It's been rough going for the "public option" this afternoon. But Jonathan Cohn, The New Republic's resident health care wonk, finds cause for optimism even in the event--dreaded by most liberals--that a government-run health insurance plan doesn't become a part of the final health-reform package. Cohn argues that liberals can accept, and even embrace, a model for health-care reform that does not include a public option. They should look to the Netherlands, which in 2006 instituted a "successful universal health care program based entirely on private insurance":
Under the new system, the Dutch government has required that everybody gets insurance; in return, it makes sure insurance is available to everybody, regardless of pre-existing medical conditions or income. Although the government finances long-term care through a public program, it has turned over the job of providing basic medical coverage exclusively to private insurers, including some for-profit companies.
Still, there’s a catch. A big catch. Private insurance in the Netherlands works because it operates more or less like a public utility. The Dutch government regulates industry practices tightly--more tightly than the reforms now moving through Congress propose to do in the United States.
Cohn concludes, "If Congress ends up gutting the public plan, in part or in whole, then it needs to work even harder on making private insurance work." We're not there yet, but he approvingly cites a proposal in Congress to mandate "a 'coverage label' modeled on the nutrition label that all food products must include" as one example of how we might go Dutch after all.