August 29th, 2009

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”.

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