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The irony is that the insurance industry wants this, too, as long as they also get the federal government to require everyone in America to carry insurance. That means more business for them, but it also means they can spread the risk (and the cost) of provisions they don’t currently want to write, such as a ban on denying people coverage for pre-existing conditions.

If President Barack Obama had made the passage of such a law and the establishment of such an agency the centerpiece of “health-care reform,” he would be in a lot better shape politically than he is. But for whatever reason─perhaps he doesn’t want to come off as a “Big Government” man─he hasn’t really done so. At least he hasn’t explained his proposals in this way, or explained it clearly and compellingly. Which is puzzling, since this is a stirring theme, and one in the American grain, stretching at least as far back as Teddy Roosevelt and the Trust Busters of a century ago.