Health care reform shorts: A wrong repeated?

There's some buzz on the nets today that our ever-so-slow moving Senators have found a compromise that will let the "public option" survive Congressional sausage making. That's the plan to lower premiums by giving the insurance companies some competition from a public non-for-profit insurer. All Republicans and those Democrats in the pocket of insurers hate the public option; they argue it would be unfair to make insurers compete to win customers. Maybe we should just call these legislators the "defenders of the private insurance monopoly"?

Anyway, the latest idea, promoted by New York Senator Chuck Shumer among others, would be to create a national public option -- but let states "opt out," choose not to participate. This has attractions -- it placates Congresscritters who want to be able to say they voted against "government-run health care" while creating a framework in which most of the big states whose populations want a public option get what they expect from health care reform. So who loses?.

Josh Marshall mused on what would probably happen:

The general assumption is that the opt-out states would be heavily red, disproportionately small in population and centered in the Mountain West and the South. And a number of people from these states wrote in today saying, Why is this such a great idea if it leaves me high and dry? It's a good question. And I think there's a decent issue of principle at stake in reform being national. We didn't do opt-outs for Medicare or Civil Rights (we'll okay, for a while, but not eventually) or Social Security (labor laws provide something of a counter-example). So why now?

Actually, creating legislation that kept out most Black people was exactly the compromise that enabled passage of the most important New Deal reforms. Social Security and unemployment insurance initially didn't cover domestic workers or farmworkers. Neither did the laws that gave unions a chance to organize. Who were those workers? Blacks, Latino farm workers, the rural poor.

During the New Deal, African Americans were sacrificed to get the framework of the U.S. version of a welfare state passed. It took the Civil Rights movement of the 1950s and 60s to get everyone included.

Do we really want to pass health care reform by leaving a lot of people, again many of them poor Blacks in the South, under the thumb of the insurance profiteers? Can we even consider this having just elected a Black president? Is that reform or regression?