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The Health Care Kerfuffle

By js

The recent controversy over health care has reminded me of something lots of people apparently do not know: The debate between Hillary Clinton and Barack Obama over health care is fake. It?s fake because both plans are missing important details; this is political posturing, not legislation. The plans themselves are meaningful indicators of the candidates respective approaches, but there is not, so far as I can tell, ground enough to base real policy comparisons.

Two unknowns make this so. Clinton has not said how she would enforce her mandate (though she's refused to rule out garnishing wages). Obama has not said what would happen to those who ?game the system? by refusing to buy insurance until they need care (he?s mentioned paying back premiums in a debate). These two parts of their plans serve equivalent economic purposes. Without these details, no real comparison is possible.

And note what the Urban Institute study (pdf link) recommending mandates says about the mandate-enforcement mechanism:

However, our preferred approach is that the state deem all residents to be covered and that the tax penalty serve as a way of collecting unpaid premiums.

These differences are starting to look pretty minor. So Obama's mailer (pdf link) on the subject is indeed unfair. As is Clinton?s common refrain that Obama?s plan is not universal. Real policy debates are good fun, as is trading unfavorable inferences with overblown rhetoric, but let's be honest about what we're doing.

Full post as published by Expressio Unius on February 24, 2008 (boomark / email).