The Edwards Mandate Revisited

THE EDWARDS MANDATE REVISITED….Writing from the land of tulips and universal healthcare, Ezra Klein says I’m giving short shrift to the political merits of individual mandate healthcare plans (i.e., the kind of plans currently on the table from John Edwards and Hillary Clinton). But I think he missed the point of my criticism (here) of Edwards’ plan for enforcing enrollment in his version of IM.

As it happens, I really do think individual mandate plans are dumb on pure policy grounds. But I also realize that my preferred alternative is a political loser and that IM is (possibly) a political winner. So I’m for it. But that’s exactly why Edwards’ Diogenes-like effort to define his enforcement mechanism for IM in such mind-numbing detail is a bad idea: it practically forces voters to confront the fact that IM doesn’t really make much sense. If you’re really that dead serious about forcing everyone to get coverage, why the Rube Goldberg mechanism? Why not just tax everyone and sign ’em up for Medicare?

This is, frankly, something you want to keep a little blurry, not something you want to sharpen, and a smart politician understands this. Ezra is right when he says that IM “basically trades away certain amount of economic efficiency in order to evade the political implications of nationalizing health spending.” That being the case, it’s politically wise to keep things fuzzy at this point — especially since enforcement is a detail that has no chance of surviving the political process intact anyway, and accomplishes nothing except providing your opponents with an opening for demagogic attacks. Right?

UPDATE: Nicholas Beaudrot points out that all the healthcare plans on the table (including Edwards’) provide various subsidies and tax credits for poor people, and that in any case, everyone has a political incentive to make sure that the middle class doesn’t pay too much for healthcare. “Thus, in practice, the number of people who would actually see their wages garnished or get taken to collections would be relatively low.”

Exactly. And I’m sure that Republicans all realize this and will therefore refrain from using it as an unprincipled way of panicking Harry and Louise about jackbooted IRS thugs raiding accounting departments across the country and demanding that H&L’s wages be garnished. So I guess no harm has been done after all.