Accidentally perfect analogy
On one of the Sunday morning "news" shows, Chuck Schumer made an analogy that didn't work the way he thought it did. Attempting to sell the Public Option, he said "It would be just like the way colleges work. We have public colleges and private colleges competing, and you can choose whichever you want."
He may have believed he was pointing to a positive vision, a system that works better than our health system, but in fact he was pointing to a negative vision, a system that works just as badly.
Here's how colleges really work: Our media, businesses and culture stir up the idiotic idea that everyone should be "college material", that a GOOD degree is the best qualification for every job. The prestigious private colleges take advantage of this message and charge unlimited tuition. This pulls up the tuition for the state schools because they're competing for the same students and have no reason to look cheap by comparison. The upward spiral is assisted and enabled by subsidies, grants and loans, which remove the direct price tag from the product for most people.
Before 1970 there was a much sharper distinction between Ivy League and state schools. State schools were more humble, more directly devoted to serving the people of the state, less concerned with tenure and publications. They weren't competing for Harvard-quality students, nor for Harvard-quality faculty
. Thus the state schools were quite cheap, sometimes (as in Calif) totally free to in-state residents.
This vision would be a better goal for health care. At one time Obama may have been thinking along these lines, but unfortunately he's too weak to pull away from the corporate interests who want to continue stealing the country.
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A separate observation on the same general subject: We keep hearing about the Young Invulnerables who "choose not to have health insurance." I understand the demographic: been there, done that. But in practice I don't know how you can simply choose to go without insurance. Employers don't give you that choice.
Either the company has health insurance for all workers or it doesn't have health insurance for anyone. And those two types of company won't be competing in the same category for the same employees. Thus if you're working without insurance, it's not your voluntary selection; it's because your skills and preferences place you in the uninsured parts of the job market.