Americans Aren't Guinea Pigs for Health Care
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In my humble opinion Ezra Klein has been one of the best writers, on or off the internets, on both the politics and the substance of health care reform. Which is why I hate it when he gets all abstract and so far into Village politics he starts to forget there are real people affected by this stuff.
Case in point: A Public Option Compromise That Might Actually Work....on lab rats. Ezra is arguing that a compromise under consideration by "the Democratic leadership" is a reasonable compromise of the compromised compromise postion. Or something.
So the argument is that a public insurance option would be the default position for all state insurance exchanges, but states would have the right to opt out of a public option if they wanted:
States would then have the right to vote -- either by referendum, legislature, or simply a gubernatorial decree -- to make the option unavailable in their health care exchanges.
Ezra is arguing that this is a good idea since it provides a real world opportunity to test the impact of a public option:
It also creates a neat policy experiment: We can see, over time, what happens to state insurance markets that include the national public option and compare them with those that don't. We can see whether the worst fears of conservatives are realized and private insurers are driven out and providers are forced out of business due to low payment rates, and we can see whether the hopes of liberals are right and costs come down and private insurers become leaner and more efficient. Or both, or neither. It's an opportunity to pit liberal and conservative policies against each other, rather than just pitting liberal and conservative congressmen against each other.
According to this logic it makes sense to give this whackjob or this nutcase or the looney tunes making the rules here the authority to decide whether or not the people in their state get access to a public healthcare plan. And this is all a good idea because hey! lab test!!
In a word...No.
People are not lab rats. There's no need to test whether "the hopes of liberals are right". Public options have been tested - they're called Medicare and the VA. They work. They're cheaper and, when done right, provide better continuity of care than our current mishmash of a system.
Any governor or legislature that decides to forgo a public option on behalf of the citizens of their state should first be required to forgo the public healthcare they are no doubt receiving thru their state job.