The administration continues to affirm its belief in "competition with the private sector" as a key element of health care reform:

In her interview Sunday on CNN, [Kathleen Sebelius] was asked if it was time to come up with an alternative to the public option. She replied that the president's main concern was to promote competition with the private sector.

Increased choice and competition would certainly be welcome in health care. As the Department of Health and Human Services helpfully points out, 63% of Michigan's insurance market is dominated by one insurer: Blue Cross Blue Shield of Michigan - the very company that currently receives government backing and "competes" with the private sector in Michigan by acting as the state's insurer of last resort.

Michiganders concerned about choice in insurance, then, shouldn't be comforted by speculation that the government-run insurance agency will be replaced by government-backed private co-ops as proposals for health care reform evolve. These co-ops would enjoy many of the advantages that already allow BCBS to dominate Michigan's insurance market, perhaps crowding out more private insurers and restricting choice further.