I understand what Noah’s saying. Really. I do. But if a primary goal of health insurance reform is to cover almost everyone—including people who have preexisting conditions and therefore either can’t get insurance at any price or can’t get it for a price that they can afford—why isn’t it a good thing to have a public plan that would guarantee them access at a price that, at worst, is only slightly above the price that healthy people pay to for-profit insurance companies, and much less than they would pay to private insurance companies?

If there is no public option available to them, and private insurers are forced to accept them, then wouldn’t that raise the overall private-insurance premium rates?

The main problem with the public option as it appears in the current bills is that so few people will have access to it. If instead, everyone has the option to join it, whether individually or through their employer, then it indeed would cost its members less than private-sector insurance would, and it would put competitive cost pressures on the for-profit insurers.

Yes, but putting that kind of pressure on the private insurance business is precisely what the public option is not being allowed to do. I see two reasons presented: first, that it would be found by the courts to be an unconstitutional taking, and second that it would be socialism, which for some reason is supposed to be a Bad Thing.

Well, one thing I think I can say with certainty is that the Supreme Court—even this Supreme Court— would not find competition from a publicly-run program a Fifth Amendment “taking.” There is no constitutional guarantee that the government will not reduce your business profits by competing against your business for customers.

And, saying that putting that kind of pressure on the private insurance business is precisely what the public option is not being allowed to do begs the question of whether enough congressional votes can be mustered to change the bill so that it does exactly that.

CBO is saying that the public option will have a higher premium because it is a higher quality plan - one that won't cancel on you just because you get sick. A guaratee that one's claims would be paid is peace of mind which the insrance sales guys keep telling me is worth extra money.