Democrats and liberals would take steps to create a more structured market for individual insurance — allowing people to buy into a purchasing pool like the Federal Employees Health Benefits Program or a public plan like Medicare, as well as requiring insurers to accept all comers regardless of pre-existing health conditions.

Sen. [Barack] Obama’s health reform plan contains many of these features, but leaves the tax preference for employer-sponsored coverage intact. Conservatives take the opposite approach, relaxing insurance regulations and promoting more unfettered competition, while promoting measures such as high-risk pools as a fallback for people with health conditions that would exclude them from non-group insurance.

As discussion of moving away from the employment-based system continues, not very much attention has been paid to a giant question: How will the public (and voters) feel about such a big change?

Health reformers have learned the hard way in the past that whatever the appeal of policy proposals on their merits, they ultimately have to be acceptable to the public or they will not fly.

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