Opt-out amounts to selective secession

If it becomes law, the opt-out public health care plan will amount to a form of selective secession, which may not be a bad result.

The opt-out scheme is being offered in Senate legislation to ensure that health-care reform provides a government-run system in lieu of health insurance afforded by private companies and other operations. Each state will have until 2014 to “opt out” of the public system, as Senate Majority Leader Harry Reid explained it in media reports.

The predictable assumption would be that more conservative states controlled by Republicans will be inclined to forgo a public option while moderate and liberal states will embrace it. Obviously, New Yorkers and Californians will savor the public option while someone in Idaho or South Carolina might be denied medical insurance because of the reaction of their legislature and governor.

Many would readily concur that the Civil War never ended, as the war re-emerged in different forms since 1865. The war is ongoing between those who seek to help the have-nots and those who think they are protecting their wealth. The issue was slavery at one time, segregation at another time, now it is health care.

After the last three decades of conservative dominance, I have often wondered if South Carolina had the right idea when it seceded from the Union and touched off the Civil War. To say the least, I am certainly glad that slavery ended, but bear in mind that Southern states and other conservative enclaves have often straight-jacketed our government from improving opportunities for the less fortunate and, in general, allowing progress.

What would have happened had President Lincoln just permitted South Carolina and other southern states to secede from the Union? We can make speculative arguments for both pros and cons, especially the question of slavery, as to what might happen. Getting into these arguments need to wait for another column.

The opt-out concept is intriguing because of its genuine potential to lead to comparable arrangements for other policies. States that wish to avoid participation in a national policy can go their own way. Of course, secession meant that a state or states would go their separate ways entirely.

In the case of health-care legislation, most states with the largest Jewish populations will almost certainly accept the public option, while many small states with low Jewish populations, in addition to Texas, might opt out; more than 100,000 Jews are estimated to live in Texas.

Florida would be especially tough to predict. Would seniors who inhabit much of Florida believe the public option will threaten Medicare or help them? One-third of Florida’s 18 million citizens live in the heavily Democratic and Jewish southern counties of Broward, Miami-Dade and Palm Beach, while northern and central Florida is much more conservative.

While some members of Congress belong to the opposition, political figures in their own states could opt in, anyway. The wooing of U.S. Sen. Olympia Snowe of Maine was silly. Both of Maine’s representatives in the U.S. House of Representatives - Democrats Chellie Pingree and Michael Michaud - have posted announcements supporting a public option, and in fact Pingree’s daughter is speaker of the Maine House of Representatives. Gov. John Baldacci led the formation of a state-run health-insurance program six years ago, so I cannot imagine Maine leaders resisting a national system if it beats their own system.

Three years ago, Pennsylvania’s two senators could be expected to oppose a public option had the issue arisen, but now the state’s two senators are among its advocates. Republican Rick Santorum was ousted in 2006 by Democrat Bob Casey in 2006 and Arlen Specter switched from Republican to Democrat earlier this year because he feared he would lose next year’s primary to an ultra-conservative challenger; it is no secret that President Obama would support his re-election bid in return for his support on core issues. Democratic Gov. Ed Rendell clearly wants affordable health insurance, but the Pennsylvania legislature might be sharply divided on this issue because of party loyalty and ideological differences.

Disputes over tax dollars allocated for some states and not others is barely pertinent. The heaviest flow of federal tax revenues originates in places such as Beverly Hills, Manhattan’s Upper East Side and Fairfield County in Connecticut, all states with substantial support for a public option; SenatorsChristopher Dodd and Joe Lieberman are split and all five House members openly support it or are seriously considering it.

Even states whose leaders are dead set against a public option might come around later if the public option succeeds elsewhere. Public demand could eventually pressure them into accepting the option.

Lawsuits from both sides of the issue could be filed. Individuals who live in no-option states might complain that they are being deprived of a federal service. Opponents could argue that a law which only benefits some states violates the constitution.

The same opponents never complained about disproportionate spending for projects in their states.

The opt-out clause is fine so long as my state, Pennsylvania, permits all its citizens - including moi - to be covered by affordable health insurance. Though people may question the constitutionality of this provision, but the constitution says nothing about selective secession.

The founders would not have been so surprised. They experienced plenty of convoluted politics themselves.