Alan Grayson, (D-Fla) Introduces The PUBLIC OPTION ACT HR 4789

http://voices.washingtonpost.com/ezra-klein/2010/03/the_public_option_act.html
March 10, 2010

‘The Public Option Act’
This is a good idea:

UPDATE: Grayson has picked up 50 co-sponsors in just 2 days

Congressman Alan Grayson, (D-Orlando), today introduced a bill (H.R. 4789) which would give the option to buy into Medicare to every citizen of the United States. The “Public Option Act,” also known as the “Medicare You Can Buy Into Act,” would open up the Medicare network to anyone who can pay for it. ...

“The government spent billions of dollars creating a Medicare network of providers that is only open to one-eighth of the population. That’s like saying, ‘Only people 65 and over can use federal highways.’ It is a waste of a very valuable resource and it is not fair. This idea is simple, it makes sense, and it deserves an up-or-down vote,” Congressman Grayson said.

Comprehensive visions for reform and incremental visions for reform have been at odds throughout this process. That was proper, in many ways: When you’re building a new structure where the different parts work together, you have to be relatively comprehensive about it. But once that structure is constructed, incrementalism makes a lot of sense. Want a public option? Write the bill. Want to outlaw fee-for-service in the exchanges, or give a tax break to insurers who are constructing networks where the doctors have a different payment structure? Offer it in committee. Think subsidies should be higher, or maybe lower? Amendments are a wonderful thing.

A lot of these reforms become easier to implement when there’s a place to put them, and incentives you can offer to encourage their adoption. The exchanges are a big step forward in that regard. The public option is a good example. If we passed a public option now, how would you get it, exactly? Call the government? And how would you handle the adverse selection problem, where sicker people who were rejected by private insurers would use the government’s offering as a last resort?

There are a lot of other good ideas that wouldn’t work very well in the current system, but work a lot better when you’ve got a simple marketplace where a lot of different insurers are competing with transparent prices, standard descriptions, and some basic rules of the road. You need a comprehensive bill to set that up, but it can play host to a lot of incremental legislation going forward.