What's more important? A public option OR single-payer at the state level?

[pilsner]

Single-payer, Medicare for all started in the province of Manitoba and swept across Canada because it became clear that it's a superior system.

Rep. Dennis Kucinich has an amendment in a house bill that would allow states to enact single-payer at the state level. By law, states can not currently do so.

The public option wouldn't have near the cost savings of single-payer.

My city alone, Columbus Ohio, pays over $100 million dollars a year for health insurance premiums for city workers and their dependents.

Just imagine what a windfall it would be for school districts and state and local government to cut their health insurance costs for public employees by 40 to 50%!!! And, the worker's comp system could be practically eliminated saving businesses billion$.

IMO, President Obama ought to be having Democratic mayors and governors pounding podiums across the country demanding single-payer, Medicare for all in the name of fiscal responsibility for taxpayers.

I think our best hope is that Rep. Kucinich's amendment survives and makes it out of the final bill that goes to the president's desk.

[Juche]

1. State level single payer

California has tried to pass it 2x, but it was vetoed by Schwarzenegger.

Some other states with dem majorities that might look into it are Illinois or New York. Those 3 states alone probably have 1/4 of the nation's population.

[Lasher]

3. I'll bet WV would go for it.

If our DINO Governor wouldn't veto it. :-(

[ThomWV]

24. West Virginia would be a horrible state to start with

There are very few comprehensive medical facilities particularly outside of just a few major cities (some rural areas are not only underserved, they simply are not served), our costs are among the highest in the nation, and we have one of the, if not the, lowest tax base in the nation.

Start with Massachusetts, a state that is already half way there.

[ThomWV]

25. Self delete - landed in the wrong place

[Lasher]

2. That is a very good point.

If I had to pick one I guess I would go for the state single payer option. But I don't see why it would have to be one or the other. Why not both?

[Juche]

4. True

It should be both. Imagine if 10 years from now we have 40 million + on the public option, and 50+ million on state single payer. Then you have over 60% of the public on public plans when you combine state single payer, public option, medicare, medicaid and SCHIP. Maybe at that point the plans can be combined into one massive single payer plan along with medicaid, medicare & SCHIP.

[Cleita]

5. If one state gets a good single payer plan going and it's successful,

most other states will follow. It happened in Canada. It could happen here.

[Juche]

7. California would save $344 billion over 10 years with single payer

http://www.pnhp.org/facts/single_payer_system_cost.php?page=all

February 2005: California

California could save $344 billion over 10 years with single payer

A study by the Lewin Group, finds that singlepayer would save California $343.6 billion in health care costs over the next 10 years, mainly by cutting administration and using bulk purchases of drugs and medical equipment.




Keep in mind this was 2005, and it is 2009 now so its going to be bigger savings by now.

If California (which has tried to pass single payer and has 1/8 of the nation's population) gets it, it has higher satisfaction and the California government saves $30-40 billion a year on health care it will be a huge victory for single payer.

[Cleita]

9. Well, we have the terminator vetoing our single payer bills,TWICE.

What do we do? BTW the Lewin Group is an astroturf group funded by United Health Care.

[Juche]

11. It still sounds like a legitimate figure

There are 2 studies finding federal single payer would save $400 billion a year in lower administration and bulk negotiations. So California could save at least 1/10th that kind of money.


Illinois will save $18 billion a year under single payer

http://www.healthcareil.org/financing2008.pdf

[Cleita]

12. I'm surprised they put something like that out.

Maybe since they were outed, they are trying to look legitimate. Actually, the California Nurses Association has some really good studies on this.

http://www.calnurses.org/

[Selatius]

16. When does Arnold's term limit come up? Could they try again with a Dem governor? nt

[Cleita]

31. In 2011. I understand that Jerry Brown is going to run. I can hardly wait!

:bounce:bounce:bounce:

[MarjorieG]

6. Why not both. States could offer it, and more supplemental ins. on exchange.

[pilsner]

8. I'm not opposed to the public option choice

but I think it's getting overplayed in the debate/reporting.

I think single-payer at the state level is much more important in the long run.

I've been calling the editor to my local papers asking them to do a story on what single-payer at the state level would mean. Of course they are too busy reporting on what the deathers and school opter-outers are doing to get to that.

[REACTIVATED IN CT]

17. State level is more doable IM O

MA has done it, San Francisco has done it, Howard County MD has done it. I'm sure there are other examples. It would take Federal funding to make it work, but I think people would find it easier to accept than "big government" involved in health care

http://www.healthyhowardplan.org/visitors/costs ( I heard it on NPR this am)

[MarjorieG]

22. Agree on both counts, hence Obama's de-emphasis interpreted as caving in.

We know that alternatives mentioned, co-ops don't reduce costs. As we regain debate, Town Halls over, media may have to cover debate and fact, again, we tried all the options and government-run option on the exchange the best.

My concern is offering something now. Some variation of Medicare age lower.

[bemildred]

10. Well, it is funny how the "states rights" people are not into this example of local rule. nt

[subterranean]

13. Aren't states allowed to enact single payer now? If not, why not?

Why did California try if it's prohibited by law?

[REACTIVATED IN CT]

18. Probably due to lack of funding

Most states are hurting these days.

[WeDidIt]

14. Neither

Allow multiple states to form single payer coalitions in order to build a larger bargaining pool.

What would ahppen is Jesusland would stay for profit health care states and blue states would form a single, huge coalition.

Eventually, the blue states would pay about 2/3 of what the Jesusland states pay and Jesusland would be forced to become rational.

[pilsner]

15. I like your thinking

but this stuff is going to happen incrementally and single-payer at the state level is our best hope at this time, IMO.

[REACTIVATED IN CT]

19. I agree that the incremental approach is the most viable.

Its too big a system to change all at once.

[Hepburn]

20. State level single payer....

...a successful state run system hopefully would lead to the end of the health insurance companies being allowed to rape the public.

[LeFleur1]

21. Single Payer?

How would that work for travelers? Right now, with our insurance, if we get sick or have an accident in another state our insurance will pay 70% (they say).

70% can be a lot if the sickness (or injury) is serious. Would each state take care of its own if their citizens were traveling throughout the US?

[Motown_Johnny]

23. It would be nice to have both, but I agree with you

if we can only have one then allowing state run single payer systems would be better.

[LWolf]

26. single payer at the national level is more important than either. nt

[ThomWV]

27. Opponents would love to see the fight broken into 50 winnable segments

They could kill it a lot easier that way.

[Hekate]

30. I see it exactly the same way, Thom. nt

[Donnachaidh]

28. single payer WON'T fly in all states -- OPTION and force the wingnuts to do it

So, basically you'd be willing to toss the people in red states under the bus just to help your own community? Is this the Dem version of *Fuck y'all, we've got ours*?

WOW. This country is getting frigging EMBARRASSING...

[Hekate]

29. It needs to be federal, and since I don't think Uncle Sam can buck the corporations...

... in America that means it will have to be public option and not single payer. Leaving it to individual states is going to end up preserving the status quo. California, for example, is dead broke and all social services are being cut to the bone. The reality is bleak.

Now, if the way is left open for individual states to create single payer plans over and above federal public option (as with air quality standards and the like), then that will work for states that are both socially liberal enough and have sufficient funds.

I wish the USA could have single payer, but it's not happening this year.

Hekate