Are Health Care “Co-Ops” Good Enough?


I just got booted from a conference call with Jacob Hacker, the Yale political scientist widely considered to be the brain behind the “public option” component of health care reform. Ayo, I’m tired of using technology. But before I was so rudely and abruptly removed, I got a chance to listen to Hacker slam the so-called health care “co-ops,” which the Senate Finance committee is reportedly considering as an alternative to the public option.

Hacker said the public plan is a “crucial linchpin” of health care reform, and “co-ops should not be seen as a substitute for the public plan because they are not a serious way to provide public option’s three main goals.” Those three main goals, Hacker says, are the “three Bs”: a Benchmark for prices, a Backup for patients, and a Backstop for cost-control.

Hacker argues that co-ops wouldn’t be able to meet his goals for the public option because they “won’t be effective in competing with private insurance plans.” That, of course, is the larger point of the public option—competing with private insurance. But not everyone (especially not the insurance companies) wants the private plans to have to compete with anything. They barely compete with each other now. So co-ops that would face huge problems entering the market might be just the thing—if you want to keep the insurance companies happy.

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