Tuesday, October 13, 2009

Health Care Doomsday Is Here!

Oh man, guys, at 2pm today the horrible Senate goblins will vote on the goddamn Senate Finance Bill, which is exciting for Internet people but not so much for the other 98% of folks. The Democrats are convinced they have the votes to get it out of committee, but all eyes are on President Olympia Snowe to see if she will in fact vote with the Democrats (who cares!?!?!) or if she was lying the whole time (so what?!?!?!)

OH MY GOD THE INTERNET MOVES SO FAST! I was typing that last sentence, and then this happened:

Snowe Will Vote “Yes” on Baucus Bill in Committee

But, she says that her "vote today is only her vote today," so, uh, look for a book of Zen sayings by members of the Senate next Spring. Once the bill gets voted on and such, I'll try to find what smart people are saying about it and report that stuff here.

For now, the fate of the Public Option is still up in the air. I've been arguing for a while now that what the President ultimately signs will contain something called a Public Option, so Rahm could get his "win," but whether or not that "win" was good for anybody other than partisan hacks remained to be seen. As a lifelong Chicago Cubs fan, I've learned not to put any faith in a team down the home stretch, so I'll refrain from doing that here.

There are still two very potent weapons that can be leveled against the public option: the state "opt-out" plan, and the even worse Olympia Snowe (Rahm Emmanuel) "trigger" plan.

The trigger plan goes like this. States would have fail safes (triggers) built into their reform plans, so if health coverage got TOO INSANELY AWFUL then a public option would be "triggered." The problems with this plan are obvious and numerous. For one thing, nationwide health coverage has already reached a catastrophic point, so waiting another 5 or so years to create a public option is absurd. For another, no one has clearly defined what the mechanisms would be to create a public option--ie, what exactly would cause the trigger to get pulled, and what would the bullet be aimed at.

The state opt-out plan goes like this. States could, on an individual basis, decide not to participate in a federally provided health care program. In theory, either a Republican Governor, a Republican legislature, or both, would have to decide to opt-out. On the wonkish side of things, this hurts everybody, because if, say, Texas decides to opt-out, then the country loses cost-lowering leverage because it loses all the purchasing power of Texas. More importantly, on a moral level, the goal of universal health coverage is to make it universal, not just for "Blue State" residents.

The opt-out plan would weaken a Public Option immensely. The trigger plan will effectively kill it. The reason that the bill is not worse than it is can be directly linked to the work of progressives putting pressure on the House, and that pressure moving up to the Senate. There is still plenty of time for the insurance companies to kill this thing, though. Updates to come, as they show up.


Breukellen said...

It occurs to me that at least with an opt-out plan, when red staters see what they are missing they may demand the same. Or is this idea pitifully naive?

John Knefel said...

Yeah, that's the idea that progressives are kind of getting behind.

I worry, though, that people in South Dakota might not actually realize that Nebraskans (or whatever) have a substantially better deal. Or is that being too pessimistic?