Senate Majority Leader Harry Reid (D-NV) announces that the public option is now in the Senate version of the health care reform bill.  With one caveat that it will include an opt-out option for states.

So Democrats now believe in a form of federalism? Hmmmmm… It would seem that the only way Senator Reid feels he can keep liberal members of his caucus on board is if he keeps the public option.  The moderates would only vote for it I suppose is if it includes an opt-out.  So he thinks that he will then have the votes he needs to get this through the Senate.

I bet this opt-out is lost in a House-Senate conference.  I don’t see Speaker Nancy Pelosi going for that.  Also, I wonder will states be able to “opt-out” of their state’s share of the taxes that will fund this nightmare?  If not can you truly say your state gets an opt-out?  I don’t think so.  Liberals wouldn’t want that anyway.  That would be true federalism at work.  People can vote with their feet.  We’ll truly see who wanted the public option and who didn’t, as well as, what the effect is on their state’s economy.  They can be a laboratory.

That won’t happen though.  How about an opt-in?  Definitely won’t happen either.  You know if this does pass with a state opt-out, look for an unintended consequence – health care reform will become a state and local issue.  That should scare Democrats as well.  Suddenly we start asking our state representatives and senators how they’ll vote on this.  We’ll put pressure on our Governors on whether or not they’ll sign the bill.

This could be a way to clean house at the state level, and that might not be a bad thing.  Which is another reason this won’t happen.

Video HT: Motor City Times

32 comments
    1. @Don, Cost to taxpayers… could lead to single payer health care…. People could end up losing private insurance… It doesn’t address actual health care costs.

      And… it’s a further encroachment on the Constitutional responsibility of the federal government. I don’t recall seeing health care anywhere in there.

      If you are brave enough to link to anything from Crooks and Liars, you put yourself in the line of fire, LOL.

  1. If being a Republican puts me in a box….I may soon leave it! Actually I believe I’m a bonafide RINO. 🙂 I like to examine things from all aspects, not just from the party line. I reserve the right to be different! I like the competition aspect of the Public Option. Actually I’m not all that opposed to the single payer idea. I just think America could design one better than all other attempts. I strongly believe health insurance should be available for everyone!
    btw, DO you approve of what was talked against in that “Crooks & Liars” piece by Bill Moyers?
    There are so many things we are doing that weren’t covered in the Constitution that using that argument has become quite lame, IMHO.

    1. @Don, Don… if you want to embrace the RINO label, go right ahead. Your FB profile suggests that you are mostly conservative and libertarian. If you were truly libertarian the constitutional argument you wouldn’t find lame, you’d be just as disgusted as I am with large government.

      There’s nothing conservative or libertarian about this a public option or this current health care reform plan. There are numerous free market approaches that could be tried that aren’t included in this bill such as:

      1. Allowing you to shop across state lines for health insurance. We can do that for anything else why not health insurance? Oh that’s right – government regulations!
      2. Tort reform – still not being seriously addressed, but even the CBO said it would lower the cost of health care.
      3. Medicare/Medicaid fraud – they can’t even police the program they currently have and they want to expand it? They need to eliminate fraud that is happening and save taxpayer money.

      Dr. Frank Rosenbloom at American Thinker has some pretty good ideas – none of which are being considered to my knowledge – http://www.americanthinker.com/2009/06/a_real_free_market_health_care_1.html. I’d encourage you to check that out.

  2. Don,

    A public option is not necessary to provide competition. Dems love the example of Mississippi where there are allegedly 2 insurance providers. The public option would provide one more. Knocking down the walls and creating a national insurance market would provide hundreds. Overnight.

    And when the government “competes,” they make the rules and have an essentially unlimited source of capital. That would allow them to, as they have often said they want, drive the private insurers out entirely so that we’re left with a single-payer system.

    Single payer is bad because it’s 1) unconstitutional and 2) unsustainable. Canada’s system is broke. So is Britain’s. And France. They’re broke because “free” health care is terribly expensive. The only way they have to control costs is limit access to care or reduce the quality of care.

    There are other options. But they will not even talk about small-government, market-based approaches to this issue. Single-payer is a holy grail to them. So who’s putting you in a box?
    .-= ChrisB´s last blog ..Billboard Reveals Secret to Health Care Reform =-.

    1. @ChrisB, None of these plans actually address what is causing medical costs to go up. It’s blame the doctors or blame the insurance industry. A recent study (I’ll have to find the link) shows that the medical insurance industry is far, far down the list of industries with the most profit at only 2%…

      I don’t want to say there isn’t abuse because there is. However perhaps people may want to consider that insurance premiums are going up because health care costs are going up. I know it is hard for liberals to understand that in order for any business to stay in business they need to make a profit. It’s evil I know, but no profit, no reason for them to be in business.

      We need to address what is truly causing health care costs to increase. It’s very likely the government is a big part of the problem.

  3. @Chris B. I’ve never been to Canada or France, but I can tell you GB’s health care is just fine. Australia’s is even better. They are far from “broke.”
    To sau that the Federal government wants to drive private insurers out of business is beyond stupid. Why would they WANT more people to lose their jobs due to companies going out of business? You can’t rail against Obama for bailing out GM while accusing him of wanting to drive Big Insurance out of business; which is it?
    @Shane, Insurance premiums have skyrocketed over the past 12 years; why would you think that doing *absolutely nothing* would magically arrest that trend? Additionally, why do you hate Medicare? That’s all this is: Medicare for everyone.

    1. @Adam, I hate to break it to you, but Britain’s NHS is rapidly running out of money. They do all they can to reduce costs to no avail. I don’t know much about Australia except that they send patient’s to the US when they don’t have the technology to treat them there. What will the world do when we’re in the same boat as them?

      Why would they want to drive insurance companies out of business? Because to them single-payer health care is an intrinsic good. I don’t know why, but it’s been the holy grail of the Dems for many years. I’m sure they’ll try to find nice government jobs for all of those folks.

      “You can’t rail against Obama for bailing out GM while accusing him of wanting to drive Big Insurance out of business; which is it?”

      Yes you can. Apples and oranges. But to some extent, it is the same — they’re steadily moving more and more of our economy under government control.

      And Medicare (which is broke and riddled with fraud and waste) for everyone? Terrible idea.
      .-= ChrisB´s last blog ..Billboard Reveals Secret to Health Care Reform =-.

      1. @ChrisB, Chris, it is most certainly *not* apples & oranges. Ultra-Conservatives wanted to let GM fail. Obama knew that would have massive negative repercussions on the American economy, and that it would be disastrous. So he reluctantly bailed them out. He has said –publicly and repeatedly– that he doesn’t want to be in the car business, and that he does not want to take over health care. Why on earth wouldn’t you take him at his word? If you don’t know why (you said so in your post) they would want to drive insurance companies out of business, that should make you seriously question the validity of your theory, no?
        In order to keep the debate focused, we can only use what the players have said on record. Making stuff up, or inferring based on prejudice does nothing to advance the debate.
        NHS might be losing money due to many reasons, but it will survive. It probably needs to adjust to the Baby Boom generation requiring more care than is currently being paid into it by younger generations. (Just like us.) The solution is to EXPAND the risk pool by letting under-employed people buy into it, and requiring them to do so.
        In Australia or the UK, anecdotal evidence cuts both ways. For instance: in Sydney, my wife needed gallbladder surgery, and got it in 10 days.
        What matters is the gross numbers: America pays more, but gets less. Our citizens die more, and more preventably than the UK, AUS, or most European countries.

      2. @Adam, Obama, and many of his advisors, has also said publicly that he wants a single-payer health care system in this country. Many Democrats are on record (God bless YouTube) saying the “public option” is a means to that end.

        Since Obama has gone back on his word many times since taking office, this really shouldn’t come as a surprise to you.

        What NHS needs is more money, and there’s only one way to get it. So you can keep going to the tax payers for more and more money until they can’t take it anymore, or you can find a different system, one that doesn’t require sucking tons of money out of our wallets.

        Expand the pool? EVERYONE in Canada and Britain is paying into those health systems. How do you expand the pool? You think Britain’s going to finally conquer France? Try thinking outside the socialist box for a minute.

        The health care system in the US has problems. Lots of problems. But it is the engine of medical research on this planet, and it is the provider of last resort for every other country in the world. Let’s not screw that up.
        .-= ChrisB´s last blog ..Further Schizophrenia on Abortion =-.

  4. I’m on Medicare with a Supplemental from an Insurance Company. I LOVE it! I’m paying $400+ per month for the 2 of us but I have no co-pays or deductibles. Medicare controls how much a medical provider can charge and the amount is split between Medicare and my Supplemental Insurance Co.
    IF we can set up something like that for everyone, I think it would be great! Medicare ISN’T putting Insurance Companies out of Business! To my way of thinking if this type of situation was applied to single-payer, it could still be Free Market controlled.
    Talking about Medicare, Medicaid and any other Gov’t program being broke etc. is ludicrous because the U.S. Government has been in debt up to our eyeballs long before Obama became President….it is ONLY getting worse. We are borrowing from China to finance the wars in Iraq & Afghanistan! IF you REALLY cared about the welfare of the citizens of the U.S. you would be in favor of ending our involvement in those 2 countries in favor of helping our own country!
    The problem I have with the piece at “American Thinker” is that it is the same “It my way or the highway” mentality as the Democrats regarding his solution. We need to be willing to meet in the middle. It is galling to me to see the Republicans demanding everything to be their way when they aren’t the one in power now. We stand a better chance of getting 1/2 a pie if we don’t keep insisting on having the whole thing!
    btw, Shane, I changed my Political Views on my Facebook page to better reflect my feelings. 🙂 ChrisB, Saying I was a Conservative & Libertarian seemed to be putting me in a box where I wasn’t allowed to have ideas contrary to what they insist on. I’m a Life-long registered Republican but apparently I’m also a RINO. 🙂
    Shane, my point on the Constitutional argument being lame is that we do lots of things that aren’t in the Constitution. Things that Conservatives think are just fine too! 🙂

    1. @Don, Medicare only functions because it exists along side the private system. They get away with paying less than it costs to treat patients because private payers make up the difference. If everyone was on Medicare, it wouldn’t work — at least not for long. (Suggest you read the piece I linked to above.)

      I know the entire government is broke and has been running off credit for years, but Social Security and Medicare are supposed to be self-sufficient. They’re not. So recognizing that the government is broke, why would we want to make it responsible for more people’s care?
      .-= ChrisB´s last blog ..Billboard Reveals Secret to Health Care Reform =-.

  5. One reason Medicare isn’t working is they are subsidizing the Medicare Advantage Plans. I believe the Baucus plan is going to eliminate this.
    I don’t understand what you meant by, “They get away with paying less than it costs to treat patients because private payers make up the difference.”
    I had sinus surgery. The Dr. charged $13K+. Now we know this is an inflated price. Medicare allowed $1400+ Medicare & my Private Ins. shared this cost. This is really no different from the Private Health Insurance I had last year with United Healthcare Ins, while still employed. They too discount the prices allowed to be charged.

    1. @Don, Medicare pays less than treatments actually cost; private payers then have to pay more so that hospitals can afford to operate. If this didn’t happen, hospitals would start closing down. If everyone were to get treated at Medicare rates, our health care system would collapse.

      Like Shane, I wouldn’t design any single-payer system. They’re not sustainable.

      Our government spends a lot of money it shouldn’t; I would make draconian cuts. Cancel foreign aid, NEA, subsidies. Make SocSec and Medicare explicitly the welfare programs they already are with means testing. Every family and business stops spending when they run out of money; government should do the same.
      .-= ChrisB´s last blog ..Billboard Reveals Secret to Health Care Reform =-.

      1. @ChrisB, You’re forsaking the moral imperatives that are the reason for the very existence of government. Government serves to protect its citizens, both from external threats (foreign enemies) and internal (profiteering companies). There is a reason we have the NTSB, FEMA, FDA, et cetera. Pulling funding from those groups to line the pockets of the super-rich is morally repugnant. Health care is a right. One cannot pursue happiness in liberty if one cannot access basic health care. This is morally untenable. What if the firemen checked to see if you’d paid your premiums before putting out your flaming house?
        Government exists so that we can pursue products safely in the marketplace.

      2. @Adam, you need to stop beating up those straw men; it’s not nice.

        I’m not calling for a complete shut down of the government. But we have this constitution thingy that tells us what the federal government is actually allowed to do. If we let them get away with not following it sometimes, we really have no room to complain when they do so on other things.

        I have no idea where you got the “super-rich” idea. I don’t know about you, but I’m not super-rich. I do, however, pay lots of taxes that are used for things that are unnecessary, ineffective, and unconstitutional. I’d like that to stop. There are legitimate duties of government; I’m willing to fund those.

        Is health care a right? Yes. Does that mean someone is obligated to provide it to me? No. Constitutional rights are protections from government, not obligations upon it.
        .-= ChrisB´s last blog ..Billboard Reveals Secret to Health Care Reform =-.

      3. @Adam, I confess I’m condensing paragraphs into sentences, so it can appear like I’m creating a straw man argument, but I assure you I’m not. What I was talking about reducing taxes on the top 1% of income earners while slashing the regulations that protect our citizens is morally wrong. Health insurance is in the same boat. To refuse to raise taxes on those who can most easily afford it while citizens die is morally wrong. Money is *not* more important than life.
        You’re only getting federal government half right: it is not only protection of you FROM over-reaching government; it is also protection OF you BY the government. The best example is terrorism. You don’t worry about another 9/11 because the federal government protects you using it military. You don’t worry about your plane crashing (much) because the government protects you from unethical airline practises using the FAA & NTSB. These are some of the moral imperatives of government.
        To say that there is such a thing as a right without an inherent obligation is illogical. I have a 4th amendment right to my property. This creates multiple obligations on the local constabulary if they suspect me of a crime. Turn the tables: I am a victim of a crime- now the police have an obligation to track down the suspect, arrest and try him. Protection FROM and BY the government.

  6. Shane & ChrisB, I would be curious how you would design a single-payer system, if you were given the task, that would be workable and pay for itself? I have never understood why the U.S. is confined to doing anything like another country has done it? Can’t we learn from their mistakes and design something better?

    1. @Don, I wouldn’t design a single-payer option Don. I don’t think they work. The disadvantages are inherit with the system. You look at TennCare and “RomneyCare” in Tennessee and Massachusetts where they were tried at the state level – both riddled with quality of care issues and cost issues.

      It doesn’t address the real problem – why is health care itself costing so much?

      1. @Shane Vander Hart, Health care costs so much because the insurance cartel has gone unchecked for decades, resulting in a “pay for services” schedule, rather than a “pay for results” schedule. If doctors & hospitals offered guarantees of their repairs (like almost any other service), you’d see costs drop right quick. Also, all those unnecessary tests would disappear. Doctors would be free to say “no” without harming their income.

  7. Shane, you say you are disgusted at the size of our Government. What would you get rid of? Police? Parks? DNR? Streets, as in snow removal? There is a long list of things we take for granted that we would dearly miss if they were eliminated! To my way of thinking, if we have someone in charge of deciding which Government programs are good for us and which we can eliminate, is no different from having someone in charge of deciding which healthcare options are good for us and which we can eliminate.
    Just think of all the money we could save if we eliminated Government altogether. Government is portrayed as this big boogie man that controls everything and is just a waste of money. Would you feel more comfortable with a private Police Force like in Robo Cop? Government is just a way of pooling the needs of the citizens into one entity to take care of those needs. The Government is still “we the people.” As long as we are getting our own way…as long as OUR team is in power….we LOVE the Government!

    1. @Don, You are totally twisting my argument.

      Limited government doesn’t mean no government. I’m not for anarchy, and have never advocated such. There are legitimate roles of government and law enforcement would be one of them. There are things state and local governments do, that I wouldn’t necessarily want the federal government to do.

      DNR & parks – I think they are good at the state level. Federal authority has overreached in this area though. By the way, my brother who used to work for Iowa DNR, and now works for the Iowa DOM… could tell you how much duplication of departments we have in the federal government – just within the Department of the Interior and EPA for example.

  8. ChrisB, you said, “Medicare pays less than treatments actually cost; private payers then have to pay more so that hospitals can afford to operate.” How does this differ from what Blue Cross & Blue Shield and all the other Health Insurance Companies do when they discount the amount you have to pay the hospital?

  9. Shane & ChrisB, your reluctance at designing a single-payer system that would satisfy you is impossible only because you have been railing against the term for so long that you are come to believe the very term is evil.
    Single-payer health insurance collects all medical fees and then pays for all services.
    I fail to understand why Blue Cross (for example) couldn’t collect the premiums & the medical fees and then pay for all the services. Medicare ISN’T FREE. In fact the premiums I’m paying are way more than what I was paying to United Healthcare Insurance. So, if UHC is making money, why couldn’t a Private Single-Payer system make money?

    1. @Don, no matter who handles the money, a single-payer system is the government. They are responsible for allocating the funds, they make the rules for what gets treated, and they raise the taxes when the system runs out of money.

      I know Medicare isn’t free. I pay tons of money for your Medicare. But any system — Medicare or private insurance — that lets you pay $25 for a $2000 procedure makes the treatment appear far less expensive than it really is. It gives the user no incentive to concern himself with costs. That is what allows health care costs to rise so quickly.
      .-= ChrisB´s last blog ..Billboard Reveals Secret to Health Care Reform =-.

  10. Regarding Medicare, a single-payer system, you do know that as far as the Medicare Advantage Plans go, they are totally administered by Private Insurance Companies, right?

  11. ChrisB, you are obviously IN the medical field in some capacity because you are highly biased for them! You will NEVER convince me that the amounts they charge are legitimate. They are way over-inflated to obscene amounts! Next I imagine you are going to tell me the hospitals are building in new locations because they are running out of money! LOL!
    You love to talk in generalities and to exaggerate too. I have ALWAYS concerned myself with every bill I have received and examine it for errors or abuse and have called the Insurance Co. on several that looked to be fraud. What is THE $2000 procedure that only gets $25? Conversely how do you explain the hospital charging $100 for one pill as if you got 90 of them? As far as I’m concerned the Medical field is their own worst enemy. You would like us to believe that everyone in that field is about to go to the poorhouse.
    btw, is everything the Government makes rules about, bad? Or just Medicare?

    1. @Don, you’re right — I am in health care. I see up close and personal just how screwed up it is. And how good it is.

      There are a lot of reaons behind how much hospitals charge. Greed can certainly be part of it, but it’s not the only thing. Most health care organizations in this country are non-profit — though they still have to make a profit to operate.

      One thing you have to remember about that $90 pill — you’re paying for more than the actual pill. Just as what you pay in a restaurant covers more than the actual food you eat, that $90 covers the person who brings you the pill, the light bill, the insurance the hospital carries in case you decide to sue, and the pill for the guy in the next bed who can’t pay his bill.

      I’m glad you check your bill closely, but what you seem to be missing is the fees Medicare pays may not cover what it cost to treat you. (I linked to a piece about this above.)

      As far as working in health care goes, I think a single-payer system is far better for me than the reforms I think need to be implemented. If the changes I’ve called for are put into place, the growth in my income is going to slow dramatically. But if single-payer happens, the patient will suffer.
      .-= ChrisB´s last blog ..Billboard Reveals Secret to Health Care Reform =-.

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