Today's Column and What Next?

Today's column is about what the Baucus plan represents culturally: one last chance to see if private insurance can work to get us to universal coverage in an affordable manner. And the Baucus plan is quite similar to the Chafee plan offered in 1994....so what was once considered a moderate Republican alternative is the vehicle to move ahead when the Democractic party holds the White House, 60 seats in the Senate, and a big majority in the House. There actually has been some bipartisan health reform disucssion....it has just all taken place within the Democratic party.

There is a lot of chatter about a public insurance option that would be national in scope, meaning offered through exchanges in all states, unless state opted out. Sens. Schumer and Carper are driving this, and Howard Dean and Sen. Ben Nelson (Colorado) both seem to be supportive. Dean and Nelson are both mammals, but that is about it.....they are also both Democrats, but they demonstrate how much political diversity exists in the Democratic party. And if they are both for this, well, seems a pretty good chance. Republicans will have to oppose state options/rights to be against this....which I am sure they will be (gov't takeover and all that). But, really, they are running out of effective arguments because their lines of attack have been so fully played already. This might be what raps up Nelson to vote to break a filibuster and then allow him to vote against the bill in the Senate. Blanche Lincoln and other conservative Democrats, who knows? At this point, the only way to snatch defeat from the jaws of victory for the Dems is to blow everyting apart over the income tax increase (house) v. tax on high value insurance policies (senate). But, if they can't work that out, you really have to say the Dems will have shown themselves unable to govern.....and if they can't close the deal now, what is the point of the Democratic party?

In the, I am as dumb as I look category, I counted public option as totally dead for the past month, and have been saying so, but I appear to have been wrong.

Most interestingly for those of us in the Tar Heel state (I work at Duke but went to UNC--3 times, so it doesn't bother me to write those words), what would happen in North Carolina under this public option/opt out approach? Would we opt in, or out?

Many might assume since the Democratic party controls everything in N.C. we would opt in.....but I would suspect that Blue Cross/Blue Shield NC would lobby for the state to opt out and I wouldn't bet against them. I don't know they would be opposed for sure, it is just my guess.....