Two steps backward

Remember the health care debates of the 1990s?  Defenders of the status quo, or more market-oriented versions thereof, placed their hopes in HMOs and managed care.  Managed care did show promise in lowering costs, but few people liked the idea that mainstream institutions would simply say "no" to patients.

Democrats pushed a plan for national health insurance, based on a Hillary-led modification of the German health care system.  Health insurance would be detached from specific jobs, reorganized into regional cooperatives, and new taxes would finance universal or near-universal coverage.  For all its flaws and complications (and no, I do not support the idea), this idea still makes more sense for the American context than do the single-payer plans.  They put all those smart Democrats in a room way back when, and there is a reason why they came up with this.  It not only had some chance of passing, but compared to the single payer model it was more consistent with America’s decentralized, federalistic, corporate interest-heavy ways of running government. 

Sadly, current debates on health care have yet to reattain their status in the 1990s.  I know full well why both ideas failed and lost popularity.  But still, if we wish to debate health care today, we probably should be taking two steps backward.