Oh well. Health insurance reform — best thing since sliced bread. Uh-huh.

Just thinking out loud… Could MA organize a state co-op that buys into Federal Medicare as an option?

I know, crazy.

In theory any state can basically create any public company or corporation they want. North Dakota has its own bank for example. If Mass wanted to they could create a state run public option. Instead they insist on the need for middlemen.

So, the state could create the competitive market? I’ll hope people in MA are just fed up enough with the private insurance co’s to rally the state to set up a state public option.

Watch the insurance co’s quake when the state , through the action of a PO, says, “Fine walk out, don’t be competitive.”

Because if MA can pull off a PO, the nation will be watching.

Hope so do but don’t seem to see any action on the part of Mass legislature to move on the issue.

The Corporate Socialist aren’t about to allow Mass. to slide into the swamp of actual Socialism where real people’s needs are actually considered. The profits of the Ins. mafia must be protected against the desire of some to give the suckers( I mean the citizens an even break). Such behavior must be crushed where ever it rears it’s ugly head. In other words don’t hold your breath waiting for a PO in this country it’s not ever happening.

I wonder what the Massachusetts system will look like in 2014?

Lesson from MA: when the health insurance corporations playing in the exchange butt heads with the government over rates, the corporations win. They merely, together, sell outside of the exchange, as they choose, until they get their way on the exchange. Basically, if the corporate sellers of insurance decide they don’t like the regulatory system, they don’t have to play in it. The imbalance is, that, even if the insurance consumers don’t want to buy insurance, they still have to.

And, clearly, if 90%+ of a state market is controlled by a monopolizing company, then the entire idea of the exchange is pretty much meaningless if there is no public alternative. If the state regulator decides to expel the monopolizer from the exchange, then, really, all the state regulator is doing is expelling the exchange from the state market.

Maybe Mass. could get Obama to wag his finger at the Insurance Company execs? Tell them how bad they are?

Then again, I suppose it’s a fine line between being a “Savvy Businessman” and being “bad”. Or is there a line at all?

Maybe he could even threaten them with a “Credit Card Reform Bill” of their own? Oh wait, that would only enocurage them.

Thanks Obama, you chickenshit sleaze.

the new federal bill just signed into law will prevent that from occurring for some time. States are not allowed to create their own “public option” under this new bill. Insurers demanded that provision be included. Oops.

Insurance Commissioner Joseph G. Murphy said he has asked insurers to quote rates for new coverage through the state’s Health Connector website by week’s end, and reminded them that they are required by law to do so. The new quotes would use base rates set last year, plus additional factors such as the age and size of a company’s workforce, Murphy said.

…

Murphy asked Connector officials to remove the posted higher rates and request that insurers recalculate them in light of the rejections.

Are they refusing to offer plans, or is this a question of getting the databases dialed in? I used to work in online pricing, there can be substantial delay if you’re doing overnight pushes through multiple systems…

There is no provision stopping states from creating their own public companies. If there is such a provision in the bill please name it.

let me do my reasearch then…

um, does this mean that celticare might be the big winner here?

When the Harvard Med Docs are not getting paid, let me tell you, the state will move on it pronto.

My brother’s practice has taken a big hit.(BTW not Harvard Med.)

Does MA want to be the state with the highest number of unemployed doctors? Talk about a hit to the tax base for the state.

I am surprised Mass General has not stepped up to address this.

Jon- perhaps a PO with MANDATORY OPEN ACCOUNTING (that would be real accounting following the same rules as private industry — the only way to keep the insurers fully accountable) —

would be a way to really show how much health care really costs.

Problem would be if government PO ran with perpetual losses when held to same standards as private industry.

Never could have seen that coming. /s

http://fdlaction.firedoglake.com/2010/03/08/how-to-get-a-state-single-payer-opt-out-as-part-of-reconciliation/

The current Senate health care bill has a provision (Section 1332. Waiver for State Innovation (PDF)) that will allow states to opt out of the current reform structure if they can provide the same level of care for the same amount or cheaper with a different plan. Given how poorly designed the Senate bill is, that shouldn’t be hard on a policy level. In theory, this could allow for state-based single payer plans, and reconciliation could deal with two major problems with the provision.

Delayed Until 2017

The first problem is the date of implementation. States can’t apply for the waiver until 2017, which is completely ridiculous. There is no reason for the delay, and it would make state innovation very difficult to implement. It would first require states to go through all the work of setting up the new system of exchanges for 2014, only to turn around and try to replace it with another new system three years later.

The other big problem with the date is that 2017 would be right after Obama left office (assuming that he served two terms). Since it is very rare for one party to hold the presidency for three straight terms, it will likely be a Republican in the White House in 2017. Assume their HHS secretary would not be open to granting the waiver for a state-based single payer system, it would likely not be until 2020 or 2024 that this provision could be used for creating state single payer, and that assumes a supportive Democratic president is elected. This is completely unacceptable.

Getting Around ERISA

The other major impediment is the scope of the waiver, which I interpret to mean it can’t be used for a waiver of ERISA.

That has nothing to do with a state creating a new public company that sells health insurance.

http://www.workinglife.org/blogs/view_post.php?&post_id=2324

The only ray of light down the road to fix this, if you just deal with the Senate language, is Section 1332. Here is Bernie Sanders’ explanation:

If the Senate bill is passed, the only opportunity that states would have to move towards a single payer system would be to get a waiver from the Exchange requirements through Section 1332.[1]

Section 1332 enables a state to apply for and receive a waiver (beginning in 2017) from the requirement to operate an Exchange. In order to get such a waiver, the state would have to present an alternative plan that would provide coverage at least as comprehensive and affordable, to at least a comparable number of residents, as the federal legislation would achieve. The state plan could not increase the federal deficit.

States could apply for Section 1332 waivers for up to 5 years at a time. To do so, they would have to comply with transparency regulations in the development of the state plan and enact a law providing for state action under the plan. If the state waivers were approved, the federal government would provide the State the aggregate amount of any tax credits and cost-sharing reductions that would have been paid to residents of the State in the absence of a waiver, which may only be used for providing health insurance coverage under the state plan.

Section 1332 does not expand existing waiver authority under any existing federal health program (e.g., Medicaid, Medicare, CHIP), but it would require the Secretary to create a coordinated waiver process so that a state could submit a single application for waivers under Sec. 1332 and under any other federal health law for which waiver authority already exists.

In order for states to try a different approach without first having to set up an Exchange, the date the waivers are currently available under Section 1332 of the Senate bill would have to be changed from 2017 to 2014. Otherwise, a state seeking to innovate using a different model – including something approaching a single payer system at the state level – would first have to go through all the trouble and expense of establishing and operating an Exchange before having the opportunity to receive a waiver.

Assuming the date in section 1332 is changed, however, this provision will facilitate state efforts to set up single payer systems. If a state plan to cover everyone through an alternative model is approved, they will not be required to set up an Exchange through which private companies compete. In other words, after receiving such a waiver, states would no longer be preempted from setting up their own systems in lieu of an Exchange.

Perhaps not, but being infected with too many Republics in office will certainly stop it.

again this has nothing to do with a states ability to create public corporations that can do everything private corporations can do.

I think the term “state based public option” needs definition for us to debate its legality or practicability.

If you mean that the individual state will be able to offer a state-agency single-payer type of option (like a state’s version of medicare) then the SEction 1332 waiver DOES APPLY to that and it will require a waiting period of until 2017.

If youmean that the state can simply setup a publicly traded corporation that offers insurance as a competitor, then you are completely mislabeling that as a “public option” because it will not have any of the trappings of a state-run agency – which is what people argue gives the state the leverage needed to bring down costs and impose regulations.

Remember, this Federal bill preempts the ability of a state to regulate premiums directly. States can’t just ignore that. The exchange is the mechanism that states must use to regulate premiums. And if states try to do so outside the mode of the exchange, they are violating the federal law.

Yep – much like workman’s comp insurance.

The State of Colorado runs one, Pinnnacol, so that all business can (must actually) carry workman’s comp if they can’t/don’t want to buy from another carrier.

Weird how they can have a mandate and a publicly subsidized option, isn’t it? :)

you answered my question before I hit submit… but then I disagree with you calling a “publicly traded company” that is “owned by the state” as a viable alternative.

The concept of a public option involved a STATE AGENCY being the one that sells the product.

A state-owned publicly traded corporation is NOT the same thing as a state agency, for a multitude of reasons. And it thus has none of the enforcement or leverage of a state-agency.

The workers comp example is a good one. That is NOT what people had in mind when they were clamouring for a Public Option.

What people really wanted was a SINGLE PAYER option. A state run publicly traded company is simply going to have to compete on the exchange under the terms of the existing federal bill. That will not really solve anything.

Doesn’t the fact that multiple insurance companies are acting in unison suggest something akin to price fixing? Perhaps we should start referring to the Insurance Cartel.

Why do you think the company will be publicly traded? It will be a company owned completely by the state. Just like the bank of North Dakota.

because you said it will be a publicly owned company, just like a privately owned company. There are only two kinds of companies – publicly held companies and privately held companies (like family owned businesses).

That’s what YOU called it.

Amtrak is not a publicly traded company. Just a company owned by the federal government.

Yeah, and cartels are illegal, under our Antitrust laws. But Insurance companies are EXEMPT from those laws, remember? And the Dems decided to keep it that way.

No a public corporation can refer to one that is owned by the government. Just like a public school is owned by the government.

Show me a state that sets up one of these solely state owned insurance companies without running afoul of Section 1332 and I’ll believe you. And then explain to me how that single state-owned company (which will be required under federal law to follow the same exact rules as the other antitrust exempt behemoths) will make a difference. It will not be allowed to use tax revenue – which is a MAIN PIECE of any TRUE public option. A public option bereft of tax revenue and the regulatory power of the state (as an agency) is basically just another company. You use Amtrak and BAnkof North Dakota – both of which are companies NOT GOVERNED BY THIS LAW.

Do you realize that Amtrak and public schools are funded by TAXATION?

Do you think your hypothetical “state owned insurance company” will be?

NO. NOT ALLOWED BEFORE 2017.

the public option was not meant to get tax revenue. no public option offered in congress even the stronger Medicare buy in style ones got added tax revenue.

What? You just claimed that Medicare does not require taxation?

Do you know what the FICA witholding on your paycheck is for? Medicare.

You are trying to make your argument fit into this construct that Obama signed into law. If you think that Medicare is not funded by tax revenue, then you misunderstand the entire premise of the “public” option. It is one that is funded by a state actor, with the power to levy taxes to fund it. It then is open to ALL taxpayers as a result.

You are trying to describe a state-owned company that will get the same results without the power to tax the people it will cover.

A state-tax funded option will have to wait til 2017 to apply for a waiver from the HHS in DC to operate such a program under this new Federal law.

Could MA organize a state co-op that buys into Federal Medicare as an option?

A Co-Op could cut into the profit margin that the InsurCo’s are walking with but it still leaves us with the rising cost of the actual Health Care.

That’s a big nut to crack …

You should really read all the Healthcare posts Jon and Jane have written from, say, the beginning of March until now.

Reading all of the posts during the Fall through till March wouldn’t hurt either.

I’m talking about the medicare style public option. It was meant to pay all cost with premiums. Same with basically all public options offered in congress.

Thanks for the Update Jon

First of all, I will gladly read all your posts from march till now when I get the chance.

Secondly, I don’t know what you are trying to say when you claim that medicare was meant to pay all costs with premiums. Medicare is TAX FUNDED. I don’t think people realize that, or else we would not be debating it.

Public options are “public” because they are paid for, at least partially, out of the “PUBLIC FUNDS” – a government owned company that relies solely on market based economics and zero tax revenue is NOT anything like a state-run AGENCY That administers a public program.

What part of that do you not understand?

I am going to respond to what you write HERE AND NOW. If you have something relevant that you said in March last year, then please say it now.

You are claiming that state can setup their own medicare style option under this new law. You are peddling a dishonest statement or an ignorant one when you make that claim. The current law that was passed (which did not exist since last March, so all your comments then were hypothetical and predicated upon what kind of law would pass NOW) DOES NOT ALLOW STATES TO OPERATE A MEDICARE STYLE PLAN until they obtain a WAIVER in 2017 from the HHS.

Calling a state-owned company the same thing as MEdicare is dishonest. Medicare relies, in part, on tax revenue. State-run companies do not.

Example: AIG, right now, is a STATE RUN COMPANY that also is getting huge amounts of tax revenue in the form of bailouts. State budgets are not run the same as the FEderal Government. STATES ARE NOT ALLOWED TO RUN DEFICITS. A state that wants to setup a company that competes with other publicly traded insurance companies will be simply be a company that has to market for premium dollars, operate under FEDERAL rules for financial reserves, and operate under STATE rules for all insurance companies. And that state-run company will not have any leveraging advantage over the other multi-billion dollar competitors like Blue Cross.

The advantages that a “public” option have involve the regulatory power of the state and the purse strings of the state. BOTH ARE neutralized as leverage when youdescribe an amtrak style health insurance company that will be prohibited from using state funds to operate.

For all the readers of this blog out there who think that Medicare is funded by premiums and not by tax dollars, then I suggest you get some edumacation before you blather on about the topic.

http://www.medicare.gov/Publications/Pubs/pdf/11396.pdf

Payroll taxes paid by most employees, employers,
and people who are self-employed
Other sources, such as income taxes paid on Social Security benefits, interest earned on the trust fund investments, and Part A premiums from people who aren’t eligible for premium-free Part A

http://www.medicare.gov/Publications/Pubs/pdf/11396.pdf

The important thing to remember is that medicare exists because of payroll taxes. The BUYIN with premiums is only possible once a TAX FUNDED PUBLIC OPTION Is first available in some form.

A state can’t just create a medicare style program when its been federally preempted from doing so, and then claim that it will do it EXCLUSIVELY with premiums. Good luck charging a competitive rate.

In an escalation of the fight, almost all of the insurers in the state stopped offering new coverage on the exchange.

i don’t understand what the big deal is. i live in MA, i buy my insurance as an individual policy – before the reform, just as i do after the reform. every year i check the policy options and every year i choose not to purchase my insurance on the exchange.

i get a better policy off exchange — from the same company (bcbs) that participates on the exchange.

……

and the lack of a public option is not the problem with the MA system.

a public option as a means of competition with private insurance has never, to my knowledge, worked in the usa (probably because we don’t have the regulatory infrastructure).

no more STUPID NEOLIBERAL POLICIES that depend on false concepts of market competition.

PROGRESSIVE POLICY = SINGLE PAYER.

for a public option built on medicare infrastructure see stark’s hr 193, not the hacker/hcan proposal.

Thanks Selise. Everyone needs to read the summary below and see that most of those provisions require a GOVERNMENT AGENCY to enforce them. Organizing a corporation that simply has a single shareholder – the government, but is otherwise preempted by a federal law from using the revenues and agency-like powers of a state government is nothing like the kind of bill described below. This is how OBama fooled everyone. He deliberately put a waiting period in the bill that only expires AFTER he leaves office. So this entire debate we are having on this post is somewhat moot until after Obama’s second term is up. And then, good luck getting your state waiver under the new president.

Here is the summary of HR 193: 1/6/2009–Introduced.AmeriCare Health Care Act of 2009 – Adds a new title XXII to the Social Security Act (SSA) entitled “AmeriCare Health Benefits.” Makes all U.S. residents eligible for AmeriCare benefits, including prescription drugs and biologicals. Requires the development of an AmeriCare enrollment mechanism that includes automatic enrollment at birth and the issuance of AmeriCare cards for identification and claims processing purposes.Provides that an individual may elect not to be enrolled for benefits under AmeriCare if the individual has health benefits coverage under a group health plan at least equivalent to AmeriCare coverage.Provides the same benefits under AmeriCare as are provided under parts A (Hospital Insurance) and B (Supplementary Medical Insurance) of SSA title XVIII (Medicare).Provides additional AmeriCare coverage to children under age 24, pregnant women, and low-income individuals. Establishes the AmeriCare Trust Fund.Requires the modification of Medicaid (SSA title XIX), SCHIP (SSA title XXI [State Children's Health Insurance Program]), and other federal health programs to avoid their duplication of AmeriCare coverage. Provides for the regulation of AmeriCare supplemental policies.Establishes the general obligations for individuals and employers for the cost of health insurance coverage provided under this Act. Provides for additional premium subsidies.

http://pnhp.org/blog/2009/09/05/the-chicken-and-egg-problem-can-the-public-option-succeed-where-prudential-failed/

Jacob Hacker laid out his vision of what is now called “the public option” in papers published in 2001 and 2007. Hacker spelled out five criteria he believed the “option” had to meet:

(1) It had to be pre-populated with tens of millions of people;

(2) Only “option” enrollees could get subsidies (people who chose to buy insurance from insurance companies could not get subsidies);

(3) The “option” and its subsidies had to be available to all non-elderly Americans (not just the uninsured and employees of small employers);

(4) The “option” had to be given authority to use Medicare’s provider reimbursement rates (which are typically 20 percent below the rates paid by insurance companies); and

(5) The insurance industry had to offer the same minimum level of benefits the “option” had to offer.

Although I question some of the assumptions Hacker made in these papers, including his assumption that the “option” will inevitably enjoy Medicare’s low overhead costs, I have little doubt that an “option” which met Hacker’s five criteria would stand an excellent chance of surviving its start-up phase in most markets in the U.S. (I am ignoring here the question of whether an “option” as strong as Hacker’s original has a better chance of being enacted than a single-payer system does. Events of the last few months should disabuse the entire world of that myth.)

But when the Democrats drafted legislation early in 2009 that included provisions creating an “option,” they abandoned the first four of Hacker’s criteria and kept only the last one (the one requiring insurance companies and the “option” to cover the same benefits). Proponents of the “option,” including Hacker, did not raise a fuss about this. Not surprisingly, the “option” provisions of the bills introduced in July – one by the Senate Health, Education, Labor and Pensions (HELP) Committee and the other by the chairs of the three House committees with jurisdiction over health care reform – were basically unchanged from those in the draft versions. The Congressional Budget Office estimates the HELP Committee’s “option” will insure approximately zero people and the “option” in the House bill (HR 3200) will insure roughly 10 million people.

If I understand what jon is saying:

1. Any insurance company/corporation meeting the eligibility requirements can offer insurance in a state exchange. That can include non-profit entities.

2. A state could create such an entity.

3. Once it this insurance entity were eligible for a state exchange, it also becomes eligible for federal tax credits/subsidies to help enrollees pay its premiums.

I don’t understand jon walker to be claiming much more than this for such a state-created entity. He’s not claiming it’s the same as Medicare, nor that it would be funded the same way as Medicare. It’s not the same as “Medicare buy in” and wouldn’t be able to piggyback on Medicare’s leverage. It’s just a state-incorporated public insurance “option” operating within the state’s exchange.

You’re a hell of a typist to pump that out error free plus a link 3 minutes after your last comment.

What if we let foreign owned private health insurance companies (say Dutch owned, since they’re highly regulated by their government)to operate in the US exchange. Is there a US law against that? They probably will give US insurance companies a run for their money.

Scarecrow, I would agree with you, except that Jon DID Say it would be precisly that. SEe his comment at 40.

I will respond to what he says, not what I wish he had said.

Your comment describes something that is doable, but then that requires analyzing it on its own merits. Do you think that your proposal would significantly impact the insurance industry’s cartel like behavior without further action by the federal government?

“Public options are “public” because they are paid for, at least partially, out of the “PUBLIC FUNDS” – a government owned company that relies solely on market based economics and zero tax revenue is NOT anything like a state-run AGENCY That administers a public program.”

That’s not true. There are elements of both in ‘the public option’, it’s intended to be an insurance company administered by the government that doesn’t have a profit motive, essentially a public utility. Costs are paid by premiums but premiums are no more than that. No 73 million dollar golden parachutes for their CEO’s.

that is all quoted from the link. The block quotes aren’t showing up for some reason. I don’t claim any credit for the actual typing of post 49. Only the pasting of it with the link.

I already said BOTH sources are used, but that you can’t rely solely on premiums and be cost competitive because you will have to corner a large share of the market to get those kinds of rates. Look again at the medicare public information pamphlet in comment 44. That clearly indicates that medicare is built on TAX REVENUE for the bulk of what it does, with premiums as a secondary revenue.

Jon was describing a solution for states that have been PROHIBITED from having a tax-revenue funded solution until after 2017. That is my whole point. Jon is advocating something that sound nice, but IS NOT ALLOWED BY OBAMAS BILL. That is my point. We can’t replicate Medicare unless we can ALSO have the tax revenue part of it.

you do realize that in quoting me, you included my words “at least partially” and then told me what I said was not true, that the program is funded by BOTH premiums and tax revenue. Isn’t that what “at least partially” meant?

Are we arguing just to argue, here? Or are we going to READ what I write and actually talk to one another? Jon suggeted a medicare style public option by the states. I am telling youthat is not allowed until 2017. I know that medicare is partially funded with premiums. But it also requires TAX revenue or its not going to work the same way.

“I already said BOTH sources are used, but that you can’t rely solely on premiums and be cost competitive because you will have to corner a large share of the market to get those kinds of rates. ”

Apparently you’re talking about something other than ‘the public option’ and I missed it, then. ‘Both sources’ of revenue are not used in a public option, just premiums. It makes no sense to say the insurance pool wouldn’t be large enough, wouldn’t you buy equal insurance at a lower cost? Who wouldn’t??

Well, fine. You’re talking about the bill which was passed, and I’m talking about a public option, which was not passed.

The terms we use can be ambiguous, but I think you’ve misunderstood what jon meant.

At one point, there was a proposal for a PO linked to Medicare — not the same as Medicare, but linked. That meant (to me, and I think to Jon) that the public insurance plan automatically got access to Medicare providers (perhaps they could opt out?) and those providers would charge Medicare prices/rates (or Medicare plus 5%, etc).

That PO would be offered in the exchange(s). People would be free to choose it or choose something else in the exchange.

Except for start-up costs, the PO would function from premiums, not Congressional appropriations/payroll taxes, etc, but part of those premiums would be subsidized for some consumers.

Then you ask, where does the money come from to pay for the subsidies? It would come partially from whatever funding sources the US had, including possibly higher payroll taxes on those with high incomes, as the final bill provided.

Having read dozens of jon’s posts, I’m fairly certain this is what he’s talking about. Again, it’s not the same as the Medicare program that I, being 65, use, which is paid for by payroll taxes (and supplemented by the budget as needed), and jon is not claiming it is.

I don’t think there’s a real disagreement here.

Roger.

Forgive me for not relying upon what he meant then. I am responding to what he wrote.

But can we move past this point to understand a bigger one? The current law, as written and passed, will require states to wait until 2017 to do what you are describing. You indicated the money for subsidies would come from payroll taxes. States cannot do that under this current Federal law as passed, to the best of my understanding. The reason is because of the Waiver in Section 1332. Basically this law requires states to setup an EXCHANGE and manage that exchange. A state can set up a private company and own it, but then they have to market it pursuant to the insurance commission rules of that state. Until you have enough people paying premiums, you will not be able to offer subsidized premiums. Why? Because the STATE has to go through the exchange to do that. And the state cannot arbitraily go outside the exchange without permission from HHS and only after 2017 are they allowed seek that permission.

The basic point being that OBama and the Dems cleverly cutoff most of the escape hatches that the Insurance industry didn’t like. At least until the Big O got his two terms in and could leave it as someone else’s mess.

“The basic point being that OBama and the Dems cleverly cutoff most of the escape hatches that the Insurance industry didn’t like. At least until the Big O got his two terms in and could leave it as someone else’s mess.”

I doubt you’ll get much disagreement about that around here.

Couple things here., to keep this simple:

The creation of the exchange is mandatory; not participation in it. Companies can sell insurance outside the exchange.

A state could make it’s own insurance company, and not participate in the exchange.

A state could NOT institute single payer prior to 2017.

hi marsdragon. thanks also for your link to kip sullivan’s excellent post at pnhp on what even hacker (who i have less and less respect for every day) wrote was required for his po.

back to hr 193, i cross posted (with permission) drsteveb’s diary here on it last spring:

DrSteveB: Strong Public Option: 100% Coverage & Cost Control

Yes. Thanks for keeping it simple. So, my point is that when the state is prohibibited from doing single payer, it really can’t make much difference in a cost-effective way, except just try to do what MA is doing right now – which appears to be backfiring on them.

The problem is that we are all now going to see states try to make do with the artificial and unnecessary limitations this bill creates.

I keep hearing so many democratic voters and pundits claim that “at least this was a step forward.” I don’t really think it was. The more we learn about it, and see how it will be implemented, and we appreciate the timing of these things, we can see that this bill in many ways actually restricts innovation and virtually enshrines the Insurance industry’s stranglehold on the delivery of healthcare in this nation. I really would rather no bill had passed than this. We have had a net step backward.

There we have agreement. In the end, myself and others here at the blog, especially since womens’ reproductive rights were sacrificed, were against passing the bill in it’s form.

As regards the public option though, there was a political function and purpose to it. As David Sirota told me when we were delivering the Public Option petition to Mike Bennet’s office prior to the Senate passage:

“Power concedes nothing without demand.”

While in the end we lost, indeed we made the demand of Power. Having not made the demand would just have been concession without even asking, much less demanding that power hand over some crumb of benefit.

Mars you clearly don’t know the difference between a public option and a single payer system.

the postal service is a public option for package deliver. It is not payed by taxes but by the rates they charge for their services.

I don’t know if anyone has said this yet, but the unmitigated failure of the MA health insurance program is probably the only possible way we’re going to get any political traction to readdress the train-wreck we just signed into law before 2014 (or possibly 2017 when the option for ERISA waivers kicks in).

When, not if, MA’s system tanks it will be very easy to draw the parallels between the MA system and the federal system, and point out that we don’t need to wait and see, because we already know it’s going to fail based on the MA model.

I mean, lots of us already know this, but the political and rhetorical cover won’t be there to pacify things.

Well, well, well. Now we see why Obama and the Democratic Party were being so stupid when they dealt away the public option to the corporations. Give the corporations what they want, guaranteed business forever with individual mandates to buy whatever they sell no matter how bad it is and no public option way out, eh?

Obama and the Democratic Party think that those so very many who turned out in 2008 for freedom from corporate pillaging will turn out in 2010 and 2012 after being so betrayed? So many in 2008 turned out to reverse The Reagan Destruction, to take up where FDR and Johnson left off. Instead, with corporate deals, voucher systems, mandates, and no public option, they got ROCKEFELLER REPUBLICANISM.

Obama and the Democratic Party, in spite of their claims, have yet to heed THE MESSAGE OF MASSACHUSETTS: Stop dealing away to the corporations what people desperately want and need, kick the corporations out the door, and again meet the needs of the people with strong government services (including such public options) and strong regulations (including on all banking) – or witness significant staying-home and/or protest voting.