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

Averting a Health-Care Backlash

Create a political safety-valve: let people opt out of the mandate. Just don't let them opt back in at will.

A Senate staffer passes out paperwork prior to a health care news conference. (AP Photo/Harry Hamburg)
No provision of the health-care reforms being debated in Congress is as likely to generate a popular backlash as is the individual mandate -- the requirement that individuals purchase health insurance if they are not otherwise covered. But there is an alternative to the mandate as it is currently structured that can accomplish the same purpose without raising as much opposition. The bills in Congress would impose a fine on people who decline to buy coverage after the system is reformed, unless they have a religious objection to medical care or demonstrate that paying for insurance would be a financial hardship even with the new subsidies being provided. Under the Senate bill, the fines per person would begin at $95 in 2014, rising to $750 two years later. The House bill sets the penalty at 2.5 percent of adjusted income above the threshold for filing income taxes, up to the cost of the average national premium. The trouble with the fines is that they communicate the wrong message...

Faster, Please

Democrats in Congress should focus on enacting job
measures and health reforms that show voters immediate progress.

(Flickr/White House)
The continuing rise in the unemployment rate, up to 10.2 percent in November, has to give a sense of urgency to Democrats in Congress and the administration about the work they have at hand before next fall's elections. In 2010 Republicans are looking to repeat the success they had in 1994 after Bill Clinton's first two years, and if Democrats do not produce results soon, Barack Obama may suffer the same kind of midterm reversal as Clinton did. The one good thing for the Democrats about the risk of losing control of Congress next fall is that, as Samuel Johnson said about the prospect of a hanging, it concentrates the mind. And it ought to concentrate congressional minds in two areas where the pressure is greatest to match promise with performance -- the economy and health care. It is now clear, as it should have been earlier, that the stimulus package passed in February was too small for this severe a recession and that more needs to be done to generate immediate growth in jobs. The...

Bipartisanship in One Party

The Democratic health-reform proposals are built around ideas Republicans used to favor.

Senate Finance Committee Chairman Sen. Max Baucus. (AP Photo/Pablo Martinez Monsivais)
As the debate over health reform enters its decisive stage, there is a lot of talk about the need for compromise between Democrats and Republicans. That was a sensible point to make in years past when Republicans offered alternatives for reform to compete with Democratic proposals. But this year there are two problems with the idea of bipartisan compromise. The first is that Republicans in Congress have not even made a pretense of offering constructive alternatives. The second is that the Democratic proposals are built around the ideas that Republicans used to favor -- those proposals already are bipartisan compromises. Unfortunately, they are compromises with a Republican Party that no longer exists. In the late 1940s, when Harry Truman proposed legislation for national health insurance (what today would be called a single-payer plan), a group of Republicans including Congressmen Richard Nixon and Jacob Javits advocated a system of government--subsidized, private nonprofit insurance...

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...

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