Friday, December 25, 2009

If final federal legislation allows an opt out from federal pro-insurer constraint, Minnesota could have its own SINGLE PAYER healthcare reform.

Eric Black used to write for the Strib, and since has moved to Minn Post. His work has always been first rate, his latest item included; this link.

In it, Black reports about six of ten DFL candidates for Governor that support a John Marty drafted state bill that would establish single payer coverage for all Minnesotans, with the privateer-profiteers of the insurance-industrial complex frozen out, driven to the sidelines to offer extended coverage plans and proposals, as is proper in a proper world as the proper private insurer function because access to decent baseline healthcare for everyone is a fundamental human right. Including dental coverage. With cost-payment administration to get fair prices from providers and Big Pharma. Even if it means buying in Canada for Minnesota plans. If UnitedHealth wants to provide Schiavo coverage above and beyond basic, bless them and all who'd buy it. A market for extra-wealthy-extra-coverage extensions would not close the privateers out entirely.

Detail of how a state single payer system would interface with Medicare and Medicaid and the multinational corporations providing private-funded coverage might need to be worked out, but that is opportunity, and not problematic. Some large multinational businesses self insure now, with or without insurance firms holding management contracts, but again, detail can be squared with the basic rights of everyone to adequate healthcare being the cornerstone to all details of reform.

The screenshot, below, gives a feel for the entire article, via a few opening paragraphs. There is much beyond the opening in the item for intelligent readers to enjoy. Please read this item if you read little else between the holidays. It presents hope for the public. It shows that not all in politics are crass, or compromisers, or appeasers, or tools of lobbying cash. Six - Marty, Kelliher, Thissen, Dayton, Bakk, and Rukavina are reported by Black to embrace single payer for Minnesotans. They have the good sense to affirmatively distance themselves, on the record to the press, from the mess that the DC divas are producing against us, rather than for us. That is six out of ten candidates reported to favor this true reform. The other four? Who cares?



Again, to read the entire article and to be able to follow items linked to in the Minn Post's report, this link.

________UPDATE_______
From a cursory reading of Eric Black's report, I was unsure he'd pinned people down on positions. He did. He did not rely solely on bill sponsorship. Right now, from his reporting, and the waffling and hesitations of some, and late arrivals to the thought; I am leaning more and more toward favoring John Marty and Mark Dayton as the best progressive candidates in the crowded field. Others are quality people, but healthcare is my major issue and after the mess made by BOTH houses in DC, there's little hope for any decent package at the federal level. That is why I would base a decision on Governor by who shows the most courage and dedication to healthcare as a human right, and all others fall by the wayside, the naysayers and the qualifiers. Those resorting to shilly-shallying might make some feel more comfortable, but I prefer, so far, the unqualified commitments of Marty and Dayton.

And let the GOP tax warlocks have their bleating frenzy, for we are talking decency and human compassion - for real people with real needs, and we should do that and not slip instead to splitting hairs over the hypothetical status of embryos as a means to deny families the fundamental right and ability to choose how to manage their size and make up, and to time family expansions they might desire, rather than to have unwanted changes thrust upon them because of feelings others have that they should choose such things for all families. That kind of hubris fires the GOP zealots in their RINO purge frenzy; and may they remain the happy unified loud obstreperous minority they seem intent to be.

Further update - the second paragraph of the post was revised and extended.

___________FURTHER UPDATE___________
There should be no bar against a state opting for its own single payer system. If the federal bill permits opt-out for states wanting and liking the status quo, it is only simple fairness to allow opt-out to permit various other forms of state experience - experiments to allow the chance of finding better ways.

This fits the well known quote of Justice Brandeis that the states are the laboratories of democracy. For thoughts in that direction, here, here, here, here, here.

The Brandeis dissent was in his Supreme Court dissenting opinion in New State Ice Co. v. Liebmann, oft called “Laboratories of Democracy” quote:

It is one of the happy incidents of the federal system that a single courageous state may, if its citizens choose, serve as a laboratory; and try novel social and economic experiments without risk to the rest of the country.


Massachusetts has its Romney plan, which some have characterized as faulty and far too expensive - and it has similarities to what the two houses of Congress are up to.

Minnesota should take the shot that the DFL hopefuls support, and prove single payer a far better way to proceed. It would be a fine laboratory of democracy up on the hilltop in St. Paul, if it happens.

On that, the base coverage per single payer should be top-down thoroughout government. From the Governor to every city receptionist - no special deals. If the bureaucrats want better terms and conditions, for the taxpayers to pay for that, then they have to lobby the legislature, on the same plan, to change things for everybody.

Their feet should be to the fire. They should not have any better deal than the deal available to the taxpayers who would be funding things. That would mean a legislated bar to any collective bargaining contract with a government entity for the bargaining unit to cut special deals for themselves at consumer-taxpayer expense.

Private entities could provide privately provide extended coverage, and pay on government bargaining unit contracts can be adjusted so that the bureaucrats can have extra cash compensation with which they could buy the extended coverage, or not.

But to make it work, there would either have to be few but well defined tiers of single payer coverage via some opt-in greater payments by the covered individuals above the base threshold; or only a base threshold with all else private sector - at least at the start.

But that's getting too far into details. The aim should be to establish the framework, Minnesota goes single payer, statewide, public and private workers, farm labor, all included. One person proprietorships, multinational corporations employing people in state. Everybody in, no opt-out, and then there can be opt-in extended coverage possibilities, or not.