Federalism and the public option III

A state-based public option?

Harry Reid, searching for a way out, is mulling over a public option that isn’t public and run by the Feds, maybe, um, a sort of coop.

In the current deranged climate, it’s possible that Reid’s problem really is the connection of Obamacare with the evil Feds, who make such a notorious mess of running socialist Medicare, the socialist VA, the socialist DoD health scheme for serving military, and the nomenklatura socialist scheme for members of Congress.

I hate to mention it, but there’s a third alternative: a public option run by the states. They could piggy-back the plans administratively on the backs of existing ones for state employees, assuming they have them, so setup could be fast given the will.

If the states are too small, they could and should link up (doodled map here), but the big five – California, Texas, New York, Florida, and Illinois, with populations comfortably over 10m, collectively over 100m, would surely be big enough to go it alone. Unlike a wimpy coop, a California public option plan could rapidly become a major player, taking CALPERS as its role model for toughness, and a pacesetter for the rest of the country.

A plan like this would still be a major defeat for universal health care. Red states would drag their feet, and the poor in Mississippi on the health exchanges would face a more expensive and inferior menu of private insurance than those in New York. It could take decades for a national public option network to emerge. But unlike the feeble coops, state-based public plans would be serious contenders from the start, and offer an evolutionary path to universality.

Of course I’d much rather Reid borrowed some cojones from Nancy Pelosi and Henry Waxman, and called the national public option the “Kennedy plan”.

Author: James Wimberley

James Wimberley (b. 1946, an Englishman raised in the Channel Islands. three adult children) is a former career international bureaucrat with the Council of Europe in Strasbourg. His main achievements there were the Lisbon Convention on recognition of qualifications and the Kosovo law on school education. He retired in 2006 to a little white house in Andalucia, His first wife Patricia Morris died in 2009 after a long illness. He remarried in 2011. to the former Brazilian TV actress Lu Mendonça. The cat overlords are now three. I suppose I've been invited to join real scholars on the list because my skills, acquired in a decade of technical assistance work in eastern Europe, include being able to ask faux-naïf questions like the exotic Persians and Chinese of eighteenth-century philosophical fiction. So I'm quite comfortable in the role of country-cousin blogger with a European perspective. The other specialised skill I learnt was making toasts with a moral in the course of drunken Caucasian banquets. I'm open to expenses-paid offers to retell Noah the great Armenian and Columbus, the orange, and university reform in Georgia. James Wimberley's occasional publications on the web