Paul Starr

Paul Starr is co-editor of the The American Prospect. His most recent book is Remedy and Reaction: The Peculiar American Struggle over Health Care ReformClick here to read more about Starr.

Recent Articles

Healthy Compromise: Universal Coverage and Managed Competition Under a Cap

This is how the system might work:You would

get your health insurance through a new, regional health insurance purchasing

cooperative. The purchasing cooperative, bargaining on behalf of large blocks

of subscribers, would contract with a variety of private health plans, including

health maintenance organizations (HMOs), preferred provider plans, and one

conventional free-choice-of-provider option. Each plan would have to offer a

standard, mainstream benefit package to every prospective enrollee. Once a year

the purchasing cooperative would ask you to choose among the health plans (or "networks,"

Detoxifying the Debate

As an art form, caricature is fun. The caricature of ideas, however, does not have the same appeal. And when the caricaturists seek to arouse fears and anxieties by distorting unfamiliar ideas into misshapen and threatening images of insidious evil and betrayal, they do public debate and even their own case a great disservice.

Delivering Health Reform

Can the Clintons find the votes for health care reform without wrecking the logic of universal coverage, cost-control, and managed competition?

The Social Security Act in its final form was far from a perfect piece of legislation. In important respects it was actually weaker than the Wagner Lewis bill of the year before. It failed to set up a national system and even failed to provide for effective national standards. It left to the states virtually every important decision and thus committed the nation to a crazy- quilt unemployment compensation system. . . .

For all the defects of the Act, it still meant a tremendous break with the inhibitions of the past. The federal government was at last charged with the obligation to provide its citizens a measure of protection from the hazards and vicissitudes of life.

What Happened to Health Care Reform?

Republicans killed it. The White House strategy misfired. Reformers couldn't unite. The center failed. And the moment was lost.

It was one year from euphoria to defeat. On the evening of September 23, 1993, I sat in the gallery of the House of Representatives for President Clinton's speech introducing the administration's Health Security plan. For those of us who had worked on it, this was the climax of a long, intense, and not always easy collaboration. I had been one of about ten people on the health policy team in the White House who had written and rewritten the plan after the cast of hundreds had left. Now the president had the nation's attention focused on ideas we deeply believed in, and he spoke with tremendous force.

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