On reform and purists

I will say something about this ...

I'm about as progressive as they come when it comes to health care policy. I just have a basic philosophical belief - one that has arisen through a variety of personal experiences with the private insurance industry ... the majority of them incredibly negative - that profit should be not a motivation in providing coverage. As a result, I think that health insurance ought to be done via a non-profit model or as part of a public service offered by the government.

I believe the private sector can only make a profit in the private sector by keeping premiums high, denying coverage to invididuals and limiting the payments of benefits to those in need. Remove the profit motivation and put the emphasis on providing quality coverage for all who need it, and things will work out.

That said ... I'm a pragmatist, not a purist.

So talk of progressives rising in mutiny against President Obama because he potentially might signal a willingess to offer a 'trigger' element to the public option - where the public option would only come into play in areas where the markets were consolidated and costs couldn't be controlled by the existing private sector - or explore the possibilities of a co-op are incredibly maddening to me.

Make no mistake, I'd rather see a robust public option put into place, but I'd much rather see comprehensive reform happen, and the proposals not pertaining to the public option in the various plans floating through Congress are good ones ...

- They'd expand Medicaid coverage for more low-income individuals.

- They'd establish sliding-scale subsides for middle-class families dealing with rising costs.

- They'd set up an exchange where small businesses and individuals could shop for plans.

- They'd remove arcane state-by-state barriers which restrict companies from working across state lines.

- They'd close the 'doughnut' in Medicare Plan D, thus making more prescriptions more affordable for senior citizens.

- They'd modernize many elements of information delivery in the health care industry, thus lowering administrative costs.

- They'd prohibit insurance companies from denying coverage due to pre-existing conditions.

These are all really, really good things, and proponents of reform shouldn't lose sight of those positives as this debate moves forward. Like Ezra Klein, I'm a 'structuralist' which means I want reform that is cost-efficient, improves the lives of others and offers room for more positive growth in the future.

These reforms do just that.

The process isn't about the means, but rather about the ends.

And if more folks can get good, quality, affordable coverage through other mechanisms, then I'm open to evaluating and supporting those plans.