In the current battle over health reform, progressives may have set themselves up for trouble by pinning all their hopes on the creation of a government-run insurance plan. A public plan is not a bad idea -- indeed, it could be a critical element in successful reform -- but it could also easily turn out to serve the opposite purposes from the ones progressives intend.

All the proposals receiving serious consideration in Congress allow employers to continue to insure their workers and dependents directly. They also call for new "insurance exchanges" as an alternative means for individuals and employee groups to purchase coverage. If there is a new government-run plan, it would be one of the options in those exchanges.

The American political system, with its "status quo bias" (as political scientists call it), is not set up for moments like this when the economy is sinking fast and the country requires strong action that breaks with previous policy. After the election, many people concluded that conservatism was over and done with, and at least in one sense, that's true. No credible response to the crisis has come from the right. But if conservatism seems dead, it isn't nearly as dead as it should be. As the battle over the stimulus package indicated, the right can still exploit the many "veto points" in the system (such as the need for 60 votes to pass legislation in the Senate) to delay, water down, and obstruct the kind of coherent and capable action we need.