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High Weirdness by Mail

February 26th, 2008 · 4 Comments

I haven’t been paying a *huge* amount of attention, but I have been trying to suss out precisely what is supposed to have been so terrible about those “shameful” mailers the Obama campaign has circulated criticizing Hillary Clinton on trade and health care.

One seems to have accurately reported that Hillary has praised NAFTA, but erroneously stuck the word “boon” in quotation marks, as though it were her own adjective, rather than a press summary of her views. I’m probably more sensitive than most to the sanctity of the inverted commas, but this doesn’t strike me as especially egregious insofar as she does appear to have said various nice things about the trade agreement. If anything’s really noxious here it’s that Obama is, by most accounts I’ve seen, the more sincere free-trader at heart, and that both candidates feel obligated to go through this ridiculous more-protectionist-than-thou pantomime when both candidates clearly know better.

Then there’s the healthcare mailer, and I’ve been trying to suss out the problem here by way of Ezra Klein. As far as I can tell, these are mostly beyond the pale because they include a photo of a couple that’s evocative of the loathed Harry-and-Louise ads, which to hear some progressives tell it were decisive in scuppering Clintoncare, despite having been seen by almost nobody outside the Beltway.

The substantive part people object to is the claim that “Hillary’s health care plan forces everyone to buy insurance, even if you can’t afford it…” Which, as far as I can tell, Ezra regards as repugnant on the grounds that mandates are teh awes0m3. And hey, if that’s how it seems to you, wonderful, and make that case, I guess. But the claim isn’t false either, and if there are poor misguided souls out there who consider “not being forced to do stuff” a policy virtue, it seems like fair game. It may indeed be folly to have different views than Ezra about the proper weights of different values in health care policy, but I’m not sure it’s “reprehensible.”

And yes, I understand that you don’t get “truly universal” salvation if you don’t cram the communion wafer down everyone’s throat, but is it really so inconceivable that Obama might just sincerely prefer less compulsion, even at the cost of universality? Or, per the flyer, just thinks his plan will get more folks covered sooner, despite its failure to write the magic word “universal” on the slip of parchment that we’ll place in the golem’s mouth? Most of the criticism I’m seeing seems, rather weirdly, to assume that Obama actually has a different value ordering, but is feigning opposition to compulsion as a cynical tactic And maybe he is: After all, I think he’s probably not much of a protectionist, but is playing one on TV lately as a cynical tactic. Still, the alternative seems at least possible.

The genuinely shady thing here, I had thought, was the omission of any mention of subsidies in Hillary’s plan. But as Ezra helpfully observes “the subsidy levels are left vague, as are the out-of-pocket spending caps. Whether they would prove sufficient is, as of yet, unknowable.”

So my tally comes to: one inappropriate use of quotation marks in an otherwise reasonable characterization of an opponent’s view, one use of tainted Republican yuppie iconography, and one basically accurate claim that fails to include all the devastating arguments Ezra knows for the policy being criticized. I’m not sure any of that really rises to “shameful” levels.

Totally tangentially—and conceding freely that this is not remotely one of my issues—I have never really understood the point of routing health care payments through private insurers once you’ve decided that the government is going to heavily subsidize premiums, regulate the scope of coverage, mandate participation, and bar the insurance companies from doing any real actuarial filtering. I understand why you’d keep medical services private even if the government was paying. But what I’ve just described isn’t really “insurance” anymore anyway; it’s Rube Goldberg public provision with a portion of the tax funding it falsely labeled a “premium.” What value is added by retaining a system of now-pointless middlemen?

Tags: Horse Race Politics



4 responses so far ↓

  • 1 dan // Feb 26, 2008 at 1:20 pm

    On your tangential point, you’re of course completely right, and everyone knows it. I have trouble believing you don’t know the answer to your own question, but just in case, the reason is that there is a broad agreement that it will be politically impossible to enact a plan that would kill the medical insurance industry in one fell swoop, so we have to enact a plan that will hopefully gradually starve them. Personally, I think it’s bogus; they’re going to fight either type of plan just as hard, and just as dishonestly.

  • 2 James Joyner // Feb 26, 2008 at 3:06 pm

    What value is added by retaining a system of now-pointless middlemen?

    Because “insurance” sounds oh so much better than “socialized medicine” or “welfare” and is thus easier to market?

  • 3 David J. Balan // Feb 27, 2008 at 1:31 pm

    Tyler Cowen has argued that private insurance companies still have value, even if the government is paying the bills, because they can be a source of innovation for new insurance products. I don’t know if I buy this (Cowen’s effect would have to be pretty big to overbalance the malign political influence that private firms would no doubt continue to exercise), but there is a non-crazy story in which private firms should exist even with single-pay.

  • 4 Pithlord // Feb 27, 2008 at 5:08 pm

    From a Canadian point-of-view, a move to allow even heavily regulated private basic coverage to compete with government coverage would either be harmless (if the regulations were too severe to make a competitive industry possible) or good (if private insurance could still offer something to people that the state doesn’t — guarantees on waiting times, say).

    In short, managed competition is still better than total socialization.