Having Congress charter a health insurance “cooperative” is just another way of creating a new government-run program that would drive private insurers out of business.

The definition of a cooperative is a health plan governed by its enrollees. Since a government chartered co-op won’t have any enrollees at first, it will be governed like any other government program. So when the Obama administration and congressional Democrats say, “We’re going to create a co-op,” what they mean is, “We’re going to create a new government health program but we will turn it over to the members in five years. We promise.”

As I explained in a recent Cato study, a government-chartered co-op would become just another Fannie Med:

It makes no difference whether a new program adopts a “co-operative” model or any other. The government possesses so many tools for subsidizing its own program and increasing costs for private insurers—and has such a long history of subsidizing and protecting favored enterprises—that unfair advantages are inevitable.

Who was it that said that thing about putting lipstick on a pig?

In a new mini-documentary released by the Center for Freedom and Prosperity, I explain several of the ways that government spending hinders economic growth.

Politico reports that the so-called “public option” provision could be dropped from the highly controversial health care bill currently being debated throughout the country:

President Barack Obama and his top aides are signaling that they’re prepared to drop a government insurance option from a final health-reform deal if that’s what’s needed to strike a compromise on Obama’s top legislative priority.… Obama and his aides continue to emphasize having some competitor to private insurers, perhaps nonprofit insurance cooperatives, but they are using stronger language to downplay the importance that it be a government plan.

As I have said before, establishing health insurance co-operatives is a poor alternative to the public option plan. Opponents of a government takeover of the health care system should not be fooled.

Government-run health care is government-run health care no matter what you call it.

The health care “co-op” approach now embraced by the Obama administration will still give the federal government control over one-sixth of the U.S. economy, with a government-appointed board, taxpayer funding, and with bureaucrats setting premiums, benefits, and operating rules.

Plus, it won’t be a true co-op, like rural electrical co-ops or your local health-food store — owned and controlled by its workers and the people who use its services. Under the government plan, the members wouldn’t choose its officers — the president would.

The real issue has never been the “public option” on its own. The issue is whether the government will take over the U.S. health care system, controlling many of our most important, personal, and private decisions. Even without a public option, the bills in Congress would make Americans pay higher taxes and higher premiums, while government bureaucrats determine what insurance benefits they must have and, ultimately, what care they can receive.

Obamacare was a bad idea with an explicit “public option.” It is still a bad idea without one.

“Death panels” are a dominant motif in the debate over health care regulation, a fact that spins off political flares like a roman candle.

Extremists on both sides have taken their extreme positions: Some literally fear President Obama and his health regulation plans; others are outraged that anyone could possibly feel that way.

Charges of special-interest organizing meet counter-charges of unfairness and false accusation. Good video from town hall meetings and volleys of “Nazi” and “socialist” give cable news networks another short reprieve from their long slow decline. It’s all manna for the writers at Comedy Central.

But let’s talk substance: Health care is a scarce good, so it will always be rationed. The core question is whether government should take the dominant role in health care rationing over from insurance companies, or whether reform should restore rationing decisions to patients advised by doctors. 

Though they would never have the name or the form, the “death panel” label roughly (and unfairly) describes what would happen if health decisions were turned over to government bureaucrats under the leading proposals today. The bureaucracy would do exactly what “reform” asks it to do(!): prioritize cost savings and efficiency over the unique, individual interests of patients and their families.

The bureaucracy would serve its own interests too. Bureaucracies are subject to capture by special interests, of course, and they can be corrupted. These things are easier when the people who might die look like statistics.

Many people feel very strongly that problems with health care today indicate the need for President Obama’s and Congress’ health care plans. But what’s wrong with health care doesn’t mean that these proposals would make things better. Because they would move control of health care in the wrong direction, they would make things worse.

Everyone has a personal story about health care, and I have one too. On the day my mother passed away, my family and I were called to the hospital and met by a social worker. He showed us to a small anteroom at the entrance to the intensive care unit, where he guided us through a lengthy conversation about my mother’s wishes and the family’s circumstances. He then called in the doctors to offer their prognosis and advice, which we took.

It was a death panel. It was our death panel — because my parents had fully prepared for this eventuality by buying insurance.

Just like health care will always be rationed, there will always be death panels. The question is who runs them. To the extent our public policy drives people away from financial responsibility for their own health care, it sets them up for death panels that are administered by government bureaucrats, not by loved ones and doctors.

Political debate is rollicking and unfair and full of inaccuracy. And in the terms of today’s health care debate, we don’t want “rationing” — meaning we don’t want government rationing. And we don’t want death panels — meaning we don’t want government death panels, because government death panels will deny people and their families an essential dignity of life: choosing how it ends.

In that sense I say with apologies to Patrick Henry: Give me liberty or give me death panels.

Afghanistan has become the new battleground, with fighting and casualties on the upsurge. As my colleague Malou Innocent has detailed, the outlook is not good.

Iraq has been largely forgotten along the way. But far from being a grand success, it illustrates why even the good news isn’t that good, and certainly doesn’t justify a continued U.S. military presence. Conservative columnist Diana West provides a surprisingly critical view:

This is not to say the U.S. military failed. On the contrary, the U.S. military succeeded, as ordered, to bring a measure of security and aid to a carnage-maddened Islamic society. Given U.S.-won security, surge architects promised us, this same Islamic society was supposed to then respond by coming together in ‘national reconciliation.’ They were wrong. Not only did Iraqis fail to coalesce as a pro-American, anti-jihad bulwark in the Islamic world (the thoroughly delusional original objective), they have also failed to form a minimally functional nation-state. And the United States is now poised to do the same thing all over again in Afghanistan.

I write this as the volume of talk of an Afghanistan ‘surge’ is getting louder, drowning out the quiet undercurrent of eye-opening reports now emerging on post-surge Iraq. Late last month, for example, the New York Times reported on a bluntly revealing memo written by Col. Timothy Reese, an adviser to the Iraqi military’s Baghdad command. In it, Reese urgently argues that the United States has ‘reached the point of diminishing returns’ in Iraq due, among many other things, to endemic corruption (“the stuff of legend”), laziness, weakness and culture of ‘political violence and intimidation.’

Reese considers Iraqi Security Forces (ISF) ‘good enough’ — just — to keep the Iraqi government from toppling. That’s reason enough, he writes, to leave early, by August 2010 instead of December 2011. Reese describes a ‘fundamental change’ in the U.S.-Iraq relationship since the June 30 handover — a ‘sudden coolness,’ lack of cooperation, even a ‘forcible takeover’ by ISF of a checkpoint. While Iraq will still ‘squeeze the U.S. for all the “goodies’ that we can provide,” he writes, tensions are increasing and “the potential for Iraqi on U.S. violence is high now and will grow by the day.’

And that’s the good news. The Washington Times this week reported on an even more dire prognostication to be published by National Defense University written by Najim Abed Al-Jabouri, a former Iraqi police chief and mayor. Al-Jabouri focuses on problems within the ISF, where, he writes, the divided loyalties of what is essentially a series of militias beholden to competing “ethno-sectarian” political factions could easily drive Iraq to civil war. He writes: ‘The state security institutions have been built upon a foundation of shifting loyalties that will likely collapse when struck by the earthquake of ethnic and sectarian attacks. Iraq’s best hope for creating a long-term stable democracy will come from an independent national security force that is controlled by the state, and not by political parties competing to control the state.’

Al-Jabouri insists the United States should exert its ‘leverage’ to revamp the ISF, which, given Reese’s evidence of plummeting U.S. influence in Iraq, seems farfetched even if it were a good idea. Which it is emphatically not. An infidel nation cannot fight for the soul of an Islamic nation — a truism that, in a more rational (non-PC) world, might bring surge enthusiasts to their senses.

The original neoconservative plan for Iraq–as an advanced military post for Washington to use in imposing its will throughout the Middle East–always was a fantasy. Whether Iraq can create a reasonably peaceful, stable, and democratic society remains very much up in the air. But its success will depend on its own efforts. It is time for the U.S. military to depart.

To cope with the growing cost of Massachusetts’ health reforms, some suggest government should block competition by new producers. Here’s a poor, unsuccessful letter to the editor of the Boston Globe highlighting the flaw in that approach:

The Public Health Council is wrong to claim that requiring government approval for new outpatient clinics and ambulatory surgical centers will contain the costs of Massachusetts’ health-care reforms [“State toughens rules for building new clinics,” Nov. 14]. According to University of Alabama health economist Michael Morrisey, economic studies of such “certificate-of-need” (CON) requirements “find virtually no cost-containment effects…If anything, CON programs tended to increase costs.”

Morrisey suggests the real reason for such barriers to market entry is protectionism: “A reasonably large body of evidence suggests that CON has been used to the benefit of existing hospitals…Prices and costs were higher in the presence of CON…The continued existence of CON and, indeed, its reintroduction and expansion despite overwhelming evidence of its ineffectiveness as a cost-control device suggest that something other than the public interest is being sought.”

If the Commonwealth wants to reduce health-care costs, it should stop protecting inefficient providers.

Wow:

Obama’s aggressive endorsement of a healthcare plan that does not even exist yet, except in five competing, fluctuating drafts, makes Washington seem like Cloud Cuckoo Land. The president is promoting the most colossal, brazen bait-and-switch operation since the Bush administration snookered the country into invading Iraq with apocalyptic visions of mushroom clouds over American cities.

You can keep your doctor; you can keep your insurance, if you’re happy with it, Obama keeps assuring us in soothing, lullaby tones. Oh, really? And what if my doctor is not the one appointed by the new government medical boards for ruling on my access to tests and specialists? And what if my insurance company goes belly up because of undercutting by its government-bankrolled competitor?…

I just don’t get it. Why the insane rush to pass a bill, any bill, in three weeks? And why such an abject failure by the Obama administration to present the issues to the public in a rational, detailed, informational way? The U.S. is gigantic; many of our states are bigger than whole European nations. The bureaucracy required to institute and manage a nationalized health system here would be Byzantine beyond belief and would vampirically absorb whatever savings Obama thinks could be made. And the transition period would be a nightmare of red tape and mammoth screw-ups, which we can ill afford with a faltering economy…

[S]omehow liberals have drifted into a strange servility toward big government, which they revere as a godlike foster father-mother who can dispense all bounty and magically heal all ills. The ethical collapse of the left was nowhere more evident than in the near total silence of liberal media and Web sites at the Obama administration’s outrageous solicitation to private citizens to report unacceptable “casual conversations” to the White House. If Republicans had done this, there would have been an angry explosion by Democrats from coast to coast. I was stunned at the failure of liberals to see the blatant totalitarianism in this incident, which the president should have immediately denounced. His failure to do so implicates him in it.