I can hardly imagine that PA would opt out, at least not with Ed Rendell as governor, and with both senators (now) in the Democratic Party.

However, I worry about those living in red states with unenlightened leadership in their capitols.

There is speculation on other threads about this topic, that such moves by the governors in those states might mean the death throes of the Republican Party. I doubt it would be that dramatic, considering the comebacks I’ve already seen in my lifetime.

They should do what Southern states did for voting registration in decades past: for a state to “opt out” of the public option, the state’s governor has to pass an intelligence test.

We’d have 50-state-participation for sure!

:)

Yes, I fear that with Charlie Crist doing his best to win over the wingnut faction of the Republican Party in the Senate primary, he will steamroll an instantaneous Florida opt-out. My neighbors will suffer.

Breaking: Blago building balloon in backyard.

I know this website has been critical of Harry Reid in the past. So have I for that matter. But he really should be commended for what he’s doing here: taking on powerful special interests over the objections of the White House in order to deliver a health care system which puts patients before profits.

Harry Reid is doing the right thing. He should be commended. And people should always be grateful for his actions today. It was a brave and politically risky move–the kind of move that, if it succeeds, will put him in the company of great Leaders of the Senate when the history of this is written.

Can we see the actual bill and his actions leading up to passage before we enshrine him?

In my view, it’ll be a lot like the stimulus. Conservative Governors will make noise, threaten not to accept it, but once they figure out it’s good for the people of the state, accept it and trumpet it. Like Bobby Jindal bragging about a road construction project, or Rick Perry bragging about stimulus linked education spending.

Further, even in the reddest states, Democrats have some state-level power. The Governor of Oklahoma is a Democrat. The Alabama legislature is controlled by Democrats. Texas and South Carolina are the only states likely to opt out. And the chances of that are pretty slim.

I think this is his actual action. He’s making a strong stand for a public option and using what limited power he has to stand up for a public option. Whether it succeeds or not is up to the 44th President of the United States, I think.

Opt out, ugh. We can’t get anything decided in California, so maybe that’s good. Is “opt out” the compromise on “triggers”?

I agree with the folks in the earlier threat today about the “Opt Out” provision. Its just a giveaway that allows the insurance companies to make this into a 50-state, state-by-state buyout instead of one massive Federal buyout. I also believe (FWIW) that the truly Red states (like the Deep South) with Republican controlled Legislatures and Governor’s Mansions will opt out of the public option as fast as they can.

I don’t see how it will cost them any political points (they’re already opposed, and not even Federal $ has changed their tune lately – just look at the stimulus for details) since their base is rabid about not having “Government Run Healthcare.” Heck, AZ is already moving to stop government run healthcare despite that it would kill Medicare, Medicaid and other popular programs, but people are signing as fast as they can.

I don’t see why this is so hard to do.

1) Medicare for All. Fix the reimbursement rates where necessary (some reimbursement rates ARE too low), make the premiums pay for the coverage.

2) Repeal the insurance companies’ anti-trust exemptions. There’s no valid excuse for keeping this on the books.

3) Tie insurance company executives’ salaries to the number of subscribers they have. That way, if they want more money, they have to find a way to get and keep more subscribers.

4) Regulate the loss ratio. Limit what the can make in profits from peoples’ illnesses and injuries to percentages that are reasonable.

I’m sure there’s more (like Single Payer!), but this seems to be the floor for workable reform. Anything less that this is a waste of time. The only reasons it is hard to accomplish this is that it would hamper the ability of vultures to suck the lifeblood out of our country.

How about adding an amendment that allows residents and small businesses to purchase health insurance across state lines. Everyone has access to a PO.

Let’s see Republicans vote against their main talking point. A few DINOs may come along for the ride.

It’s important to remember that the PO with or without trigger or opt-out will still be delayed until 2013 and have limited availability.

What is the history of the opt-out insertion? Time to start digging into these stories and less quoting of the papers and press releases.

I can live with on opt-out if it requires state voter referenda for opt-out. Then almost every state would have a public option. If Reid wimps out and goes for a trigger, that would be very bad. Hope Pelosi and House have made it clear they will have hard time voting for a reform with no definite start date for a public option.

If there is an opt-out without a referendum for opt-out, then I think either one of two things would happen. GOP controlled state governments would cave to prevent being creamed in next election, and opt-out would amount to nothing. Or, they would not cave and get creamed in the next election. Problem with opt-out is that people would die needlessly in states that opted out.

I think any reform this year will be partial halfway house. Need public option for everyone who wants it, and strict Swiss style federal health insurance regulation of private insurance. Anything else is weak reform that will start to unravel within a few years.

Snowe is on record in interview saying that what she really wants is more pointless delay. Will that be enough for the gazillion dimension chess masters in the WH to forget about their transparent and meaningless bipartisan fig-leaf? I hope so.

Sure but wouldn’t it have been nice to have a Majority Leader who:

- Didn’t have a 35% favorability rating going into tough negotiations
- Didn’t have to go to the Wizard to ask for Courage

Opt out is not good enough. Gotta keep the pressure on…

Sorry but you seem to have a novel threshold for bravery.

You deem this person brave because when faced with a sound measure that is supported by upwards of 70% of the public, physicians, nurses and which in the bargain is cheaper while being opposed only by the industry that is profiting from the abscence of such a measure, he is supporting a watered down version of this measure.

Wow. Where does Neville Chamberlain fit in on this scale, he did after all hold the German army in abeyance for a while. That took some guts. Or Obama for panicking and waiting all of 12 minutes before transferring the public’s savings to Banks, he did after all wait a little bit.

Reid is spineless at best. A man with convictions acts on those convictions forcefully and persistently. I think that such a man whether a politician or shoemaker deserves to be considered brave.

I think any reform this year will be partial halfway house. Need public option for everyone who wants it, and strict Swiss style federal health insurance regulation of private insurance. Anything else is weak reform that will start to unravel within a few years.

if we could have swiss style federal health insurance regulation, there would be no need for a po (i’ll leave aside for the moment that the success of a po depends on adequate regulation). however, given our gov’s current distain for regulation, especially of the FIRE sector, imo single payer is actually more politically feasible than swiss style regulation. if i didn’t think that regulation was such a difficult proposition with our lobbyist owned gov, i wouldn’t be such a single payer fanatic. at least the fight for single payer is out in the open where public mobilization can have a voice. relying on regulation puts the fight behind close doors, where the lobbyists are strongest and we are at our weakest.

no easy solution, and wishful thinking doesn’t change that.

my 2 cents. ymmv.

Karen, I too am from PA. I mainly agree with you. However, I am concerned a tad. Yes, we have a good democrat governor in Rendell. And both of my Senators and my Rep all endorse a public option. But the Republicans are the majority in our State house. That’s why we had such a long tough time getting our budget passed. Now, I do not know if our Reps in Washington or the Reps in Harrisburg will be making the opt-out decision. I sure hope it’s not the ones in Harrisburg or we are screwed!

Amen!! Fool me once, etc.

Bloomberg is claiming confirmation on Opt Out for Reid

Bah. I’m eligible for Medicare in nine months. My wife’s already on it, $96/MONTH, KIDDIES! And better than any basic health plan out there. This public option bullshit is just that, bullshit. They should make Medicare available to all, period.

I say no Medicare for all? — then NO BILL! Anything less is just a gift to the evil bastards who sell you completely unnecessary and useless insurance policies. And BTW, if you’re happy with yours, then I submit you’ve never been really sick, and your premiums are going to rise like a rocket no matter what Harry Reid does. All of this Congressional and WH blather amounts to compromising with evil. You know what that means.

I think you are probably right. I will withhold judgement until I see the details.

I think if America does get a public option we should give him as much credit as we would have given him blame if we had not gotten it.

limited power ?
the guy is the 3rd most powerful elected official in the country.

and you aren’t saying he’s going with PO because it’s the right and decent thing to do are ya ?

’cause then you would have to ignore the rather large and highly influential constituency: L-A-B-O-R telling the Majority Leader, no PO, no dice

this is political expediency, not decency

I am not a mind reader. I judge politicans on their actions.

Selice for the sake of open debate and just to humor me, what say you put some meat on the bones to the extent you are able since you have a good deal of access to actuals numbers. I fully agree beforehand that the PO is only a transitional plan toward a SP.

The difference between the cost savings among the PO and the private plan is the immediate threshold question at issue here. It goes to the inherent ability of each plan to operate at a lower cost while achieving the same level of care for all subscribers.

When the PO sets about to determine the right premium it will take a given community and divide it into the 2 genders and age quantiles between 18 and 65 years of age (lets say 10 year intervals) or roughly 4 quantiles, giving 8 groups all together. Then it will take a random statistically representative cohort and determine the likely yearly health related cost for each group and extrapolate that cost to the entire community. It will then set actuarial tables for the premiums of each of the 8 groups.

Now when a randomly chosen representative cohort is chosen it must contain for each of the 8 groups more relatively healthy than relatively sick people with accordingly associated health costs

How the process differs for a private plan is that within these same 8 groups they will focus their efforts on insuring the least costly persons. With those left unpurused and uninsured then going to the PO plan.

Now some confounding variables are that the PO plan will offer Medicare + 5% rates and assesses no profit which allows for lower general costs. It also has lower managerial costs and charges. These allow for lower premiums and costs to the enrollee.

The private plan has associated higher profit and managerial costs and other charges which result in higher cost to the enrollee.

Now in order to determine whether in fact the PO is viable and preferable to the private plan one must do the math, while taking all these variables into account. Can you offer some rough estimates of what these comparative results would be?

Hi Selice,

For the sake of open debate and just to humor me, what say you put some meat on the bones to the extent you are able since you have a good deal of access to actuals numbers. I fully agree beforehand that the PO is only a transitional plan toward a SP.

The difference between the cost savings among the PO and the private plan is the immediate threshold question at issue here. It goes to the inherent ability of each plan to operate at a lower cost while achieving the same level of care for all subscribers.

When the PO sets about to determine the right premium it will take a given community and divide it into the 2 genders and age quantiles between 18 and 65 years of age (lets say 10 year intervals) or roughly 4 quantiles, giving 8 groups all together. Then it will take a random statistically representative cohort and determine the likely yearly health related cost for each group and extrapolate that cost to the entire community. It will then set actuarial tables for the premiums of each of the 8 groups.

Now when a randomly chosen representative cohort is chosen it must contain for each of the 8 groups more relatively healthy than relatively sick people with accordingly associated health costs

How the process differs for a private plan is that within these same 8 groups they will focus their efforts on insuring the least costly persons. With those left unpurused and uninsured then going to the PO plan.

Now some confounding variables are that the PO plan will offer Medicare + 5% rates and assesses no profit which allows for lower general costs. It also has lower managerial costs and charges. These allow for lower premiums and costs to the enrollee.

The private plan has associated higher profit and managerial costs and other charges which result in higher cost to the enrollee.

Now in order to determine whether in fact the PO is viable and preferable to the private plan one must do the math, while taking all these variables into account. Can you offer some rough estimates of what these comparative results would be?