We may finally have a proposal on the table that could provide a resolution to the war of attrition on the public option. Under the proposal brought forth by Delaware senator Tom Carper, states would have the ability to opt out of the national public option if they did not with to participate. From a policy perspective, it’s an imperfect but workable solution. Perhaps two-thirds of states would likely enroll in the public option immediately, giving the government a substantial customer base and corresponding bargaining power with health care providers. The downside is that some people–especially those in poorer Southern states–might not have the public option available for at least the first year or two after it goes into effect in other states.
I don’t like the idea of excluding some people from a public option simply because they have the misfortune of living in a state full of Glenn Beck acolytes and conspiracy theorists, but these states might be prodded to adopt the public option once they see that it’s working in other states (without an accompanying boom in communes and without any seizures of private property). Given the toxic politics surrounding this issue, this compromise might be the best way to ensure passage of a strong public option while simultaneously giving conservative the opportunity to realize the real-life consequences of their nihilistic public policy.
