Here is my dream healthcare plan (it’s most likely unconstitutional, practically impossible, doesn’t address really any of the nuanced issues, and is highly unorthodox). Regardless, I do believe that it represents the greatest use of democratic principles:
Step 1: Design a strong public healthcare option in Congress. Forget about the rest of it, just make sure the public option is everything that it should be (“Socialist” or not).
Step 2: Figure out how to set aside a chunk of money to pay for the public option. When Blue Dogs and Republicans get upset, just let them talk.
Step 3: Declare that we believe each state should have the right to decide whether or not to adopt this public option. Those who don’t want it, don’t have to have it. How can those who believe in States Rights not accept this? Let the advertising and mudslinging, state by state, begin!
Step 4: Put it on the ballot, state by state, and allow the citizens to vote on it.
Step 5: Those states where the proposition passes will have the public option implemented in their state (which will not take away the right to keep current coverage for those who are happy already), and will receive the necessary federal funding (as well as any other funding being provided by other elements of the healthcare industry).
Everybody (or at least a voting majority) gets what they want!
Epilogue: Two things might happen in this scenario- a) the vast majority of states could pass the prop, thus taking the decision making out of the politically motivated hands of their clearly incompetent representatives. This would be extremely bad news for Republicans. Or, b) the measure passes in some states (perhaps those that light up blue), but not others. If this happens, I foresee massive migrations over the next decade to states that offer a public plan, thus cutting down populations in some states and adding to others. This of course will have a major effect on the number of representatives allotted to a state, etc, but at least these states will be able to save themselves from what they perceive to be Socialism.
Of course this is a pipe dream. But, then again, what would be so wrong with letting each state decide? Wouldn’t that be extraordinarily democratic? It would certainly serve to diffuse a lot of the political pressure on Congress. Then perhaps they could put together some legislation that will actually work.
UPDATE: I don’t believe that only those who are poor and uninsured would migrate to states with a public option. Rather, I think it would be a major selling point for businesses who would no longer have to pay for their employees’ healthcare, as well as for anybody with domestic help who pays for healthcare for their employees (ie upper middle class+).