The puzzle is: Why does the president, who says that were America "starting from scratch" he would favor a "single-payer" -- government-run -- system, insist that health care reform include a government insurance plan that competes with private insurers? The simplest answer is that such a plan will lead to a single-payer system. <p> Conservatives say that a government program will have the intended consequence of crowding private insurers out of the market, encouraging employers to stop providing coverage and luring employees from private insurance to the cheaper government option.
The Lewin Group estimates that 70 percent of the 172 million persons privately covered might be drawn, or pushed, to the government plan. A significant portion of the children who have enrolled in the State Children's Health Insurance Program since eligibility requirements were relaxed in February had private insurance.
Assurances that the government plan would play by the rules that private insurers play by are implausible. Government is incapable of behaving like market-disciplined private insurers. Competition from the public option must be unfair because government does not need to make a profit and has enormous pricing and negotiating powers. Besides, unless the point of a government plan is to be cheaper, it is pointless: If the public option conforms to the imperatives that regulations and competition impose on private insurers, there is no reason for it.
The president characteristically denies that he is doing what he is doing -- putting the nation on a path to an outcome he considers desirable -- just as he denies any intention of running General Motors. Nevertheless, the unifying constant of his domestic policies -- their connecting thread -- is that they advance the Democrats' dependency agenda. The party of government aims to make Americans more equal by making them equally dependent on government for more and more things.