I have several concerns about CO-OPs being the main component of reform in our health insurance exchange. First of all, we are not guaranteed that they will be effective. In the past, some have started up only to fail to grow strong enough to give them effective bargaining power and they consequently disintegrated. In a House bill, it was revealed that $6 Billion would be required to fund the start-up of these local CO-OPs. They would have to grow to at least a state-wide, if not regional, size to have the market share capable of attaining the bargaining power with hospitals and doctors that insurance companies currently have. I'm afraid the insurance monopolies that exists today would either find a way to impede the adequate development of CO-OPs or they would eventually into equally corrupt entities. Lastly, high administrative costs would be another drawback of smaller CO-OPs compared to a what a national public option could provide.

The best way to control health care costs is to allow people to buy into Medicare before the age of 65, giving them a public option for health insurance. This framework has existed since 1965 and we know it works. This is the only sure way to compete with private insurance companies, reining in their lavish ways. I think CO-OPs would prove devastatingly weak, leading us right back to where we are now while wasting billions of dollars in the process.

In a recent New England Journal of Medicine poll, 75% of doctors support the public option. Doctors were out in droves in the 1960s trying to defeat Medicare, but with time they have seen that it works. Other polls this week show that 51% of business leaders support a public option along with 55% of all Americans. I remain hopeful that a public option will pass the Senate by “whatever means necessary.”