Why You SHOULD Support the Health Care Bill
I’m going to make this as simple for you as possible. I’ve seen precisely three intellectually honest reasons to support the health care bill passed today by the Senate, and they are as follows:
1. At the end of the day, passing a minimally-palatable health care bill is more important than what the bill actually says, because the primary objective is to establish a permanent government entitlement program while we have the votes. Once it’s passed, it’s a part of our lives, and no one will ever have the votes to get rid of it. Besides, it’s not like Congress won’t come back later and fix anything that goes really wrong.
In your camp: Matt Yglesias, Ezra Klein, Paul Krugman, and anyone quoting Yglesias, Klein, or Krugman favorably regarding health care.
2. At the end of the day, it doesn’t really matter what health care bill gets passed as long as it can be spun as a victory for Obama and Congressional Democrats. There’s nothing worse in this world than Republicans in power, so anything that makes it less likely for the Democrats to lose seats–or God forbid, the presidency–in 2010 or 2012 is more important than quibbling over particular provisions in the legislation.
In your camp: the DNC, the DCCC, Obama for President 2012, anyone who sang along and/or cried to that celebrity “Yes We Can” YouTube video.
3. You simultaneously hold all of the following positions to be true:
- Health care is a human right and it must therefore be afforded to all, pretty much irrespective of the costs to anyone else to provide it.
- The absence of additional regulations (the so-called “free market” health care system), rather than excessive or inefficient regulations, is responsible for the current situation.
- The current health care system is not an unacceptable framework upon which to lay new regulations.
- Forcing everyone to buy health insurance, including very healthy or very wealthy people who would prefer to take their chances uninsured (a.k.a. the individual mandate), is an acceptable tradeoff if it generally keeps premiums lower.
- The individual mandate is constitutional, rather than unprecedented and unconstitutional.
- Granting massive concessions to certain industries at the expense of others, in particular the very insurance companies that all parties condemn and that Harry Reid demonizes in every speech, is a less important concern than passing this health care bill.
- Continued healthcare-related annual deficits, or the national debt, or really any respect for the reason the CBO is consulted in the first place, are all less important concerns than passing this health care bill.
- Allowing only three weeks to read a 2,100 page bill and 24 hours to read the definitive 400-page compromise amendment, even though the majority of the legislation doesn’t take effect until 2014, is less important than passing this health care bill.
- Persuading at least one senator outside your political caucus that the bill is a good idea is less important than passing this health care bill.
- Persuading a majority of the public to support the bill is a less important concern than passing this health care bill.
In your camp: without trying to be sardonic, in all honesty, I don’t know. I’m not sure I can think of anyone who would know and agree with all the points in #3 who isn’t already covered by #1 or #2.
Accepting that my tone may not appeal to everyone, I’m pretty sure this covers it. If you support this bill and I have either misrepresented your position or I have failed to list it here, I expect you to let me know so I can amend my post. And if you can’t defend your position on intellectually honest grounds, I hope you will seriously consider reevaluating it.
Not familiar with the mechanics of the health care issue? Here’s a pretty brief explanation, at least from where I’m sitting. The most devastating critique I’ve read is courtesy of the WSJ.
Otherwise, I suppose that’s about all I have to say about health care until the reconciliation process begins. Merry Christmas.
Amy wrote:
Actually, you missed a premise in #3. If you believe that health care is a human right, you also have to believe that governments have a responsibility to protect the human rights of citizens within their borders to the exclusion of protecting the human rights of worse off people outside their borders. With only the “human right” premise, the right path would clearly be to spend $900 billion on clean water, vaccinations, and other basic medical care in the developing world, where people presumably have the same human rights as the rest of us, but their health care situation is dramatically worse.
Posted on 25-Dec-09 at 12:31 pm | Permalink
Barzelay wrote:
I’m not saying I actually support this version of the health care bill, but I do support a universal, single-payer system. Recognizing that this bill is NOT that, and is unlikely to lead to that, and that this bill has vast and terrible consequences, I do not support it. However, I think your third option overstates a lot of things.
If I believe this bill would lead to a net improvement in the overall situation, and I believe that it is the best bill that has a chance of passing, I should support it. For instance, even if I thought that a completely free market system would be best, that doesn’t matter at all if I am certain that the current regulatory framework (or something similar, or something worse) will never get repealed and de-regulated. So, this shouldn’t be required: “The absence of additional regulations, rather than excessive or inefficient regulations, is responsible for the current situation.” I can think that excessive or inefficient regulations is to blame, but I think those regulations are unlikely ever to be scaled back or improved. That principle applies equally well to several of your other positions.
You seem to come from the perspective that no laws should get passed unless they are good laws. The legislature doesn’t agree with you on that point. They pass a bill if they think it makes the law better than it is now, whether or not it makes it good. That’s still a reasonable way of doing things, and is usually the only way to make any change to the law under this system of government.
Posted on 26-Dec-09 at 4:00 pm | Permalink
Chad wrote:
David, your point is well taken. If I believe that a given bill will improve on the existing system (according to my criteria for improvement) and represents the best chance for any improvement at all, then I should support it. You are also mostly correct about my preexisting bias against passing laws at all. It’s not that I’m trying to make the perfect the enemy of the good (or even the good the enemy of the better); it’s that I am so highly skeptical of the government’s ability to pass laws that are a net improvement according to any of the principles I hold dear. Or, if you prefer, I hold pretty strongly to the public choice school of political economy.
I can certainly point to examples of laws that were net improvements, but — to try and turn your comments on your head — I can identify so few laws resulting in net improvements that, although not the ideal solution, it may be a net improvement to simply obstruct the passage of new laws altogether. I might be more optimistic if there were changes in the rules to make it at least theoretically easier to pass better laws, e.g. a maximum bill length of four pages to keep the legislature out of the weeds; a requirement that all bills be read aloud before voting; a prohibition on all amendments not directly related to the bill’s purpose. But I’m not optimistic about the chances of any of these changes, for the same public choice reasons.
And if at the end of the day, someone truly believes that federally-funded coverage of an additional 30 million people in the manner proscribed in this bill is worth all the other tradeoffs I’ve outlined — and they’re willing to go on record saying so — I believe that’s an intellectually honest position and I respect that person for saying so. I don’t think I said anything in my post to invalidate that claim.
Posted on 27-Dec-09 at 11:48 pm | Permalink
Barzelay wrote:
I believe that I could effectively refute the applicability of several of the positions you list as being required for supporting the bill (though definitely not the first one). In any case, a prohibition on the passage of laws would be an interesting experiment, if it weren’t for the fact that the legislature is only one way in which legal norms arise in this country. The judiciary, local police departments, district attorneys, federal agencies, etc. can all effect pretty drastic changes in the law. The law would keep evolving, and still usually for the worse. If anything, the legislature gets it right more often than most of those other sources of law (more often than anything but the judiciary, I’d say).
Posted on 30-Dec-09 at 5:34 am | Permalink