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

What You Need to Beat Goliath

In Michael Mann's gripping new movie The Insider, the two central characters uphold the truth through acts of corporate disobedience—the moral equivalent of civil disobedience in an age when the threat to freedom so often comes from corporate rather than state power. Fired as head of research at cigarette-maker Brown & Williamson, Jeffrey Wigand (Russell Crowe) breaks a nondisclosure agreement to tell 60 Minutes about his former employer's deceit and malfeasance. But before the segment is aired, its producer, Lowell Bergman (Al Pacino), finds himself up against everyone else at CBS when the company's lawyers advise killing the interview for fear of a lawsuit from Brown & William son. In the movie's dark twist, Bergman turns out to be in the same position as Wigand: Both are insiders who confront a corporate decision to deny the public vital infor mation, and then choose to go public themselves. Repeating an early scene in which Wigand leaves Brown & Williamson, the last...

How Low Can You Go?

How to Zero Out the Debt J . Fife Symington III, the Republican governor of Arizona, is so conservative that he has sought to abolish the state's Depart ment of Education. But, poor fellow, he's broke, as the Economist recently reported. When he was elected in 1991, Symington said he was worth $10 million. Three months later, he claimed his net worth dropped to a negative $23 million. These things happen. This past fall, in an unprecedented step for a sitting governor, Symington filed for bank ruptcy protection under Chapter 7, which allows him to stiff his creditors and get a fresh start in life. Now this is an imaginative new idea in state fiscal policy. Many conservatives say they are opposed to debt; only Symington has shown how to get rid of it entirely. We all sometimes need a fresh start, governments included. And Symington is doing it in a way that demonstrates personal responsibility by protecting home and family. His home is in his wife's name, and her fortune is beyond the...

Healthy Compromise: Universal Coverage and Managed Competition Under a Cap

T his 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," as Bill Clinton calls them) and inform you about their monthly charge and quality of care, including consumer satisfaction. Money would flow into the cooperatives from employers and employees, from other people according to their ability to pay, and from government. Money would flow out to the health plans according to their enrollment: The purchasing cooperative would pay each plan a...

Detoxifying the Debate

A s 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. In an article in the previous issue ("Healthy Compromise: Universal Coverage and Managed Competition Under a Cap," TAP Winter 1993), I presented a proposal for universal health insurance through new, regional health insurance purchasing cooperatives, which would represent the consumers and employers who pay for health care and be responsible for keeping the growth of health spending within a nationally set budget limit. The purchasing cooperatives would negotiate with competing health plans over costs and services, provide consumers information about their alternatives, conduct an open enrollment, adjust the total payments to plans in line with the risk of...

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