Paul Starr

Paul Starr is co-founder and co-editor of the The American Prospect. and professor of sociology and public affairs at Princeton University. A winner of the Pulitzer Prize for General Nonfiction and the Bancroft Prize in American history, he is the author of seven books, including most recently Remedy and Reaction: The Peculiar American Struggle over Heath Care Reform (Yale University Press, revised ed. 2013). Click here to read more about Starr.

Recent Articles

The Opt-Out Compromise

How to let individuals out of the insurance mandate and improve the odds of health-care reform.

President Barack Obama at Arcadia University in Glenside, Pa., Monday, March 8, 2010. (AP Photo/Charles Dharapak)
If the House of Representatives passes the Senate health-care reform bill with the changes recommended by President Barack Obama, and the Senate then passes those final changes through reconciliation, no one will be more pleased than I (see " Underrating Reform " in the Prospect 's March issue). But suppose that after the White House and congressional leadership press their case, twist arms, and count heads, they are still short of the votes they need. Should they just give up on the legislation, or can they make any additional concession to attract votes while preserving the aims of reform? Last Thursday, in an op-ed in The New York Times that built on a November article in the Prospect , I proposed a change that may help gain the votes of some conservative Democrats and assuage the concerns of many Americans who object in principle, or out of fear, to a federal health-insurance mandate. My proposal would enable a congressman to say to constituents angry about the federal mandate, "...

Last Chance for Health Reform

Neither the progressive nor the anti-abortion House Democrats are making any sense in threatening to kill the Senate bill.

(White House/Pete Souza)
The following column was written before the release of President Obama’s proposed changes to the Senate health-reform bill. Those changes, to be made through the budget-reconciliation process, should reduce objections from House Democrats on several points. In particular, the president proposes to raise the threshold for the excise tax on high-cost health plans to $27,500 and to postpone it to 2018. A compromise on these lines should help ease the transition to a new system of coverage with better incentives to control costs. After the House and Senate passed similar health-care reform bills late last year, Democrats seemed unlikely to snatch defeat from the jaws of victory. But as of early February, that looks to be the outcome unless House Democrats come to their senses and vote for the bill the Senate approved in December, preferably with changes made through the Senate's 51-vote budget-reconciliation process but without those changes if necessary. Before the Massachusetts election...

Underrating Reform

Even with its compromises, health reform is the most ambitious effort in decades to reorganize a big part of life around principles of justice and efficiency.

Sen. Ben Nelson and Joseph Lieberman. (AP Photo/Lauren Victoria Burke)
If Congress can complete work on health-care legislation and send it to the president (as of mid-January, the final bill is still under negotiation), it will be a stunning historical achievement and the most important liberal reform since the 1960s. It may also be the most underappreciated social legislation in recent history. Never in my experience has such a big reform been treated as so small. Never have Democratic members of Congress who are putting their careers on the line for something they believe in been so vilified as sellouts by influential progressives. And never have those progressives been so grudging in their endorsement of landmark legislation or so willing to see it defeated. How this happened is clear. Facing united Republican opposition, Democratic leaders made a series of concessions to win over centrists in their own caucus and to neutralize key interest groups. One point of contention -- the public option -- came to symbolize hopes on the left, and when that...

Obama Year One

Obama was right to take on a wide range of tough problems, and no one should be shocked at the obstacles in his path.

(White House/Pete Souza)
As Barack Obama ends his first year in office, there is much talk about disillusionment with the president among progressives. The litany of complaints is obvious: unemployment still at 10 percent, economic policies unduly favorable to Wall Street, the surge in Afghanistan, compromises on health care, the failure to close down Guantánamo, and a general inability to bring about the transformative change that Obama spoke of during his campaign. Policy has certainly not moved as fast or as far as many of us would like. But perhaps because I never shared the political fantasies about Obama in the first place, I don't feel let down, and I don't think other liberals should. No president was about to turn the country around on a dime -- the structure of our government doesn't allow it. And anyone who paid attention to what Obama said as a candidate about specific matters of policy would have realized he wasn't the lefty some imagined and others feared. It is a myth, as the historian David...

Deal or Die on Health Care

Why progressives should support a Democratic compromise.

Senate Finance Committee Chairman Sen. Max Baucus, Monday, Dec. 14, 2009, in Washington. (AP Photo/Haraz N. Ghanbari)
The moment of decision on health-care reform is arriving for progressives in Congress. Some of them have insisted they will refuse to vote for any bill without a public option, and that is now the only bill that has any chance of passing. If they hold to their position, the most significant social reform on behalf of low-income Americans in 40 years will go down to defeat. It should hardly be surprising that we have come to this point. The requirement for 60 votes in the Senate to pass ordinary legislation was always going to empower the most conservative members of the Democratic caucus or the few moderate Republicans who might support a bill. For a while this past week, it seemed as though a provision to allow 55- to 64 year-olds to buy in to Medicare might provide an acceptable alternative to the public option and secure the 60th vote for the bill. But when both Joe Lieberman and Olympia Snowe said they wouldn't support a Medicare buy-in, that hope dissolved. None of this, however...

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