Health Care, Cost Control and Sneakiness

Yesterday I might have been a little harsh on Fred Hiatt's health care op-ed, but I wanted to underscore my last point. Hiatt says

Single-payer national health insurance may be the best outcome, but we should get there after an honest debate, not through the back door. (my emphasis)

I didn't like that sentence for two reasons. (1) The country has spent the last six months debating health care reform in town halls, Congress halls, cable shows, morning shows, blogospheres, and dining rooms. I just don't know what "honest debate" Hiatt holds his breath for; (2) What's wrong with a little sneaky public policy?



Today, Ezra Klein quotes Jon Kingsdale, director of the Massachusetts health insurance exchange:

If you're going to do health-care cost containment, it's going to have to be stealth. It's going to have to happen before any of the players understand what's happening.

As a political matter, there are problems with developing a reputation for this kind of thing, because eventually stealthy starts to look like a euphemism straight-up lying. But a bit of sneakiness is probably going to be necessary to get some cost control legislation through Congress. We need higher taxes for more than the richest one percent, and right now, America won't vote for any candidate who says that. If you agree with both parts of that sentence, doesn't that necessarily make you a friend of stealthiness?