This Is Still Not a Game

I still remember the day after the public option was finally pulled from the bill that would someday become the Affordable Care Act. One of my conservative friends (I have many, by the way) called to gloat about its demise. In one of the rare moments that I lost my cool, I snapped back, “Congratulations. You just increased the deficit by about $70 billion over the next decade. Nicely done.”

I feel the same way today. If the mandate goes, so be it. The general consensus is that it will raise the cost of premiums significantly for those in the exchanges and lead to significantly fewer people getting insurance. If that’s what it takes to make the law “constitutional” then again, so be it. As I said, there are other ways to address adverse selection and gaming.

I put “constitutional” in quotes because I sometimes feel like I’m the only one who’s a little uncomfortable about that word.

I get why pundits like to make excited pronouncements about it on TV. It’s how they get to be on TV more. But predicting how nine justices will decide in June from some questions the last few days is like predicting how the election will go in November based on the first debate. They’re making a guess. That’s all it is. Moreover, they don’t impress me because they sound sure today. They sounded sure last week, too, when they were saying the exact opposite thing.

Moreover, I really wish people would stop acting so darn sure about whether the mandate is constitutional or no. You know what? I’m not sure. I think it seems reasonable, but I don’t profess to know it as truth. But you know what’s crazy? The Supreme Court justices can’t agree! That means the people who are actually in charge don’t even “know” if it’s constutitional. We have to wait until we can poll them and get a consensus before we “know”. And you know what will happen right after that? Half the country will start crowing about how they were “right” and treat the other half as if they were crazy.

Am I the only one who thinks that’s insane? If it’s 5-4 then even though 44% of the Supreme Court justices felt the opposite, they are “wrong”. And so is everyone who agreed.

Can we all develop a little humility here? Can we agree that our system of government is open to interpretation and reinterpretation and stop with all the surety?

No matter what happens, though, I can tell you what you won’t see here: gloating. This is not a game. It wasn’t then, and it isn’t now. This is about policy, and trying to make the health care system of the United States a little better in terms of quality, a little more cost-effective, and open to more people.

I say this now so you won’t be surprised in June. We don’t strut, and we won’t tolerate it here from anyone else.

[Cross-posted at The Incidental Economist]