Ezra Klein: A Man Date And A Movie

Jon Cohn has a long exploration of the policy debate involved in how many people Obama's plan leaves uncovered. The answer is...we really don't know. It depends how strong the employment mandate is, how lavish the subsidies are, how much the plans cost, what's defined as the minimum coverage threshold, etc. Jon's conclusion is forthcoming, but mine basically remains: If you're not substantively striving for universality, you're not going to get universality. Too much will get bargained away. Additionally, you can't make the necessary reforms to the insurance market without putting everyone in the coverage pool. The point of the reforms is not merely to keep insurers from gaming consumers, but to keep consumers from gaming insurers. You can't have one without the other. And lastly, because he's not relying on a coverage mandate, Obama relies heavily -- more so than Edwards or Clinton -- on employer-provision. I'm not necessarily against channeling some insurance through employers, but further strengthening your reliance on that system seems like a tremendous mistake to me.

This seems to me like a policy compromise that's searching for a rationale, and because various people want to support Obama, rationales are being constructed. The world is full of smart people who can think up smart reasons for not-so-smart things. But at the end of the day, even folks like Jacob Hacker, who are supportive of Obama's plan, had mandates in their plans. And even Obama, who is supportive of Obama's plan, has a mandate for kids in his plan. How you explain that in contrast to his attacks on a mandate for adults beats me. Obama could, of course, have come out and said that his sense of the political landscape was that a mandate wasn't popular enough, and would harm the chances for passage. But because he's made a big deal out of being bold and unbound by political considerations, he had to pretend that this was a decision made on the policy, rather than political, merits, and it's just not a very credible claim.

http://ezraklein.typepad.com/blog/2007/12/a-man-date-and.html

I don't know whether mandate vs. no mandate is the answer. Robert Reich seems to like Obama's plan better, Krugman likes Hillary/Edwards's. My good guess is that it doesn't matter: none of these plans are what will be proposed in 2009 when the next president is in office, and certainly none of them will be what occurs when it gets through the meat-grinder of Congress.

But in purely political terms, here is what I think is going on. If you believe that Mitt Romney will be the eventual Republican nominee (and that is a very good guess--I agree with Josh Marshall here), the idea of a mandated plan is going to be called "The Romney Plan"--because no matter how he may have tried to undermine aspects of it (especially the employer costs), he signed it into law. The Democratic candidate whose plan is mandated is going to have a tough time drawing distinctions: point, Romney. Obama is making a smart political chess move here: setting himself up to have a clear difference that Romney can't co-opt.

BTW: I don't think people understand all that much about these plans. I found this article in which Obama's health-economics adviser explains his plan, and it has many aspects that are NOT being talked about: it actually contains more mandates than you might think. Another political move? I really recommend reading this:

http://commonsense.ourfuture.org/advisor_describes_obama_health_plan

.. he will have painted himself as a flip-flopper.