Paul Starr of Princeton, one of the real wise men when it comes to health care reform, put things into the correct perspective in yesterday’s New York Times: the most important challenge is to create a system of robust health care exchanges–that is, super-stores where individuals and small businesses (and, eventually, larger businesses) can select from a variety of health insurance options. Starr doesn’t say so directly, but the obvious deal is to give up the severely crippled public option, which probably can’t get past the Senate in any case, in return for the best possible system of Exchanges–the best would be one big Exchange; second best would be a regional system–that would begin operating as soon as possible.
Once again, I have nothing against the public option. It might increase competition and reduce costs, if drawn differently from the current Senate plan. But I would much rather see health reform pass without a public option, and with a strong Exchange system, than have no reform at all.