I'd be interested in hearing more about those discussions at Washington Monthly. The issue isn't cut-and-dried for anybody who looks deeper than ideology. I restated the topic in the subject line as "universal health care" to avoid falling into the trap of thinking narrowly of "government health care". I'm sure you know by now that I don't automatically reach for a governmental solution (though you nevertheless love to accuse me of it all the time).

I think that a major cause of confusion around the issue is that presumption that it's the responsbility of business and that doing it another way is some sort of radical change in the natural order of things. I suspect that business would welcome a change--I can't recall any business person ever expressing gratitude at the privilege of paying for employee health care. In this I'd expect business would be happy to shift the burden to somebody else too. So maybe a way to begin to change is to make it easier to afford and get private insurance. Maybe cooperative insurance pools (which is what, a triple redundancy?) to spread the costs. Such things already exist, and could be expanded.

Then there's the semi-governmental approach like Fannie Mae (or Amtrak--damn, I hate the countervailing examples). It seems like health costs respond well to economies of scale and buying power--large organizations get better deals--and some large quasi-private organization could bargain with healthcare providers from a position of overwhelming strength--contracts for millions of clients' worth of business.

Note that I'm not thinking of the government actually running healthcare operations through some sort of National Health Service (except at the edges for care of last-resort). I think we both agree that that's likely to be a dog's breakfast. The government's better at paperwork than execution, and paperwork agencies like Fannie Mae wield the paperwork weapon to our advantage. The FNMA versus Amtrak paradox resolves in the difference between paperwork and execution--the government can't make the trains run on time but it can keep the paper flowing.

Funny, isn't it? America excels at so much else, why not admit that we have the world's finest bureaucrats too? I know that not everyone thinks bureaucrats are a good thing, but on general principles, I think that if a person's going to do something, he/she should always do it well, no matter what it is. America can be proud of the United States Bureaucrat Corps!