This diary is indeed a reply to my good friend, colleague, and fellow California progressive activist thereisnospoon, who argues that the "opt out" public option compromise is a good idea.
My view, as laid out in very brief detail in this comment to TomP's diary earlier today, is quite the opposite. Not only is this a bad idea because of the policy and political costs of throwing "red states" overboard, it dramatically understates the very real risks that even so-called "blue states" would choose the opt-out.
Even states like California.
As you are probably aware, here in California we are facing a severe budget crisis. It's partly a self-inflicted wound - 30 years ago CA voters passed Prop 13 and doomed the state to eventual ruin. Our electorate is much more willing to raise taxes than people realize. But the combination of the asinine rule requiring a 2/3rds vote to raise taxes or pass a budget and the Democratic Party's historic difficulty in winning the governor's office (since 1900 only four Democrats have been elected governor, with two of them being named Edmund G. Brown) has instead produced a political system designed to squeeze public services by starving them of revenue. The worst recession in 60 years has further weakened the ability of our state to fund vital services.
So earlier this year, Governor Arnold Schwarzenegger, who recently made a big show of telling America he supports health care reform, proposed and ultimately won passage of a budget that made cuts to Medi-Cal, removing benefits from thousands of Californians even though doing so meant the state gave up matching federal dollars.
This is California. The classic "blue state." Where support for "Obama's health care plan" is 52%. Where Obama himself won over 60% of the vote in November 2008.
What's going to happen in other supposedly "blue states," the states that are supposedly going to refuse to opt-out of a public option? Washington, which is even bluer than California, cut $10 billion from its budget earlier this year and froze enrollment in the state's Basic Health Plan. Numerous other states are facing severe financial constraints. We've already seen such states, including "blue" states, make major and devastating budget cuts to the safety net. It is not a stretch of the imagination to envision blue states opting out of a public option under Republican claims of saving the state money, even if that claim is a lie.
Setting up an opt-out is therefore just as likely to backfire on "blue states" as it is on the "red states."
That's one of thereisnospoon's points that I feel is not supported. Here are some others:
But it would do wonders to completely reframe the entire debate over the public option and healthcare in general by allowing, at long last, those states with Randian ideological pedigrees to truly "go Galt", in a head to head test of ideologies to see who comes out ahead and why. If we play our cards right, it might just be the ticket to Democratic victories in the South. And it might be, over the long run, the best avenue toward real, affordable universal coverage for everyone.
If that were the case, progressives would already have won this argument. States like California, Washington, and others have long provided more robust health care, welfare, and other services as compared to the penurious programs offered in states like Texas and Mississippi. Yet those states haven't seen Democratic victories. They haven't seen a mass abandonment of crazy-ass right-wing anti-government ideologies. Instead those ideologies have been reinforced particularly over the last 20 years, as Blue Dog Dems gut any effort to provide government services and programs to people in those states.
spoon goes on to argue that Republicans would be "put in the hot seat" - we'd be calling their bluff, either they push through an opt-out or give in and accept the public option.
Well, that's what these wingers want. They will happily push through an opt-out, partly to appease their base, partly to poke Obama and progressives in the eye.
Especially since they will continue to lie about the effect of the public option. thereisnospoon argues that the opt-out "hampers the ability of Republicans to lie about healthcare issues." As he well knows, Republicans will lie about anything regardless of the actual facts on the ground. They will continue to spin things to their benefit - especially if they benefit from the other aspects of the Obama health care reform bill. A public option isn't the only valuable part of the bill, and even states that opt-out from the public option will see benefits from the end of rescission, subsidies to purchase private insurance, and other cost-saving reforms. Republicans will use that to argue the public option wasn't necessary, that their states are doing just fine without it.
spoon also says "Businesses will have an incentive to move to blue states." Here I do not think it is so cut and dried. There are complex reasons why businesses locate where they do. I don't see the public option as offering a compelling reason for a business to move to a particular state, certainly not the way a state with a single-payer system would. The public option will save individuals and businesses some money, but probably not a whole lot, since subsidies to purchase will be limited and since subsidies to the program itself will also be limited.
Some businesses will see an advantage and move to a public option state. Others won't, and will see an advantage in the supposedly lower costs of the non-public option states (especially since these states will still have lower taxes, less regulation, and right-to-work laws that actually damage economies but do on occasion attract a high-profile employer or two).
I also thoroughly disagree that the opt-out would "create Democrats." It will do no such thing. It will piss off voters in those states who will come to believe that they got sold out by "liberal elites" on the coasts who wouldn't fight for them.
If you want to build the Democratic base, and convert more people to the progressive cause, you have to show them that government helps them. When Republicans failed to help victims of Hurricane Katrina, it reminded many Americans of the need to vote for Democrats who would supposedly provide government services when people needed it. It worked in convincing people in previously red states like Ohio, North Carolina, and almost Missouri to vote for Obama.
If we abandon those people, we're going to create conditions where they'll be annoyed and bitter because they didn't get to participate in the health care reform others enjoyed. But, and this is key, they will take that anger out on Democrats who "abandoned" them, and not on the Republicans in their states who pushed through the opt-out. Again, if the notion that Republican willingness to abandon federal programs leads to their defeat was true, we would have seen much broader Democratic and progressive gains in red states than we have seen recently. Someone like Arnold Schwarzenegger would never have gotten away with leaving federal health care money on the table.
Finally, and this is the most important of all, the opt-out undermines the moral case for health care reform. We win health care by promising to fight for ALL Americans, and mobilizing them to demand benefits they can feel confident they will receive from the Congress and the White House. We aren't going to accomplish anything but undermining our own cause by saying in one breath that "health care reform is the most important task facing our country" and then saying in the next "but it's OK if not every American can participate."
I also have much deeper moral qualms about throwing innocent people overboard like this. Have we so quickly forgotten the message of Barack Obama's 2004 DNC speech? Where he explained that there are good and decent people in the "red states" who deserve our allegiance and our support?
I fight for health care reform because of my fundamental believe that every single American deserves to have health care regardless of where they live, regardless of whether they can pay for it, regardless of any other consideration other than the fact that they are a living, breathing human being.
I cannot fight for a health care reform that has placed political hesitancy - which this opt-out compromise most certainly would be - above that powerful moral message. I know thereisnospoon is himself a deeply moral person, and he very much understands the role of moral language, as well as clear and honest framing, in shaping political messaging and action. I'm not saying backers of the opt-out are amoral. What I am saying is that they're actually undermining our most powerful and effective arguments by saying that the benefits of health care reform can be denied to someone because they have the misfortune to live under a Republican government.
This idea of cutting off the red states so the blue states can live also bears some resemblance to California politics. Here in CA we often hear that we should solve the budget crisis by slashing spending in Republican districts. Well, I live in a "Republican district." So does thereisnospoon. (At least in terms of who represents us in the State Senate.) I don't think I should see my community's schools shut down, our parks closed, our kids denied health care, just because a Republican won the election. I cannot imagine how that advances progressive causes, and I know that won't win any new votes for Democrats.
As far as I can tell, this opt-out is designed to wedge apart the powerful progressive coalition that has come together around the public option. And if enacted in the bill - which would be highly likely if it makes it to the Senate floor - it will wedge apart the potential progressive coalition that could come together around using government to meet the needs of the people, just as a similar coalition came into being around the New Deal.
We should reject this EPIC FAIL of a proposal. Throwing other people overboard in hopes they'll see the light and rise up against their oppressors is bad politics, bad strategy, bad tactics, and bad moral messaging.
UPDATE: To those who say CA voters would never listen to the insurance companies and opt-out, I present Proposition 72. In November 2004, the same election where John Kerry won 55% of the vote, only 49.2% of CA voters stood up to the insurance companies and big businesses and upheld a law passed in the waning days of the Gray Davis Administration creating an employer mandate to provide insurance. Arnold Schwarzenegger opposed Prop 72.