Public Option Re-Dead
The public option appears to be dead again, but odds are it will not rest in peace.
As I’ve mentioned before, the weak version of the public option was not likely to be a big policy success. Its allure was largely that it would serve as a placeholder for future structural improvements that could really make a difference, such as pegging reimbursement to Medicare rates. In fairness, the public option might have provided better access and benefits than its private competitors. But even its advantages might have become liabilities if the PO winded up underperforming on cost control, as CBO analysis suggested it probably would, because of the likelihood that the public plan would serve a higher-risk population than would its competitors.
Against limited real rewards on the policy side, the public option presents serious risks on the politics side. Even if the leadership could drum up the votes for the public option, collateral damage from that discussion could imperil the whole bill. Again. Better to stick it in a drawer and come back to it when we’ve put the other reforms firmly in place.
Reviving the Medicare buy-in is another possibility. It would be much simpler to implement; the politics are not quite as perilous; it could easily pass muster under the reconciliation process; it would be a much more effective policy in terms of serving populations in need of health insurance; and it would make more direct progress toward the rational, universal system so desired by the left. But it would almost certainly stoke the opposition and hang conservative, red-state Democrats out to dry. Right now, Democrats need to dig deep, find some discipline, and . . . you know what’s coming . . . pass the damn bill.
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Why not have a simple Medicare buy-in for all, sliding scale based on income, continue payroll tax but without a cut-off and at a lower rate to keep the buy-in cost low; those without means for any buy-in get government subsidy. Private insurers can give better service/coverage beyond Medicare or whatever they think the customers will buy from them with whatever conditions they choose.
http://www.healthcare-now.org/sidewalk/
Feb 25: Sidewalk Summit for Medicare for All!
NEW LOCATION: H St NW and Vermont Ave NW, Washington, DC
http://www.healthcare-now.org/hr-676/
The United States National Health Care Act, H.R. 676