Devil’s Advocate


Here’s the most thought-provoking and perhaps most important piece I’ve seen written on the Public Option. And it was written back in June. (Here’s a follow-up debate on the argument advanced in the linked article.)

When I first focused on the public plan proposals back in the spring what was never clear to me was why, far from gobbling up the whole private insurance market, it wouldn’t become a dumping ground for all the sick people the insurance companies can’t make a profit insuring. That is especially the case if you restrict its availability to people who aren’t currently insured. (Remember: the private health insurance business model is covering as many healthy people and as few sick people as possible.) That’s exactly what Paul Starr thinks would happen in a poorly structured Public Option. And what he calls a poorly structured public option sounds uncomfortably like what we have on the table right now.

(ed.note: In this post I was speaking in broad terms and referencing earlier discussions of Public Option access. I should have said that current versions of the public option restrict access largely to those who are current not insured.)


Josh Marshall is editor and publisher of