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The Public Opt-Out Option

The hot new idea for compromise in the health care debate is to provide a national public option in the insurance exchange and then allow individual states to block their citizens’ access to it. From a policy perspective this is a craptastic idea — it will likely allow big insurers with quasi monopolies in smaller states to use their strangleholds over weak state legislatures to preserve their bloated profits. But it seems to be a winner, politically, gaining tentative support across the Democratic waterfront, from public option hardliner Howard Dean — “If this is what it takes to get 60 votes I say go for it” — and public option obstructionists like Max Baucus and Ben Nelson.

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