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From the very start of the healthcare debate, policy wonks on the left had pushed us to modify the Massachusetts model by giving consumers the choice to buy coverage on the online “exchange,” not just from the likes of Aetna and Blue Cross Blue Shield but also from a newly formed insurer owned and operated by the government. Unsurprisingly, insurance companies had balked at the idea of a public option, arguing that they would not be able to compete against a government insurance plan that could operate without the pressures of making a profit. Of course, for public-option proponents, that was exactly the point: By highlighting the cost-effectiveness of government insurance and exposing the bloated waste and immorality of the private insurance market, they hoped the public option would pave the way for a single-payer system.
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