The Brownstein article I mentioned earlier notes that in Democratic primaries, the health-care debate pits advocates of single payer against supporters of a “public option” that would allow but not force people to select government-provided health insurance. You can see why that idea would appeal to Democrats facing primary candidates to their left: It sounds like it guarantees universal coverage with less cost, coercion, and potential unpopularity than single payer.

But there are reasons that President Biden, even after campaigning on a public option and while running an administration that often catered to the left, didn’t push for the idea. I wrote about them back in 2020:

If the public option pays [doctors and hospitals] stingily and providers don’t have to participate, costs will be low, but so will enrollment. There’s no point in paying for a plan that doesn’t let you see doctors. Expanding coverage while keeping costs under control will be possible only if doctors and hospitals accept lower incomes. Even then, the........

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