The best compliment a research scientist can pay another is "I wish I had thought of that!". This idea of an opt-out for states is one such idea. I don't know who thought of it first, but I am hoping it was my state's Senator Schumer, the guy I would like to see as majority leader some day soon.
Both Al Giordano and Andrew Sullivan have noted just how explosive opt-out is to the right wing. The genius of it is that it takes a common right wing meme-state's rights- and lobs it back at them. If you think that the public option is a new tax (exactly how?), fine. Just be the Republican Governor or State Legislator who opts out of it. Wait till people hear that their unemployed cousin in New York has his kids covered by public health insurance. And that it was your state that-on its own- said "No Thanks". Just how many Governors in the end refused the stimulus money? Expose their posturing and cynicism. Force them to make the choice.
The argument that a new entitlement program has costs for the country as a whole has some merit.(In this case, the benefits-covering more people and forcing the insurance companies to compete- happen to far outweigh the costs.But that is another matter.) But that macro argument about costs is hard to make when it looks like half the country (the blue half) is getting something that is being denied to you. For no other reason than that your Republican Governor opted out of it. Once word gets out (and it will be pure pleasure to get that word out in Alabama or Minnesota or wherever) there will be a howl of protest. The cynical Republican strategy of scaring ill-informed poor people away from Govt programs they need will backfire.
Of course, for this to happen the public option must be available to large numbers of people. It needs to be visible. It needs to be talked about in union halls and HR briefings. The Public Option should not be restricted to people working for small companies or to the unemployed. It must be truly an option available to all, to be considered on par with private insurance programs. The House Bill does not do this at this moment.
The negotiated rates is no big deal according to Gov. Howard Dean. He has more credibility on health reform than almost anyone: a physician as well the architect of the 50 state strategy hat has delivered us both houses and the Presidency. We can give up quite a lot to have broad coverage: once people start to see the benefits of the Public Option we can always tinker with it. The truth is, once it is enacted, it will be political suicide to oppose it. Broad and fast implementation is more important than rates. Opt-out is way better than opt-in, but even opt-in is fine as long as the bill is enacted fast enough. That means no to triggers.
Keep up the pressure on the Blue Dogs! It is in their own interest to support a broad Public Option. Their best chance to win is to run in 2010 after people already starting to receive benefits of this historic reform. Even some Republicans will be contorting themselves to take credit for it, as they do for the stimulus bill they opposed. A broad Public Option is good policy. An opt-out provision for states is great political strategy.