I think Brad DeLong is correct that Kerry's proposal to effectively offload catastrophic health care coverage onto the government is a good one. I'm more skeptical about its workability in practice - the stakeholders with their snouts in the health care trough are rather powerful. I worry frankly that any non-nuclear health care reform (which would likely fail unless the people had taken to the streets or the rest of big bizness had finally gotten smart) will just get loaded up with more and more pork for the lovers of the free market as it sails through congress.
A rather smart person recently clarified the whole health insurance issue to me -- what we call health insurance in this country has little resemblance to actual insurance, and thinking about it as an insurance problem largely muddies the issue. What we have is a health care delivery industry, with little divide between the providers of health care and the providers of health insurance. It's all one tangled mess, and the incentives are completely skewed across the board.
An exception is catastrophic insurance, which could be more like traditional insurance if it were chiseled off. Perhaps if a clean bill could get through congress Kerry's plan is a good first step. Still, I suspect that it'll just provide another way for the health care industry, one way or another, to suck some more taxpayer dollars.
Some sort of single payer system is inevitable in this country. It's just a matter of when, who pays for it, how it's implemented, and how much the current parasites manage to suck from the system until that time (and after).