This post by Reihan Salam scores a decent technical point, but I can’t help finding its broader context cheap and/or disingenuous. The two parts of the Reinhardt interview Salam references, and the problems they highlight with the excise tax and individual mandate, are reasonable – as far as my arm-chair blogger’s abilities are able to discern. But there have been plenty of other reputable economists who don’t share Reinhardt’s worries.
More importantly, these strike me as exactly the kind of problems that could have been solved if the Republicans had been willing to play ball. The technocratic crudeness of the excise tax and the (relative) weakness of the individual mandate both result because more sophisticated versions of the former, and more potent versions of the latter, would have been politically unpopular. Getting back to this old Kevin Drum post, bipartisanship is valuable because it increases the range of combination of votes lawmakers can put together to get to a majority. (While constituencies within each party are diverse, it’s also true that each party has access to constituencies the other doesn’t, unless the parties decide to work together.) More possible combinations of votes means more chances to route around various constituencies that might have a self-interested problem with aspects of a bill that are for the broader good. Bipartisanship makes it easier to preserve policies that are politically unpopular but wise in terms of substance.
This is relevant since Salam himself and other “reformist” conservative thinkers in the same crowd – Yuval Levin, Ross Douthat, etc. – were quite happy to indulge the Republicans in their petulant fit of total obstructionism. If it hadn’t been for that obstructionism, lawmakers might have been able to fix the very problems Salam holds up as evidence of a lack of honesty about cost estimates and policy consequences and what not. It really takes some serious chutzpah.
Salam would, no doubt, reply with the gist of his very next post:
Remember the enthusiasm with which congressional Democrats scrambled to make the Bush tax cuts work by backing sweeping spending cuts? It was a remarkable display of bipartisan comity, and clear evidence of the fact that one party is more virtuous and public-spirited than the other. Wait a second …
To be sure, one could argue that the Bush tax cuts were so profoundly unwise that there was no sense in “making them work.” Rather, the only responsible course of action was to defeat congressional Republicans, and to elect a Democratic president who would then … continue all of the Bush tax cuts for middle and working class families. I was going to say “repeal them,” but that, alas, was never really on the table.
But you see my point. Many conservatives see the health reform legislation as profoundly unwise. The real motivation, as Rich Lowry has explained, was the desire to expand insurance coverage, which is admirable. In pursuit of this goal, we’ve seen a bill tailored to game the CBO process just as complex financial instruments are tailored to pass muster with rating agencies.
The sideswipe about gaming the CBO is a bunch of malarkey, but the broader point that bipartisan cooperation has its limits – even when that cooperation might result in a more ideologically preferable bill than obstructionism would – is fair enough. And if the Democrats had been proposing a single-payer system or a British-style top-to-bottom national health system, I could totally buy the “this is so unwise as to render cooperation moot” argument coming from conservatives. But that isn’t what the Democrats proposed. They proposed a reform that closely resembles other proposals which, under more favorable political conditions, Republicans apparently found amenable enough to their principles and preferences to put forward themselves. Don’t ask me, ask David Frum.
So this particular structure of reforms went, in just a few years, from being good enough to offer as an alternative to ClintonCare to being so profoundly unwise as to make any cooperation unthinkable. I don’t know about anyone else, but I’m not buying it. Especially when the only significant difference between then and now is that this particular package is now being offered by the other party.
PS: As a specific example, Salam pats himself on the back for saying nice things about Obama’s plan in the ’08 campaign, specifically because it lacked an individual mandate. Problem is, the individual mandate was a creation of conservative think tanks and in years past has been roundly supported by Republicans. No one thought it was unconstitutional or un-American back then. Indeed, many conservatives defended the mandate, not as a practical concession, but as an expression of conservative principles:
One reason the individual mandate appealed to conservatives is because it called for individual responsibility to address what economists call the “free-rider effect.” That’s the fact that if a person is in an accident or comes down with a dread disease, that person is going to get medical care, and someone is going to pay for it.
“We called this responsible national health insurance,” says Pauly. “There was a kind of an ethical and moral support for the notion that people shouldn’t be allowed to free-ride on the charity of fellow citizens.”
Now, conservatism is hardly monolithic. It may be that Salam or Levin or Douthat opposed the individual mandate in spite of support from other conservative thinkers and politicians, and said so, well before such opposition became political convenient due to the dynamics of the ’08 campaign. But I doubt it.