Paul Starr

Paul Starr is co-founder and co-editor of 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 eight books, including Entrenchment: Wealth, Power, and the Constitution of Democratic Societies, which will be out next year.

Recent Articles

Health-Care Reform Gets a Booster Shot

Obama's speech had some important news: His plan now includes some immediate relief on insurance costs.

(AP Photo)
President Obama's speech to Congress on health care Wednesday evening succeeded at several levels. Beforehand, observers said that he needed to explain to a confused public what he is proposing and why it makes sense, and the speech did that. Analysts also said that the president needed to shift the momentum from August, to confront the ugly distortions of the opposition, and to mobilize support in his own party. In those respects as well, the speech did all that might have been expected of it. But Obama also undertook several things that were unexpected -- at least, I didn't expect him to do them. He introduced an important new element into the policy discussion. He signaled his support for what is now the likely resolution of the most contentious issue -- the public option. And after paying respect to Republicans for their ideas, he used the coda of his speech to make the larger case for liberalism more eloquently than any president has in decades. The new element in the policy...

Sacrificing the Public Option

Chill out, progressives. To get health-care reform through the Senate, the public option is almost certainly going to have to be dropped.

A supporter of health-care reform leans on her sign during a rally in Belgrade, Montana. (AP Photo/Mike Albans)
Contrary to some overwrought reactions on the left, if a public insurance option fails to make it into this year's health-care legislation, it does not spell the end of worthwhile reform. The president and Secretary of Health and Human Services Kathleen Sebelius have been entirely correct in saying that the public option is only a small part of the reform effort. The general framework for health insurance that Democrats are advocating does not depend upon a public option. And if a public plan is enacted, it may be so compromised that it could backfire on reformers and become a high-cost alternative rather than the cheaper option that progressives are hoping for. Because the public option has stood no realistic chance of being enacted in the form it was conceived, its main value all along this year has been as a bargaining chip. The proposal will now have served a valuable political purpose if, by sacrificing it, the White House is able to provide enough cover to Democratic senators...

Debating the Public Option

The three founders of the Prospect discuss the perils and promise of a public-insurance option.

In " The Perils of the Public Plan ," Paul Starr warns that a public-insurance option could turn into exactly the opposite of what progressives want. Here he discusses the problems with the Prospect 's two other co-founders, Robert Kuttner and Robert Reich. Paul Starr : According to last week's Washington Post , the public option is the "crux" of the health-reform debate and the "greatest challenge" for Senate negotiators to overcome. That's an accurate description of the current political scene, but it's true only because so many people, including members of Congress, are responding ideologically to the idea of government involvement. The public option is not the biggest question in reform. Under the proposals being considered, it would be offered only within insurance exchanges at the state and regional level. The far bigger question is how those exchanges work: Are they open to all employers and individuals -- required, in fact, for employers below a given size -- or open only to...


Just around this time in the Clinton administration, the country was consumed with Travelgate, the Vincent Foster case, and other assorted minor and pseudo-scandals. This spring the scandals have been Republican as Sen. John Ensign and Gov. Mark Sanford have admitted infidelities. It's a pattern that seems to follow Obama . When he ran for the U.S. Senate, his chief political adversaries imploded, and when he ran for president, he benefited from the unsteady performance of John McCain and the selection of Sarah Palin . Of course, there have been Democratic implosions along the way (like Eliot Spitzer ). I would prefer more of a separation between public and private life, but a lot of politicians invite scrutiny because they make their family life part of their campaigns. And there is something peculiarly delicious about social conservatives like Ensign, Sanford, and David Vitter being exposed as hypocrites. -- Paul Starr

Perils of the Public Plan

A badly designed public plan could turn out to be the opposite of what progressives intend.

Sen. Christopher Dodd, D-Conn., accompanied by Sen. Tom Harkin, D-Iowa, at a news conference on health care, Tuesday, June 23. (AP Photo/Harry Hamburg)
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 great danger is that the public plan could end up with a high-cost population in a system that fails to compensate adequately for those risks. Private insurers make money today in large part by avoiding people with high medical costs, and in a reformed system they'd...