Saturday, February 02, 2008

insurance mandates

What sounds like a decent argument on Crooked Timber. I don't know all the ups and downs of the health care debate, but I get the sense that mandates are a bit problematic. Used correctly, they can potentially bring us closer to universal health care, but if you're talking about making people pay for insurance while providing subsidies to the poor to help them pay, aren't you just taking tax money and putting it directly into the pockets of the very companies that have proven to be utterly unwilling to serve the needs of their customers? If it's actually a government-funded alternative they're paying into, I guess that's better, but there are lots of middle-class people who can't afford health insurance. Will they get subsidies, too?

Possible electoral issues aside, all of this makes one ask: if it's actually a government-funded alternative that you're making poor people buy into, why not just make everyone (i.e., also rich people) pay a progressive tax on it and just sign everybody up, allowing people to purchase additional private insurance if they choose? If they already were paying for private health insurance, then they pay no more than an equivalent amount to the government (in fact, since everyone is paying and is run by the much more efficient Medicare people, they could probably pay substantially less) and can drop their HMO if they so choose.

And if the insurers don't like it, they have a constitutionally guaranteed right to go f**k themselves.

In any case, whether or not mandates are the more "progressive" option is a fair question, but Brian is right that it's pretty foolish to question Barack Obama's progressive cred just because his plan doesn't have them. It is preposterous to suggest that someone with Obama's legislative record is somehow lacking in the liberalism department, especially compared to Hillary Clinton, who, by liberal standards, anyway, is plenty suspect on foreign policy and free speech issues.

I have another issues with this argument as well. It seems to me that doctrinaire, "litmus test" politics are precisely where the GOP lost touch with the American people. They've become so obsessed with the right-left kulturkampf that they're spending whole debates arguing not about the merits and drawbacks of their solutions, but rather merely over who's more "conservative," as if it's a foregone conclusion that the most conservative candidate is the best one, but most Americans don't believe that and would scoff at the very suggestion of it. Every time I hear Mitt Romney say he doesn't think McCain's "conservative enough" or boast that his plan is "more conservative" or when Fred Thompson calls himself "consistently conservative," I roll my eyes because they sound like a bunch of Bolshevik ideologues trying to root out each other's latent capitalism. It's cultish and, I imagine, off-putting to lots of people because people have a sense that, taken that far, ideology often becomes syllogistic and naive. Should we really be arguing over who's the most liberal?

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