Yesterday, Kent Conrad floated the idea that instead of having a robust public option in health care “exchanges,” we could instead implement rules designed to spur the creation of non-profit “co-ops” that would provide an alternative to private companies without government control. Or, of course, government’s ability to piggyback on Medicare and achieve cost controls. I’ll recommend Igor Volsky’s analysis of the problems facing health co-ops that legislation would have to overcome.

I’ll say that I think this is a pretty good idea, but it stands on its own merits completely apart from the merits of a public plan. In other words, there’s no reason we shouldn’t have co-ops and private plans and a real public plan. Medicine has always been a mix of state, non-profit, and for-profit actors and I think it’s worth broadening the mix of insurance options available to ordinary people.

That said, as an alternative to a public plan this simply doesn’t meet what I see as the main objective of a public plan. But beyond this, I think the larger issue is that you sort of can’t “compromise” around the core political issues here. Insurance companies object to the idea of a public plan because they don’t want to lose business. Anything you dream up that would cause insurance companies to lose business, they’ll object to. After all, what else are they going to do? But anything you dream up that doesn’t cause insurance companies to lose any business isn’t going to accomplish anything meaningful. Insofar as what’s really going on in the halls of congress is that members are trying to balance progressive pressure for a public plan with industry opposition to it, you’re going to keep banging your head against the reality that you can’t split the difference between “incumbents face a new strong competitor” and “incumbents don’t face a new strong competitor.” And incumbents really don’t want to face a new strong competitor—incumbents hate competitors!

There’s a new advertising campaign under way in Metro taking aim at the routine use of antibiotics in commercial poultry- and livestock-raising enterprises:

Photo by Eric Goldman

For all the same reasons that antibiotics can be helpful to sick people they can also be helpful to sick animals. Or, in the minds of America’s industrial farmers, they can be given out routinely as a prophylactic measure so as to make it possible to raise animals in unhealthy and unsanitary environments, while also feeding them cheap corn that makes them ill. Unfortunately, as Eric Goldman emphasizes, this helps breed antibiotic resistant bacteria with dire health consequences for people.

The specific talking point that this increases health care costs is a cute way of piggybacking on the current political debate. In reality, I doubt that the actual contribution to health care inflation is especially large as the biggest costs are associated with chronic conditions or end-of-life situations. On the other hand, it is true that this is an important public health issue. Antibiotic resistant bacteria is, at the moment, a somewhat problematic situation. But the really scary thing is the prospect that it could become much worse. We’ve invented a lot of new antibiotics over the years, but there isn’t any guarantee that an infinite range of antibiotics are out there just waiting to be invented. In principle, we could wind up backing ourselves into some extremely problematic situations in the future, and making chicken slightly cheaper isn’t a good reason to be doing it.

Following up on the assassination of George Tiller, we appear to have a new outbreak of right-wing domestic terrorism as white supremacist James Von Brunn goes on a shooting spree at the U.S. Holocaust Museum.

Not a great deal more to say about this right now, but I hope that everyone who mau-maued the Department of Homeland Security for expressing concern about this kind of thing feels appropriately ashamed of themselves.