James Madison once envisioned states as the laboratories of democracy. Now Democrats envision them as laboratories of the public option. Ezra Klein points me to this Sam Stein reporting:
Senate Democrats have begun discussions on a compromise approach to health care reform that would establish a robust, national public option for insurance coverage but give individual states the right to opt out of the program. ...
I think I like this idea.
One thing that concerns me about the health care bills is that it seems
to me that requiring every American to purchase health care represents
a windfall opportunity for insurance companies if you don't also
include some strong mechanism to keep prices down. At the same time,
the problem with the public option, from a cost-saving perspective, was
that the original versions in the House were too small to exert much
downward pressure on prices. A compromise that would create a national
public option that allows states to opt out might highlight the cost
savings of states with the plan, but the converse could happen too. A
neutered public plan that's also rejected by many states could end up
having no impact on prices -- or states with the PP might see their
prices rise faster -- and that might discredit the idea entirely.
