Why not a "Blue State single payer health coalition"?

[mainer]

With all the protests and falling polls, I'm growing more and more pessimistic that we'll have a national single-payer option in the immediate future. So what if the blue states banded together and formed their own single payer option coalition? If the Northeast, California, and the Pacific Northwest all banded together, pooled their resources, and offered a single-payer option for coalition residents, it would:
-- force private insurers to drop their rates in those states, just to compete
-- attract employers (and jobs) because those businesses wouldn't have to foot the bill for expensive health insurance
-- and best of all, offer universal coverage for those residents.

In addition, by not having to cover people in uncooperative red states, where they have higher obesity and smoking rates, we wouldn't be saddled with the unhealthiest, most expensive patients.

Does anyone else think this would work?

[John Q. Citizen]

1. you don't understand what single payer is or what it means. That's OK but you need to do some

research.

[mainer]

2. Single payer = blue states form their own medicare-type union

what's not single payer about it? A surtax on state income taxes, allowing everyone to enroll in a Medicare-type plan for the residents of those states. Doctors and hospitals are paid directly out of that fund. No intermediary needed.

[mainer]

4. p.s.: UK has single payer, but also has private insurers as well

If you want to pay extra for "cadillac" service, you can also have private health insurance in addition to the NHS.

[slipslidingaway]

5. In the UK you still pay into the NHS even if you buy additional private

insurance...everybody contributes to the national system.

[mainer]

6. Right. EVERYONE has to contribute or it won't work, in the UK or here.

And in the UK, those who want extra options simply buy an additional supplemental policy. So the wealthy still get their privileged care.
But everyone at least gets basic healthcare.

[dflprincess]

23. The UK has truly socialized system not single payer

the government owns the NHS hospitals and clinics and the medical personel at those facilities work for the government program.

I would with a guy from England who just had to race back there because his mother was quite ill. Now that he's back he can't say enough good things about the NHS. And, Stephen Hawking has also come out with high praise of the treatment he has received through NHS.

[John Q. Citizen]

8. For one thing, they would need a waiver from the feds to use fed health care dollars in a different

system.

It makes much more sense to do it state by state or to do it federally.

[mainer]

9. how would it be using federal health care dollars?

It's only for state residents who are NOT already enrolled in medicare. It would be paid out of state income tax surcharges. (Not federal)

So it would cover residents <65, who are not already covered by federal plans.

These would be younger people, with fewer healthcare issues. That would help keep down the cost of the program.

[John Q. Citizen]

18. It's not single payer if there are multipayers. as much as you might like it to be.

The cost savings of single payer are never realized in a multipayer system. What about Medicade and SCHIP, mostly people who are younger?

What you are advocating sounds like the co-ops or a smaller "public option." So why not just advocate for the co-ops or for the public option if you feel that's the way to go?

Personally I'm opposed to market based or hybrid ideas. They have never worked in every state they have been tried in, (OR, WA, VT, MA, TN, to name a few) but they still keep trying them, the "public option" being the latest attempt.

We know that true single payer systems works. They contain costs and they cover everyone. If you want gold plated water faucets in your hospital room then you can buy supplemental insurance, but single payer means NO private insurance for publically covered services and medical supplies and drugs.

[FLDCVADem]

22. And this is where single-payer advocates lose me

"but single payer means NO private insurance for publically covered services and medical supplies and drugs."

I have zero problem with paying, via taxes, into a single-payer plan available for and and all that want it. But I'm not in favor of barring those that want to pay via other insurance or out of pocket if they/we choose to do so.

[PHIMG]

30. why would you pay for something twice>

If you pay for basic medical service via taxes under a national health care program why would you willingly pay more money to say Aetna to provide you with double coverage? Only reason I can see is that Aetna would spend hundreds of millions of dollar in advertising to convince you and all the rest of the rubes that what you get from the government is somehow inferior and that is probably why the single payer bill makes offering private insurance coverage for basic services illegal.

[FLDCVADem]

31. Because I'm very happy

With the coverage I have now (yes, with Aetna) and would see no reason to change it and potentially go with something that isn't as good or with potentially longer waits.

And so long as I'm willing and able to pay for both, even if I'm only using one, why should you or anyone else care? More money for the single payer plan but four fewer people using the benefits.
Sounds like a good deal to me (for single payer).

***edited to add that I did 20 years under government run health care (military) and it sucked. We double paid for years in order to keep our kids out of the military health care system, so been there, done that.

[PHIMG]

34. Well get sick and see how happy

When the deductibles and copayments pile up. Or how happy you are when your premium goes up 20% next year.

Private Insurance is a racket.

[FLDCVADem]

36. Our premiums do go up

though not 20% per year (yet). 10% year before last, 11% last year, and I'm still happy to have it because it's great insurance. We don't have a deductible and we have low ($15) co-pays ($25 for specialists).

But none of that matters - if I'm willing to pay more in taxes to provide a single payer plan, why should anyone care if I'm willing to also pay out of my own pocket to go outside the single payer plan? Why is that anyone's business but mine, so long as I'm willing and able to do it?

[eridani]

32. What's wrong with restricting private insurance to supplying the extras?

It would be like barring private life insurance from raiding the pool of money used for Social Security Survivors' benefits. The private life insurance is still there for those who want more.

[FLDCVADem]

37. Because I don't believe in restricting choice that way

What's wrong with allowing people to buy private insurance if they don't want to use single payer, so long as they are still paying the taxes for single payer?

[eridani]

39. Nothing, as long as they use it for extras

Allowing them to use private insurance for regular coverage means allowing them to help insurance companies kill sick people. A choice to join a pool of healthy people and dump the sick in a public pool isn't a choice that should be allowed to anyone.

[Vincardog]

3. If the RepigLICKERS and Blue Cross dogs will not allow it to proceed on the National level, it might...

[gtar100]

7. I would support that. But there would still be push-back from the health-kill industry.

And the right wing stupid virus has spread everywhere, just less pervasive in blue states.

[npk]

10. There is no competition with a single payer system

-- force private insurers to drop their rates in those states, just to compete

--------------------------------

In a single payer system their is only one entity paying for health care, and that would be the government. There would be no private insurance rates to drop, because there would be no private insurance.

Also when the federal government institutes something it applies to all states, not just to those "blue states" you refer to. That's is kinda the nature of a federal government.

There is no such thing as a all blue state and all red state. There are conservative and liberals in every state in the union. Yes even in California.

[mainer]

11. The coalition depends on states voluntarily joining.

And those who join, participate. Those who don't continue to have significant pools of uninsured residents.

Each state has to decide, and I suspect that that voters in Connecticut and Vermont will be more willing to vote for -- and join -- this system.

The federal government has NOTHING TO DO with this proposal. Why do you mention the federal government instituting this program? It's something the states may feel compelled to do on their own because Congress is too cowed (or overwhelmed by its conservative members) to ever pass a national public option.

Massachusetts already has a public option and full coverage on its books. The federal government didn't object.

[npk]

16. Basically a health care coalition amongst several states

would fall under the authority and jurisdiction of the federal government. I understand what you are saying, but that's not the way the country works. You cannot have a coalition amongst say only 20 states that is not managed in some capacity by the federal government. There may be state local oversight, but the money and authority to run and govern such a program would come from the feds. That's why states can't form pacs, or conglomerate policies that would supersede federal authority. It's kinda of a all for one sort of thing.

[John Q. Citizen]

17. MA doesn't have a public option. MA has subsidized private health insurance, and it's failing. They

are already cutting benefits because there is no cost containment.

They also don't have full coverage.

They are paying more, per capita, for health care than most states.


In my opinion a much better idea is to work to keep the Kucinich option in HR3200 (the house 'reform' bill) that would allow states to start their own single payer system and to use all the federal health care dollars for that system. That way they can eliminate the redundancy of multiple payer systems and actually contain costs, which means health care is affordable and available for everyone.

[mainer]

20. Massachusetts plan is NOT failing

You are repeating what appears to be a rightwing talking point.

Boston Globe writes this:

Mass. bashers take note: Health reform is working
August 5, 2009
Email|Print|Reprints|Yahoo! Buzz|ShareThis Text size – +
PUNDITS and politicians who oppose universal healthcare for the nation have a new straw man to kick around - the Massachusetts reform plan that covers more than 97 percent of the state’s residents. In the myth that these critics have manufactured, this state’s plan is bleeding taxpayers dry, creating nothing less than a medical Big Dig.

The facts - according to the Massachusetts Taxpayers Foundation - are quite different. Its report this spring put the cost to the state taxpayer at about $88 million a year, less than four-tenths of 1 percent of the state budget of $27 billion. Yes, the state recently had to cut benefits for legal immigrants, and safety-net hospital Boston Medical Center has sued for higher state aid. But that is because the recession has cut state revenues, not because universal healthcare is a boondoggle. The main reason costs to the state have been well within expectations? More than half of all the previously uninsured got coverage by buying into their employers’ plans, not by opting for one of the state-subsidized plans.

This should be exciting news for those fiscal conservatives, including both Republicans and “blue dog’’ Democrats, who claim to support the goal of universal coverage while despairing over its budget impact. But that’s not what you hear from the Massachusetts bashers. Trying to scare off the nation from helping the uninsured get coverage, Fox News host Bill O’Reilly said recently, “You don’t have to look any further than the universal healthcare mess in Massachusetts to see disaster ahead.’’ New York Times columnist Ross Douthat on Monday accused President Obama of “pushing a health plan that looks a lot like the system currently hemorrhaging money in Massachusetts.’’...


... Whether out of ignorance or convenience, all three bashers have it wrong. Unlike the Big Dig, health reform came in on time and under budget. It will be proportionately more expensive nationally to provide coverage for the uninsured than it has been here simply because the state began the task with a much lower rate of uninsured, 7 percent, compared with the US rate of 17 percent. But a national plan that relies, as Massachusetts’ does, on both government-subsidized insurance and a mandate on employers to offer insurance or pay a penalty (in Massachusetts’ case, a very small penalty) should be able to cover nearly everyone without busting the budget...


...There is one other statistic about the Massachusetts plan that politicians, in particular, should appreciate. According to Robert Blendon of the Harvard School of Public Health and the Kennedy School of Government, the law’s approval rating in June 2008 was 69 percent. That is a figure officeholders can only dream about.

http://www.boston.com/bostonglobe/editorial_opinion/editorials/articles/2009/08/05/mass_bashers_take_note_health_reform_is_working/

[John Q. Citizen]

24. Check who is on the board of the MA Taxpayers Asso. it's health insurance CEOs and banks.

Here's a link to a study by Physician's for a National Health Program.

http://pnhp.org/mass_report/mass_report_Final.pdf

If you read the Boston Globe article you will see that they are cutting benefits. Why? They blame it on the recession. Yet Canada has a recession and they aren't cutting benefits. that's because Canada has cost containment through single payer. Massachusetts doesn't.

So they are cutting people's benefits. No thanks.

You may have noticed that the insurance industry loves the MA plan. It's free tax payer money for them, and everyone is forced to buy their product under penalty of law. So of course the group that has a bunch of their people on the board of directors are raving about how great it is. Look for yourself. http://www.masstaxpayers.org/about_mtf/board_trustees

[customerserviceguy]

12. I think it's a reasonable idea

You would get blue states to send delegates to a convention where a system would be worked out. We already have laws that are like this, anything that starts out with the words, "Uniform ... Code" was something arrived at by a committee of lawyers, lawmakers, public policy experts, industry insiders, and consumers to come up with a basic system of applying laws.

They're enacted on a state-by-state basis, sometimes they get modified to reflect the realities in a particular state, but for the most part, they get 95-98% adopted in the form that the committee or commission came up with. Any states that think they want to join, but get pissy about the details can just withdraw their delegates, or be asked politely to leave. Any state legislatures that cannot go along with the package can just stay the way they are, and be part of the misery of the red states.

There would be strength in numbers, and if you had the Pacific states (with the possible exception of Alaska) the Northeast states, and some progressive Midwestern states in the mix, they would have powerful negotiation power when it comes to buying drugs and equipment. Anyone who doesn't like the system is free to move to another state, and like you said, red states would get saddled with the least healthy among us.

It wouldn't require a dime of Federal money, and would totally do an end-run around the jerkoffs in the red states. Maybe after a decade or two of it's success, one by one, they would join in as they pull their heads out of their asses.

[mainer]

13. Yes, drug cost negotiating power would be part of it.

Another way it would help cut costs.

If we can't get the red states to move forward into the next century, we may just have to do it ourselves.

[customerserviceguy]

14. This is the way we've approached a lot of problems

Equal marriage is being done on a state-by-state basis, that was the way that civil rights progress has worked for decades. Women's suffrage happened on a state-by-state basis before the 19th Amendment was passed.

When you have a nation that has such a diversity of political opinion, sometimes you cannot all move forward at once, sometimes there have to be leaders willing to show the way.

If the Northeast, the West Coast, and a few populous Midwest states such as Wisconsin, Minnesota, Michigan, and Illinois were in a single-payer coallition, they would have the majority of the US population covered under this. After it hit that critical mass, it would be folly to not be a part of it.

[stopbush]

15. Ah-nold twice vetoed universal health care for CA. (2006/08)

It was single payer and narrowly passed the CA Assembly.

Supposedly, he says he would sign such legislation now, but with CA's budget a disaster, no one is willing to bring forth a bill.

[abumbyanyothername]

26. California should be able to stand on its own.

We are over 36 Million people. More than Canada. More than half the UK or France.

I am not sure why the current budget mess makes any difference. The program should pay for itself in lower costs, together with diversion of the current day premium stream.

[FLDem09]

19. I like the idea

Personally I have a huge distrust for the federal govt no matter which party is in power. I think that what you have proposed is a great idea. It takes power out of the fed gov hands and allows the states control over the fine details of the plan. More people would trust a system like this that each state can tailor to fit their own needs, IMO.

[AllieB]

21. Ayn Rand? You've got to be shitting me.

And your profile says: "The only thing that we all have in common is our disdain for BUSH and company. Who would have thought that in just 8 months Obama could make Bush look so good. We'd be much better off with a CLINTON in charge."

Obama was left a flaming pile of dogshit on his doorstep by Bush. It's going to tak a lot longer than 8 months to clean up 8 years of deregulation.

[scheming daemons]

28. Dont call yourself "FLDem" when your profile indicates you're a freeper troll

[AllieB]

29. Exactly!

They're out in full force lately.

[steelmania75]

25. I say go for it. California, Hawaii, Maryland, DC, New York, New Jersey, New Hampshire, Connecticut

Vermont, Rhode Island, Massachusetts, Maine, Washington(state), Oregon, Illnois, and Pennsylvania should form a coalition for single-payer.

[scheming daemons]

27. Because millions of democrats/progressives live in red states and it isn't fair to them

[customerserviceguy]

33. They always have the option to move

to a more progressive part of the country if things get too bad. There are rural areas in each of the blue states that would be very compatible with the lifestyle they are accustomed to leading.

[JCMach1]

35. Even better, let people choose single-payer or the current system

How many of those screaming repigs wouldn't sign-up... very farking few!

[kctim]

38. That's actually a great idea

Every one of my friends say they would support President Obama's plan IF they were allowed to choose which one they could pay for and didn't have to pay a cent for the other.