The Genius Of Opt-Out
(UPDATE: The usually astute Alex Koppelman proves a bit clueless. Reconciliation always was the public option's best chance. It still is, but now we know the leadership backs it. Big Tent Democrat opines that this also puts a full public option back in play.)
On the surface, opt-out may seem a cop-out, because the leaders of some states may just be insane enough to choose that option, leaving members of their citizenry to remain without health care. But the politics of forcing said insane state leaders to make such decisions could have powerful political repercussions. As in said insane state leaders either being proved hypocrite gasbags, by backing off from their shrill vows not to participate, or by having to face the inevitable political backlash, once the public option proves itself in other states. Said backlash would result in yet more Republicans being forced out of office (where some actually might come to appreciate the public option), while their Democratic replacements would inevitably and swiftly move their states boldly forth into the world of modernity and basic humanity.
I'm a fan of single-payer. The public option itself strikes me as a compromise. Opt-out is a compromise of a compromise. But it, too, may result in something far more powerfully progressive. Insurance industry apologists say the industry can't compete with a public option. They seem to presume that most people will sympathize with the industry, because their own lack of basic humanity seems to include a basic presumption that most people share their basic lack of humanity. They seem to presume that more people care more about the well-being of private industries than about people. They seem to presume that more people care more about the survival of one specific industry that serves no positive social function, and that exists and thrives off the financial ruin, physical and mental suffering, and premature deaths of tens of thousands of people, each year, than about its victims. Who happen to be people. I'm going to make a wild guess that they couldn't be more wrong. I'm going to make a wild guess that the vast majority of people care more about other people than about a private industry. Any private industry. And particularly this private industry.
So, here's hoping that said insurance industry apologists are right. Here's hoping that the insurance industry can't survive in an atmosphere of market fairness. Here's hoping that the entire industry implodes, collapses, and rapidly decomposes. Because what will be left will be a true public option for all. Opt-out could turn out to be the beginning of the end, for the private insurance industry. I'm guessing that industry insiders know that. Because even if some state leaders do deny their citizenry the option of affordable healthcare, said citizenry will see what's happening in states that didn't opt-out, and they won't like being excluded. And they will end up electing the political leaders that will serve their public interest. And once all states have joined the plan, the insurance industry itself will have to prove the value and viability of its very existence. And unless they can do that, the opt-out public option will inevitably become a back door to single-payer national health insurance.