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.
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.
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.
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.
Until recently, the optimistic assumptions of an era of prosperity dominated ideas about the information revolution. Although many observers recognized that new technology would bring "creative destruction" -- making old industries obsolete, while opening up new ones -- the emphasis has been on the "creative" part, not on the "destruction."
Reflexive conservative ideology remains a powerful factor in national debate. So it's crucial--if not for Obama, then for others--to continue to press the case that our present problems have ideological roots.
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.