Reihan: You Can Bring A Horse to Water ...
... but should a mandate that your horse drink, particularly when the cost of uncompensated water-drinking is relatively low and any water-drinking mandate will involve a complicated, potentially intrusive set of regulations?
I'm talking about healthcare, of course, and though I've expressed strong support for mandates, I do think opponents are raising very valid questions. The default approach advanced by Matt thus has a lot of appeal.
My own view is shaped by that of Michael Graetz and Jerry Mashaw in True Security: I think we need an approach to healthcare centered on protecting families from income shocks. (Graetz and Mashaw happen to like mandates, but the idea of catastrophic coverage is at the heart of their proposal.) That's why federal reinsurance proposals strike me as an attractive interim step.
The focus on covering the uninsured leads some of us to forget that many of the insured are underinsured, and that many more face steeply rising costs: the healthcare problem extends far beyond the 47 million. Which is why John McCain's approach has some political promise. Assuming you really can deliver lower costs, the anti-nanny, anti-mandate argument suddenly has a lot of teeth.
I like the idea of relaxing medical licensure and promoting the growth of low-cost walk-in clinics, as well as promoting best practices, etc.
And this idea is also pretty good:
He would give all Americans a refundable tax credit to help them buy insurance, totaling $2,500 per person or $5,000 per family. They would get the tax credit whether they were to get insurance through work or buy it on their own. The existing tax break for employer-sponsored insurance would be eliminated, taking a step away from the work-based model in place for the last half century and toward an individual market.
But will there be a reinsurance component? If not, this is pretty thin gruel.
The DeLong utopian plan is still the best.