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'This is what makes writing about policy so frustrating'

Jon Cohn doesn't understand why the individual mandate has become so controversial. After all, in June of 2008, Sen. Chuck Grassley said, "I believe that there is a bipartisan consensus to have individual mandate." And Grassley wasn't alone. Now it's an unconstitutional abomination? The greatest threat to liberty since Thanos captured the gems? Kevin Drum, however, isn't surprised:

This is what makes writing about policy so frustrating. The answer to Jon's question is pretty obvious. Conservatives have no problem in general with mandating behavior. Nor do they have any problem with mandating affirmative behavior. In the context of healthcare reform, many of them have supported the individual mandate in the past. And the smart ones, at least, understand perfectly well why a mandate is necessary in order to make the broader healthcare reform package work.

Their opposition isn't based on any special principle. It's based on the fact that (a) they don't like healthcare reform and (b) people don't really like being forced to do stuff. This makes the mandate a convenient point of attack. Most non-libertarians don't really care about the mandate, but once Glenn and Sean and Rush have them suitably foaming at the mouth about Barack Obama's relentless attack on all that we hold dear in this country, getting them upset about the mandate is a pretty easy upsell.

But you can't just say this, even though it's plainly true. You have to pretend to take conservative arguments about this seriously. You have to write detailed responses, complete with quotes from law professors and health experts. You have to pretend that this is an actual issue, not just a handy attack point. And so we all spend mountains of time in a sort of pundit fantasyland where we all agree to talk about stuff that we all know nobody truly cares about.

By Ezra Klein  | October 21, 2010; 3:18 PM ET
Categories:  Health Reform  
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Comments

Good points all around, and an especially big round of applause for the Infinity Gauntlet reference.

I now expect the ACA to kill half the sentient life in the universe, and it's all President Obama's fault.

Posted by: MosBen | October 21, 2010 3:32 PM | Report abuse

Hey dude! Can we stick with Classical, Biblical or Shakespearean allusions? I had to look up the Thanos bit.

Of course, other than that, enjoy your column.

Old and hidebound,

Mike in Austin

Posted by: mpmck | October 21, 2010 3:32 PM | Report abuse

Jon Cohn makes the mistake that so many others make in thinking that the individual mandate is necessary because uninsured people currently get FREE CARE! DEAD WRONG! Uninsured people are actually often charged 3 or 4 times as much as the insured because they have no one to negotiate for them. Anyone who misunderstands this should read this article or disqualify themselves from talking about the mandate:
http://www.vcstar.com/news/2008/jan/26/web-site-offers-data-on-free-hospital-care/

Kevin Drum is wrong because, well he's just flat wrong. He says non-libertarians don't care about the mandate, which must mean that 71% of Americans are libertarian, because that's the percentage that oppose this mandate. But don't tell Drum, according to him, "There's no need to complicate what's going on here."

I say all of this as liberal Democratic Socialist who supports Obama. I'm all for a mandate, but only in the context of tightly-regulated, price-controlled markets, and this is far from that. That's why I'll be clapping when Justice Kennedy submits the final "No" vote sinking healthcare reform.

Posted by: michaelh81 | October 21, 2010 3:57 PM | Report abuse

I think the only way to make any sense of how the Republicans have acted in the past 18 months is through the lens of the 2010 elections in the midst of a sluggish economic recovery. If you try to rationalize it any other way, you just get confused and mad.

Posted by: klautsack | October 21, 2010 4:20 PM | Report abuse

Remember when that one rural fire department allowed that family's house to burn down even though the fire department was on the scene & the guy offered to pay this years $75 fee right then and there? The fire department refused because if they allowed people to pay that way, no one would pay till their house was on fire.

The Health Insurance mandate is just like that. Allowing someone to not pay until they need it does the rest of the community no good. Use that analogy and it is a much easier thing to explain to folks.

Posted by: kindness1 | October 21, 2010 4:27 PM | Report abuse

kindness1: your analogy only works if American fire departments were charging twice as much as any other fire dep't in the world, for service that ranked about 40th in the world, and if fire departments were in the business solely to skim off up to half their revenue to provide profits to their shareholders, as insurance companies do.

Posted by: michaelh81 | October 21, 2010 4:32 PM | Report abuse

Most people acknowledge the need to force habitual non-payers to pay for the services they receive: this really isn't the issue.

The fact that the mandate, as written, isn't Constitutional, is more of an issue. If the PPACA progresses -- which is, at this point, unlikely due to the multidude of administrative waivers and lawsuits -- the spirit of the Constitution will be dead.

It seems both logical and prudent to "allow" each state to implment the health care system that its citizens feel is the best for themselves. Of course, each state has always been "allowed" to do so -- the factor limiting states is now the PPACA itself, which gives two unelected officials the power to reject a state plan. Once a responsible leader is appointed and confirmed to replace Sebelius, perhaps the programs of states which do not adore the Great Leader Obama may be approved.

Posted by: frodo23 | October 21, 2010 4:34 PM | Report abuse

You give too much credit to conservatives for their "reasons" for opposition -- points (a) and (b). They oppose reform which many of them previously favored because Obama favors it and want to bring him down. Pure and simple. Likewise opposition to doing anything effective about the economy. They thrive on failure.

Posted by: jtmiller42 | October 21, 2010 4:35 PM | Report abuse

So did Cohn write the same thing when the Big O was campaigning against the individual mandate in the primaries? Or was he pretending to take those arguments seriously, even though they were so plainly and obviously wrong to him? Or is he just a hack? I choose #3.

Posted by: sgaliger | October 21, 2010 4:39 PM | Report abuse

There are 2 types of political positions: 1) The ones that you genuinely want to enact, regardless of the political consequences, and 2) The ones that you don't necessarily believe, but the politics are good, and so they help you get elected to enact policies from Category 1.

Posted by: vvf2 | October 21, 2010 4:41 PM | Report abuse

sgaliger, I don't know about Cohn. But during the primaries, I was a strong Obama supporter and one of the only issues I agreed more with Hillary on was the insurance mandate. I thought Obama was being either naive or just playing politics by rejecting the mandate. When he got into office, fortunately, the right policy prevailed.

Posted by: vvf2 | October 21, 2010 4:46 PM | Report abuse

Why can't one "just say this, even though it's plainly true"? People like Chuck Grassley, Mitt Romney, and other GOP-ers who rail against healthcare reform bank on Americans being unintelligent and prone to eat up whatever tripe you serve them. The press and punditry is uniquely positioned to call them on previous stances and the incoherence of their arguments.

By writing rebuttal policy pieces or "objective" news stories (you know, just quoting what someone said without bothering to verify if it's true or makes any sense) just feeds the flames and legitimizes that which should be relegated to the dust bin. And just because FOX or the Washington Times will still take the story doesn't mean anyone else is obliged to.

It's like that piece in the Onion, "Candidate May Have Lied About Heroic Death in Vietnam." http://www.theonion.com/articles/candidate-may-have-lied-about-heroic-death-in-viet,17600/ And the jury is still out on whether that candidate was telling the truth . . . about his own death . . .

Posted by: pbasso_khan | October 21, 2010 4:49 PM | Report abuse

sgaliger - agreed, Cohn's a triangulating hack.

vvf2 - Obama's opposition to the mandate was one of the main substantive differences between him and Hillary, and one of the main reasons so many like me preferred him, so curious as to why you didn't support her?

"I mean, if a mandate was the solution, we can try that to solve homelessness by mandating everybody to buy a house. The reason they don’t buy a house is they don’t have the money."
Obama - 2/5/08
http://edgeoforever.wordpress.com/2010/03/24/candidate-obama-on-mandates-why-not-mandate-that-homeless-buy-homes/

Posted by: michaelh81 | October 21, 2010 5:07 PM | Report abuse

"The reason they don’t buy a house is they don’t have the money."" posted by michaelh81

Well, he certainly solved that problem nicely enough, didn't he? He's just going to take the money from other people to buy them, not just some modest little bungalow, but a tricked out mansion.

Posted by: bgmma50 | October 21, 2010 5:25 PM | Report abuse

bgmma50 - he's not quite buying them mansions with other people's money. More like FORCING them into an underwater mortgage worth twice the real value of the home, but telling them that's ok because he'll offer them a tax credit for the underwater portion. I'm all for income redistribution, just not wasteful income redistribution.

Posted by: michaelh81 | October 21, 2010 5:53 PM | Report abuse

I've said it before and I'll say it again: The mandate may be good policy but it is political cyanide. And for the second time today I'm forced to admit my astonishment at how such smart guys can be so caught so flat-footed by something so obvious.

In my 2008 Washington State caucuses Barack Obama clobbered Hillary Clinton on the mandate issue. We were yelling at each other that Hillary wanted to put sick people in jail. Obama opposed the mandate. It was a big issue in the primaries, maybe not in WaPo or the beltway blogoshere, but out on the streets.

Do you guys have alzheimer's or something?

Posted by: pmcgann | October 21, 2010 8:05 PM | Report abuse


Not only is it something conservatives have supported; it's been spun in the past (when they were supporting it, before they were opposing it) as sort of libertarian. As in, "I'm not paying extra today because you didn't want to pay anything yesterday." It's a sort of libertarianism I agree with, actually. If I'm paying for my neighbor, which I'm ok with, I'd like he and I to both pay for cheaper preventive PCP services than acute ER services.

Posted by: ThomasEN | October 21, 2010 11:44 PM | Report abuse

"Not only is it something conservatives have supported; it's been spun in the past (when they were supporting it, before they were opposing it) as sort of libertarian. As in, "I'm not paying extra today because you didn't want to pay anything yesterday." It's a sort of libertarianism I agree with, actually. If I'm paying for my neighbor, which I'm ok with, I'd like he and I to both pay for cheaper preventive PCP services than acute ER services. "

However spun, a government mandate to purchase a product is not libertarian.

Posted by: justin84 | October 21, 2010 11:49 PM | Report abuse

I have no real argument against the mandate. What I have a HUGE issue with is the idiotic design of the minimum plans you have to buy to avoid paying the penalty. The regulations on insurers seem designed to give them and the providers a lot of our tax dollars by requiring excessive coverage and not letting consumers benefit from choosing better value providers, while letting consumers wait until they are sick to upgrade to a high benefit plan. It's a set up. The health insurers are destined to fail or have massive price increases that the Democrats can point to as a failure of industry to provide insurance. In reality, it is the ridiculous plan designs that is going to cause this whole thing to blow up. Health Savings Accounts for all would transform the market. Medicare for all will fail to bend the cost curve.

Posted by: staticvars | October 22, 2010 1:05 AM | Report abuse

"Jon Cohn doesn't understand why the individual mandate has become so controversial. "

Sorry Jon, ya can't fix stupid. Which would have to be the case in order for you to be able to understand the problem.

Posted by: illogicbuster | October 22, 2010 6:07 AM | Report abuse

Very nice article about medical insurance industry. But you could get medical insurance for your entire family at the best price from http://bit.ly/9EwL4G if you spent few mins you can find a good plan.

Posted by: carolee22 | October 22, 2010 7:18 AM | Report abuse

Thanks for the Thanos reference! That made my morning!

Posted by: gmart68b | October 22, 2010 9:18 AM | Report abuse

Bravo on the Infinity Gauntlet reference!

Posted by: jtjohnso77 | October 22, 2010 10:02 AM | Report abuse

Bravo on the Infinity Gauntlet reference!

Posted by: jtjohnso77 | October 22, 2010 10:06 AM | Report abuse

Not sure why it would surprise anyone

Right-wingers these days would rather look "cool" to their extreme base than do something that actually benefits this country

We see it daily when Republicans are told of FACTS that go against them and they either call the person a liar (for no reason) or change the subject

Posted by: Bious | October 23, 2010 8:35 PM | Report abuse

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