Krugman's latest missive on the health care situation: Passing the Buck. It's another tight piece, hits all the important points, but one of the most important bits to me is this:

...private insurers generally don't compete by delivering care at lower cost. Instead, they "compete on the basis of risk selection" - that is, by turning away people who are likely to have high medical bills and by refusing or delaying any payment they can.

PK and I both know the biggest barrier to public health insurance is ideological subservance to "Market Forces." We have to change this equation to allow for a positive role for Public institutions. We also need to be clear about just how the Market does work for Heath Insurance.

Competition in the Health Insurance industry is not over providing the best medical care for the best cost, but rather over who can keep the largest amount of premiums unspent on care. That's what delivers shareholder value: not providing care. The market drives insurers to not insure people who are likely to get sick and to push back against doctors' attempts to provide treatment to patients who are covered. The net result is that billions are spent in a war of paperwork, and the most vulnerable citizens are the most likely to be left out in the cold. The net result is more money spent by everyone, which is also good news from a pure Market perspective.

All of this is bad for people, though. It's time we joined the rest of civilization and started taking care of our sick and injured. Not only is this the right thing to do morally, but it's a boost to business, and will cost the country less overall than the current Insurance Regime.