Getting Health Care Done Right

I might not agree with Megan McArdle’s views on health care reform, but she has a better grasp of the politics than supporters of health care reform who think that we should just ram through an unpopular bill and everything will be all right:

Who are you more likely to leave:  the spouse who makes a pass at another woman, and then thinks the better of it, or the spouse who goes through with it?  Maybe you’ll leave them either way.  But it does not follow that they are better off going through with it.  I don’t think it is actually true that trying to pass a bill people hate, and then thinking the better of it because it turns out the electorate hates it, is no different from trying to pass a bill people hate, finding out that they really, really hate it, and then ignoring them and pushing it through anyway.

Moreover, I am sort of amazed that anyone does think this.  The Republicans suffered a crushing electoral defeat after failing to pass Social Security reform.  But raise your hand if you think that their electoral prospects would have been better in 2006 had they managed to ram through a bill that was polling in the mid thirties?  Okay, Karl, put your hand down.  The rest of us realize that no matter how bad 2006 was, it could have been worse.  And would have been, had the AARP been stalking the GOP with murder in its heart…

There is nothing good you can say about an actual bill that you couldn’t say about a bill that you voted for, but didn’t pass.  It’s true that this is going to make campaigns hard next fall.  But at least now Democrats can say that they thought the better of it.  What’s their excuse if they pass it?

It’s true that if it fails, it will be subject to “lengthy, painful postmortem coverage detailing its flaws and mistakes”.  But you know who reads such coverage?  Me and Jonathan Chait, and we already have pretty strong opinions. If it passes, it will also be subject to lengthy, painful postmortem coverage in the nation’s “Your Money” columns.  As a veteran of reading those columns, I am pretty sure they are going to focus heavily on the fact that starting in 2014, you will be required to buy health insurance, or pay a hefty fine to the IRS.  It will also mention the subsidies, and so forth.  But the very unpopular mandate is going to loom large, because that is, for the sort of people who read “Your Money” columns, one of the most crucial pieces of information.

Passing a bill which is this unpopular can be political suicide. That does not mean that health care reform should be forgotten. It remains necessary. This does mean that Democrats have to do more than just ram it through and delude themselves into thinking that the voters will suddenly be happy about a measure years before they can see most of the actual benefits, and years before they can see that most of the claims about the bill coming from the right are false.

Democrats need to do a couple of things. They need to fix the bill. This includes paying attention to the argument above and removing the individual mandate. There are plenty of other solutions to the free-rider problem besides relying on a mandate which is causing objections to the bill from elements on both the left and the right.

Polls which show opposition to the bill actually show that about half of the opposition comes from those on the left who believe the bill does not go far enough, with these people often objecting to a mandate to purchase insurance from private insurance companies. Despite the claims from the right, the overall health care plan is a fairly moderate proposal. It is easier to overcome objections from the left (as well as the right) to such  incremental reform if people see this as a voluntary measure for those who desire assistance as opposed to something they are forced to participate in.

Secondly, the Democrats need to sell the proposal to the American people. While it is often difficult to get past the right wing noise machine, this is not impossible considering that polling also shows that most Americans have little understanding of what is in the bill, but wind up supporting each of the provisions once they are explained. Support for health care reform increased after Obama spoke on the topic last summer. He needs to continue to do this until the truth gets through.

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2 Comments

  1. 1
    Mill Messenger says:

    #liberal Getting Health Care Done Right http://url4.eu/1IOjn

  2. 2
    Mill Messenger says:

    #liberal Getting Health Care Done Right http://url4.eu/1IOjn

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