"The real question is whether the public option will have statutory authority to require participation of doctors and hospitals, using Medicare participation as a hammer, and whether it can use Medicare with the public option to negotiate drug rates. A third point is the use of the Treasury as a cushion. If premiums are set too high or low one year, the Treasury covers the difference, and the adjustment is made to next year's premiums. This is what I would call a robust public option. With these features it can drive down costs. Without them, it can't. If it can't lower costs, what is the justification? We might just as well pour the money into the insurance companies as set up a separate bureaucracy."
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