We Need to Talk About Soft Secession

[summer_in_TX]

12. Here are three pragmatic ways to go around the actions of the federal government on healthcare.

The Super Healthcare Compact: Three Ways Blue States Can Make Federal Sabotage Irrelevant

Christopher Armitage discusses ways blue states have experimented with ideas that can, and in some cases are, becoming the means to bypass the parts of the federal government that are no longer functioning as they ought to. One set of examples "requires no new infrastructure, no government employees, no capital investment. Just new rules about how private companies operate."

"The second approach requires all of those things.
Blue states willing to commit pool 10 to 20 billion dollars and create a fully state-owned nonprofit insurance company."

"The third approach abandons insurance entirely and just provides healthcare.
The states build hospitals. They hire doctors and nurses. They operate clinics. People pay income-based premiums for access to the system. Emergency care outside the network is covered because nobody should die from being in the wrong place at the wrong time. Routine care happens inside state-owned facilities with state-employed physicians.

California spends over 160 billion dollars annually on Medi-Cal. Redirect 10 percent of that toward capital investment and you fund 50 to 100 primary care clinics and 10 to 15 regional hospitals within five years. Partner with existing public systems in Los Angeles County, New York City, and Cook County rather than building parallel infrastructure. Expand what already works."

Some of the methods expand on principles red states have carved into court rulings. Others systematize experiments some individual states have done already.