When do we start fighting for The Public Option?

[Junkdrawer]

Once the exchanges are in operation, seems like an achievable goal - especially if the government mandated minimum coverage turns into a boon for predatory insurance companies.

[GreenPartyVoter]

1. Public option and price controls.

[Skidmore]

18. Health care should be nonprofit.

[GreenPartyVoter]

20. It should be, but I don't think we will be seeing that for a while.

[pnwmom]

28. Many major insurers are already non-profit. n/t

[dionysus]

2. how about now? this is the first step. public option next. single payer last. it will all take time

[Junkdrawer]

4. Could we do the Public Option state-by-state WHILE we fight for a federal law?

God Bless Vermont, but I just don't see many states opting for universal coverage. But if the exchanges only offer crappy choices....

[dionysus]

5. i think that's how the public option or single payer will finally be achieved. in canada,

thier system began in one province and was adopted by others as it was shown how succssful it was.

[HiPointDem]

23. It began as a PUBLIC program. Not a for-profit one. And the lag between the provincial program

and the national one was only four years. Not like there was a long struggle for a national program.

[TheWraith]

27. Actually, "now" is pretty late.

http://www.huffingtonpost.com/2011/05/26/vermont-health-care-reform-law-single-payer_n_867573.html

[CleanLucre]

3. 1992

[Junkdrawer]

6. LOL. But seriously....

I'm guessing the Obama pragmatists will insist nothing be said until AFTER the election - old wounds and all.

But clearly, if we want to win this, I think we need to educate the public on what the Public Option is BEFORE they start looking at their choices in the exchange - make people aware that the Right has removed the affordable choice.

[CleanLucre]

8. yes it is serious

this took 20 years and many on DU prefer celebration of incremental change to immediate comment on What Next.

So yes, educate and motivate people to not wait 20 years for the next step.

[Bonobo]

7. Ha ha ha ha ha ha.

It is now politically impossible.

The race is run, the load is shot. It is over politically.

A middle to right conservative health policy has been repainted and branded as a"wild left wing government takeover".

The shift has jerked the rope to the right and too much ground was lost in the process.

The health insurance companies are now enshrined in the system.

The deal with the devil has been made and you won't see another attempt in your lifetime in my opinion. Just mild "self-adjustments" from the insurance companies as they "struggle" to keep down prices.

[Junkdrawer]

9. That's the current situation - our job is to change it.

Since exchanges will be a reality, seems like a logical, incremental change.

[Bonobo]

10. First people would need to believe that health care is a right.

Currently they seem so be at odds with the rest of the world and believe it is a privilege or more specifically a "service" that needs to be bought in the same way that one buys anything else -namely that companies have the legitimate right to make a profit off providing this service (that is actually a right).

Change that thinking and maybe there is hope. Until then, you are holding a deflated political football.

[Junkdrawer]

12. But that was the whole point of a Public Option vs Universal Healthcare....

people get the OPTION of BUYING into a Government run insurance program.

[Selatius]

15. Private health insurance lobbied heavily against such a scheme, for good reason.

They didn't want the United States ending up like Germany. In Germany, maybe only 15% of people use private health insurance as the primary means of access to health care. Roughly the other 85% are enrolled in something akin to what we would call the Public Option.

There in Germany, people were given a choice, and 85% of them chose the Public Option because it delivered the same service but without the profit mark-ups that are tacked on with any privately provided service.

The only market private health insurers are relegated to in Germany, effectively, are selling policies to rich people who can afford gold-plated insurance policies and the area of offering supplemental insurance to people who want more than what is covered, such as extra amenities or better food during hospital stays and other such things.

[Junkdrawer]

22. Not only that, but the Public Option paid hospitals less....

so the hospital lobby (the only power broker at the table who even remotely represented the public interest) fought it too.

It will be a tough fight either way: incremental charge (Public Option) or one-step change (Medicare for All). The odds of getting a Public Option, especially once the exchanges open, seem much better - the wealthy and upper middle class could still get mints on their pillow with their gall bladder surgery.

[Junkdrawer]

11. Kick

[Selatius]

13. Never. Line up the same amount of cash that was used to lobby against the Public Option.

If you can find a wad of cash that big and use it to line the campaign coffers of politicians in Washington to convince them to support putting the Public Option into play, you'll get what you're looking for.

Until then, it's not going to happen. The left doesn't have that kind of monetary firepower. It never did.

On the other hand, big business does have that kind of cash, and money talks.

[Junkdrawer]

16. We are told over and over that the ACA is a stepping stone to Universal Healthcare....

If it is, and it's not a poison pill designed to indefinitely forestall Universal Healthcare, restoring the Public Option is the logical next step.

The fact that the Public Option has been remove from the public discourse is telling.

[Poll_Blind]

25. Junkdrawer, I couldn't possibly agree any more. That's the situation in a nutshell. nt

PB

[PBass]

14. i think the next step- some states go for the Public Option.

Vermont seems like it is indicating this possibility? If it works there, then expect to see more states follow, much as they did/will do with gay marriage and medical marijuana. If it works on a multi-state level, then eventually it will tip over nationwide.

Just my opinion.

[PBass]

17. Wow, after reading DU again (and this thread) I'm reminded that maybe the problem with the

Democratic party isn't the leadership in Washington, it's that a large segment of the base has no fucking imagination, and an impossibly negative view of themselves and the future.

STATE BY STATE, JESUS FUCKING DUH. That's how you do it.

[Bluenorthwest]

19. Some of us never stopped doing so.

At this point what will happen is that States with any intelligence will establish their own options and systems which the Red States will then envy and imitate. While some States are fighting the Medicaid expansion, others were fighting FOR it, are ready to do so, wanted to prior to ACA and are already using the new law and new funding to work in that direction.

[TheKentuckian]

21. The real answer is probably after we "fix" NAFTA.

My answer is after we get a national exchange with universal access, until then a public option is a dumping ground for the cartel to rid themselves of the expensive to cover both by pushing them toward it and by self selection, if you have real problems who do you trust to actually provide care the cartel or Uncle Sam?

Would you select Tricare or Cigna if you had serious ailments or a terrible condition?

If we are betting our asses on "market forces" then it seems imperative that we actually give them a chance to function which means as few and as large a pools as possible and access to the market for everyone depended on it rather than sequestering a small minority into an arena where there is choice and competition.

Laser focus on the public option is probably part of the reason the bill structurally stinks as much as it does because so little pressure was ever applied in the more mundane areas like ending the anti-trust exemption or a national exchange or ramping of the population in to the exchange(s) or even how subsidies would be distributed.

I just think we need to do a hell of a lot to clean up the actual structure before we go back to fixating on features. We probably will find that there are some poison pills we allowed into the bill with the hundreds of TeaPubliKlan Amendments accepted without a single vote. Seems Ensign got a toxic bit in that will allow increases based on health and compliance with advice from wellness visits that allow substantial cost increases for one.

I also find certain treatments of people to be inconsistent like being able to carry a child to 26, in which case we are providing a needed benefit to those just starting out in life that can't afford insurance but also see a 19 year old as a deadbeat who doesn't want to contribute because that kid's parents don't have coverage or refuse to carry them.

These young folks are exactly the same except in their choice of parent but one needs generous and comprehensive help and the other is a welfare queen type that wants a free ride.
Why are the adult children of the middle and upper class in need of more patience and budget wiggle room than the children of the poor and working class without insurance?
Why does an 18 year old helper on a construction site need 8.5% (or whatever) more of their income than a 23 year old working in the same office (making similar money, to boot) I do based on the status and willingness to help of their parents?

If we as a society believe that a person needs to the age of 26 to establish themselves then that should apply to all people below 26 not just those in the more fortunate circumstances. Hell, we didn't even mandate that people carry their adult children, instead we just said if they want to they may.

The whole law is filled with separate and unequal, that shit has to be fixed.

[OmahaBlueDog]

24. I think the first step is to actually get ACA in its current form up & running

...that's not a given, but it's a lot closer.

Then, I think public option will get looked at on a state by state basis. Case in point: Vermont is actively looking at single payer. Other state may follow suit and look at that as a means of meeting the mandate.

My guess is that initially, public option will be looked at for kids. States will want to provide an affordable means of ensuring all routine visits and vaccinations take place. I suspect it will be gradually expanded to cover those with pre-existing conditions, and those who can't find affordable coverage in the exchanges due to age.

So, to answer your question: a) first fight to get Barack Obama reelected then b) fight to ensure the GOP does not get 60 Senate votes. If a & b take place, then start fighting for public option in 2013.

[Cleita]

26. I would hope that a class action lawsuit can be done stating that

in order for people to have a real choice, a buy in into Medicare should be an option in the exchanges. However, not being very well versed in legal matters, I don't know if it could be possible, but it seems it should be a right of sorts since all people who make a paycheck get FICA taken from their checks, they should be able at least opt to receive benefits from it even if there is an extra payment involved.