Without a much stronger risk adjustment mechanisms like the Dutch have, no socially responsible insurance plan (be it public, private, or non-profit co-op) can survive with this problem of adverse selection. This is the Achilles heal that will insure health care reform creates bad health insurance for everyone on the exchange.

thank you! amen!

and even if the mechanisms were put in place by congress, how many people here think a bought and paid for administration who’s economic policy is run by mr. larry no-regulation summers is going to implement and enforce the kind of risk adjustment regulation that would be necessary to make this work? and that’s if the public option could even get off the ground, which is an whole other issue.

not me.