While I am sympathetic to the public-optionites, I am more wedded to the goals of reform - as well articulated by President Obama - universal coverage, quality, and cost-control, than I am to any specific mechanism.  As a physician, I see the urgent need to meet these goals more than I feel an ideologic compulsion towards a given mechanism.

But you need to pick some mechanisms to meet these ends.  While I think the case can be made for public option contributing to these ends, I am unwilling to give up the goals because of an ideologic commitment to a specific mechanism.  .

Co-op type options intrigue me.  Here is why.  My absolute favorite companies/organization that I deal with are USAA, an insurance and financial services company open to military members, and Vanguard - a mutual fund company.  Both share two unusual features.  They are large private sector corporations that are owned by their patrons - in the case of USAA, owned by the insured and Vanguard, owned by the investors in its individual mutual funds.  Both have tip-top quality products unsurpassed customer service and very low costs.  I actually look forward to getting on the phone with their employees, unlike almost any other organization I deal with.  They could provide models fo r novel health insurance organizations that will compete with the private insurers and perhaps not alienate centrist/righ-of-center types who can't support a new government bureaucracy.

Avoid ideologic traps.  Focus on solving the problems.

It's time for leaders to lead in the Democratic party. Superdelegates should stand up and pick their candidate. Most will pick Senator Obama, and most of them already know that they will. Moreover, superdelegates should act this week. May 31st is when the DNC rules committee meets to work on the issue of seating the Florida and Michigan superdelegates. If current undecided superdelegates remain undeclared and the outcome of the primary process remains unclear, this will give the Obama camp every reason to fight hard against an unfair ex post facto seating decision that ignores the previous rules and favors Senator Clinton. However, if enough superdelegates move this week behind Obama, he can safely go into this meeting and be exceedingly generous and gracious. The goal could be to in the end either seat everybody along the lines of the popular vote (assuming the non-Clinton votes go to Obama in MI - as they should) or at least seat a higher percentage of delegates than the Republicans agreed to seat in penalizing those states in their contest (i.e. something greater than 50%). The larger goal is to neutralize any argument Republicans can use to say that Democrats ripped off their voters in dealing with this problem. Superdelegates should see that they have it in their power to make a big difference in the general election result by endorsing this week. Those who are arguing that they want to wait until all the primaries are done are being penny wise, pound foolish. As much as we care about them, the voters in Puerto Rico, Montana, and South Dakota will not play as big a role in the general election as those in Michigan and Florida will.