It’s the Policy, Stupid

IT’S THE POLICY, STUPID….Ruth Marcus on the Bush health plan:

If George W. Bush proposes something, it must be bad. Such is the knee-jerk state of partisan suspiciousness that when the president actually endorses a tax increase — a tax increase that would primarily hit the well-off, no less — Democrats still howl.

….Listening to Democratic reaction to Bush’s new health insurance proposal, you get the sense that if Bush picked a plank right out of the Democratic platform — if he introduced Hillarycare itself — and stuck it in his State of the Union address, Democrats would churn out press releases denouncing it.

Now, Marcus concedes that Bush has no one but himself to blame for this state of affairs. But at the same time, she also seems flatly unwilling to believe that opposition to Bush’s plan might actually be based not on liberal temper tantrums but on the fact that it’s a bad plan.

Which it is. It’s true that if you look at Bush’s proposal solely though the prism of tax policy, it seems fairly progressive: increased taxes on well-off people who have gold-plated health insurance combined with tax breaks for middle-income folks with private insurance. And Republicans have trained us so thoroughly to view everything as part of their long-running war on taxes that this is apparently the only way pundits are now able to see things.

That’s a mistake. This is a healthcare plan, after all, and it should be looked at through the prism of health policy. And from that perspective it’s a lousy plan. As Marcus herself points out, it increases the risk that “the already-teetering employer-based system will collapse as healthy individuals use their tax deduction to buy cheaper, private insurance, leaving employers with the older and the sicker.”

But here’s the thing: as far as movement conservatives are concerned, that’s a feature, not a bug. It’s a feature of the “ownership society.” It was a feature of last year’s HSA expansion. It’s been a feature of every healthcare proposal Bush has ever offered. He wants to push the country toward “consumer directed healthcare,” a euphemism for gutting the current insurance system, in which third parties pay for most medical costs, and replacing it with a system in which consumers pay directly for healthcare and insurance only kicks in if you suffer some kind of major disaster.

If you think this is a good idea, Bush’s plan is a good first step toward getting there, and using it as the starting point for a compromise is a fine idea. But most liberals don’t think it’s a good idea or even a good direction. We want to expand routine health coverage, not shrink it. And that’s why we oppose Bush’s proposal: because we think it’s bad policy with bad consequences. Believe it or not, that’s still what motivates some of us.

UPDATE: Max Sawicky agrees but offers a small correction:

Kevin misfocuses a tad by putting the choice as between third-party payment and consumer purchase. The real distinction is group versus individual. The Bushists want to destroy group coverage in both the employer-provided sector and the public sector.

I think it’s both things, actually, but this is a worthwhile distinction to understand regardless, especially since the whole conservative campaign to find ways to destroy group insurance pools is subtle and not much understood. More at the link.