Giving the individual mandate real-world meaning

GIVING THE INDIVIDUAL MANDATE REAL-WORLD MEANING…. I suspect nearly everyone’s heard all about the fire that burned down Cranicks’ family home in Tennessee recently*. Their town doesn’t have a fire department, and they refused to pay the $75 annual fee for what was, in effect, fire insurance provided by a nearby municipality.

Of course, once their home was on fire, the Cranicks quickly changed their mind, and offered to pay any amount, but it was too late — fire crews were on the scene, but wouldn’t put the fire out. Local officials didn’t want to set a precedent that told the community they could wait to pay for fire services only when they really needed those services. Indeed, if enough people thought that way, there wouldn’t be enough resources to have a fire department in the first place. The Cranicks were prepared to gamble, and they lost.

Ezra Klein had a smart piece today, drawing a parallel to health care reform.

When liberals explain why health care needs an individual mandate, the traditional metaphor is firefighting: Everyone needs to buy insurance for the same reason that everyone needs to buy fire protection. But if you leave the market unregulated, some people won’t buy — or won’t be able to afford — fire protection. And we’re not comfortable letting their houses burn down. Similarly, if you leave health coverage to the market, some people won’t buy it, and others won’t be able to afford it, and then, when they get sick and need it, insurers won’t sell it to them. But we’re not comfortable letting them die in the streets. Hence, the health-care law.

When Republicans talk about repealing the legislation, they keep the argument abstract. It’s about freedom. About American values. About Nancy Pelosi not reading the bill. When they actually try to repeal the legislation, things are going to get concrete in a hurry. It’s going to be about this child with that condition being rejected by insurers. And she’s going to be adorable, and her parents are going to tearful, and voters will be able to relate.

Already, Republicans are running from that argument, trying to pretend that they’ll somehow preserve the protections for preexisting conditions while repealing everything that makes those protections possible. But the bill’s unpopular parts are inextricably intertwined with its popular parts. Remove the unpopular ones and you’re asking firefighters to sell insurance for homes that are already engulfed in flames…. If you’re not comfortable explaining why you let someone’s house burn down, you’re really not going to like explaining why you let insurers turn their sick child away.

That’s exactly right. And I’d just add that Republicans, whether they want to admit it now or not, have known this for years. It’s precisely why GOP officials like George H.W. Bush, Richard Nixon, John McCain, Bob Dole, Mitt Romney, Scott Brown, Orrin Hatch, Chuck Grassley, Bob Bennett, Tommy Thompson, Lamar Alexander, Lindsey Graham, John Thune, Judd Gregg, and many others all supported the individual mandate in health care for years. It was, in fact, a Republican idea in the first place, back when there were still some GOP officials who took substantive policy details seriously.

But that was before some poll showed the GOP this could be a good talking point. Regardless, in terms of explaining to people why it can’t be repealed, the fiery incident in South Fulton, Tennessee, offers an extremely illustrative real-world example.

* Not sure why I thought this was in Ohio. It was in Tennessee. It’s corrected throughout.