Here's what I think is going down, and it's Obama-jitsu again.
What are the absolute essentials for effective and efficient health care?
Everyone must be in the pool, young and old, sick and well. Care must be rationed, using effectiveness research, like the Oregon Plan. Better care can cost more, but there must be a compassionate minimum that everyone gets.
How to do it? Get elected. Done.
Get the issue on the table. Done.
Get everyone interested, but don't lay your cards on the table until the crucial time, then settle for the minimum that will force the system into compliance with the requirements above. I think we only need two:
Everyone joins. No one can be refused. Now which one is being opposed, and by whom, and why? How are they different? The first way, mandatory insurance, captures the young and old, but makes the young unhappy because they don't think they need insurance. Of course they don't think they need car insurance, but it's mandatory.
That's the argument.
The second way, universal eligibility, requires the insurance company to accept everyone. It removes their profit margin, because only the people who are sick or worried about being sick, will apply for insurance.
Don't allow the insurance companies to pick and choose. If they want to be insurers, make them take everyone, at rates they must justify. Then the paperwork is theirs to do.
You see, the thing that was missing in the whole debate is the concept of insurance: as an insurer, you have to charge enough to cover likely payouts.
To profit, you have to run a big con, convincing people that they will get their money's worth of a product that can bankrupt the insurance company easily, and the bigger the numbers get, the less the public understands them, because they're easier to hide, fudge and fake.
Notice there's nothing about socialism, or public option, or universal care. If people don't want insurance, then they can apply for Medicaid. But a lot of people will buy insurance who are more aware of how sick they are than the insurance company can every be.
You know that. So Obama only needs to slide those two things through: everyone's eligible for any plan, and no take-backs of coverage. The rest falls into place naturally, but through emergent characteristics that the public won't understand, and the opponents won't be able to successfully object to.
Unless they read this. Watch Obama's speech to the Joint Session of Congress and see if that isn't what he comes up with. I predict he will. I trust his sneakiness.