Can progressives join forces to fight the health care industry?

Should progressives insist on fighting for a single-payer health care system, or is it more realistic to fight for a public health care plan that competes alongside private insurers. Karen Dolan at the Institute for Policy Studies has an interesting analysis.

A public option may indeed be crafted in such a way to become the wedge that ultimately wins the prize, as public plans under-price costly private plans. The public option could offer public plans designed to adhere strictly to the Congressional Progressive Caucus’ laudable principles of universality, affordability, equality. They could be carefully constructed as to be so cost effective that the Republicans fear that they will crowd out private insurance due to their affordability becomes a reality.

But a public option could also be crafted in such a way to expressly prohibit that outcome by allowing private insurers to cherry-pick the healthiest patients, eventually bankrupting a public plan stuck with the nation's sickest people. If private insurers are allowed to continue the current practice of cultivating and covering the healthiest Americans, the sickest will be dumped into a public plan, thus creating a financially unsustainable situation for the public plans.

These scenarios need to be aired, debated, and dealt with. The way that Obama and progressives on and off Capitol Hill have set the debate thus far, a "robust Public Option" is, effectively, the "left flank," and thereby the very most we can hope for. It becomes the goal rather than the compromise. Had single-payer not been off the table, it might have served as the "left flank," thus making a public option, crafted to lead to single payer, a more politically feasible option, more appealing as the compromise that it is.

Dolan's ultimare message is that members of both camps should cooperate rather than attacking each other.