Debating public health insurance

"Nobody can now say with a straight face that the U.S. health -are system is okay," said Paul Krugman in The New York Times. Polls show that Americans want unversal health coverage. Republicans are determined to block President Obama's health-care reform. If the reform fails, however, it will be because of a handful of conservative Democrats determined to kill key elements, such as "the creation of a public health-insurance option that competes with private insurers."

The details of this year's "byzantine" health-care reform bill are still being hammered out, said David B. Rivkin Jr. and Lee A. Casey in The Wall Street Journal. But the focus on public health insurance makes it clear that "Washington will have immense say over how, when, and through whom Americans are treated." So, even if Congress pushes the reform through, the courts will have to decide whether this kind of government intrusion is even constitutional.

An alternative to the public option is emerging on Capitol Hill, said Kate Pickert in Time. "Nonprofit, consumer-run health-insurance cooperatives" might accomplish some of the same goals—namely providing insurance for the uninsured and lowering "overall health costs by, in part, 'keeping [private insurers] honest,' as President Obama has said." But the "history of nonprofit HMOs is littered with failures," and it will be hard to get new health-insurance cooperatives started during an economic crisis.

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