The public option is nothing more than a political litmus test imposed on the debate by left-wing politicians and pundits who don’t want to be bothered with the real-life dynamics of the health-care market. It is the Maginot Line of health-care policy, and just like those stubborn French generals, liberal Democrats have vowed to defend it even if it means losing the war…

One goal of health-care reform is to begin to address these market imperfections. But there’s no particular evidence that a government-run insurance plan will be any more successful than what we currently get from big private insurers — unless, of course, the government-run plan is so big or so powerful that it can dictate prices to providers, as Medicare now does. Proposing that, however, would immediately unite doctors, hospitals and drug companies in opposing reform.

You also hear the argument that government-run insurance would have lower costs because it wouldn’t have to generate a profit (that’s true) and would be more efficient than private insurers (that isn’t). The evidence of greater efficiency is Medicare, which spends about 2 to 3 percent of its budget on administration. But if a government-run plan had to spend its own money to collect premiums, market itself to customers, maintain a reserve, and manage care in a way that lowers costs and raises quality — none of which Medicare now does — then you can be sure its administrative costs would be nowhere near 2 or 3 percent.