to offer you professional help.