In 2009, the U.S. Senate’s majority leader, Harry Reid, proposed a government-run “public” health-care insurance option with an “escape hatch.” According to The New York Times, “A state could refuse to participate in the public insurance plan by adopting a law to opt out.” While this proposal would barr a State refusing the public option from participating in the coops that are also a part of Reid’s proposal, the basic “opt out” arrangement is in line with federalism and, moreover, with the inherent heterogenious or diverse nature of an empire spanning across and continent and beyond. In contrast, Olympia Snowe’s preference for “a fallback, safety-net plan” that would trigger the public option in States where insurance companies fail to offer affordable plans is antithetical to federalism because the States would have no choice in whether the plan was triggered.
The approach most in line with federalism would be for the health-plans to be designed in the State governments, with the U.S. Government focused on matters that the States cannot (not will not) do, such as presenting a united foreign policy to the world. If there is a lowest common denominator for health-care in the US as per the fundamental principles of the Union, a basic program passed by the U.S. Government would be consistent with also having State plans. Next closest, the U.S. Government would supply money for health-care, which the State governments would decide how to spend. Even less in line with federalism would be the design of the programs being done by Congress and the WH, with separate opt-outs for the public and coop insurance plans. Reid’s proposal was less in line with federalism, and finally, as least in line with it, was Snowe’s preference.
Source: http://www.nytimes.com/2009/10/27/health/policy/27health.html?_r=1&hp
Showing posts with label public option. Show all posts
Showing posts with label public option. Show all posts
Monday, February 21, 2011
Health-Care Insurance Reform: A Spectrum of Alternatives With Respect to Federalism
0 comments Posted by Find Insurance Online at 2:50 AMThursday, February 3, 2011
On October 13, 2010, Fox News reported a poll that found that women are turning on Obama. The reason cited was that they feel there has been too much change—that it has been “jarring.” This reminded me of when I was sampling a food item in a grocery store and the old woman who gave me the sample, said, “We have lots of devils here.” She was referring to the array of food samples in the store that day. My reaction, which I did not act on, was to ask her what century she was from. I wondered why some people can’t seem to let go of what is so antiquated—why they are so resistant to any change. In terms of the jarring change being reported on Fox News, the journalist pointed to the health-insurance reform law as a case in point. In spite of its purported “socialism,” the law relies on private health-insurance companies, whose lobby pressured Obama into dropping his “public option” requirement and adding a mandate that requires Americans to become customers of those companies. If relying on extant private companies—giving them a guaranteed and vastly enlarged customer base—represents “jarring” change, I have to start wondering about whether those Americans have some sort of pathological issue with change itself. I have to wonder whether there isn’t in the American culture—and I am an American—some sort of pathology in which any change is felt to be traumatic. If so, we could add this pathology to that which involves denial in relying on companies (both insurance companies and banks too big to fail) that we know have been culpable. The extreme aversion to change and the tacit willingness to rely on problematic institutions can be expected to result in stagnation and continued systemic failures. The source of the problem is in us.
Not surprisingly, much of the campaigning in the 2010 midterm elections has been oriented to incremental change on given issues, rather than to real change. Even in states bordering on bankruptcy, like California, Florida and Illinois, it is campaigning as usual. I watched a candidate forum from Illinois and one of the main questions was why a candidate’s business was so successful. Meanwhile, the last governor had been impeached and removed from office by a nearly-unanimous vote in the legislature, and the government was borrowing $18 billion in 2010 alone. The forum made “rearranging the deck chairs on the Titanic” look like an everyday phenomenon. Lest one blame the candidates alone, it is important to note that it was a citizen who asked about the candidate’s business. In the California Governor’s race, Jerry Brown and Meg Whitman had a chance in their debates to persuade a statewide audience they could turn around the economically troubled state. Instead, they resorted—at least in their third debate—“to many of the personal attacks that have dominated the last few weeks of the campaign,” according to MSNBC. “Neither candidate presented any new ideas.” A poll released two weeks before the third debate found about half the respondents were dissatisfied with both candidates. No wonder.
In contrast to status quo campaigning amid major systemic governmental problems, my inclination regarding either republic would have been to discuss drastic tax increases and non-sustenance budget cuts in that state, as well as to suggest that the two states both adopt a federal system—their respective regions becoming states. Germany is the size of Montana and is a federal state with 15 regions. As soon as it is realized that Germany as a EU state is federal, federalism can be recognized to be applicable to any large US state. Comparing apples to apples enables new insights! However, if we are afraid of “jarring” change, we will be apt to resist adjusting our comparisons for any errors; we will continue to see the world just as it has been seen, and this will make it difficult for us to envision change.
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