Framing the Mandate

» TNR: Mandate Overboard (Jonathan Cohn)

Another entry in the Great Mandate Battle of 2008. It's ironic that as a supporter of Hillary, I'm rooting like crazy for Obama to not cave in on his opposition to an individual health care mandate.

Aside from that, I think Cohn covers the topic reasonably well from his pro-mandate side. I think there's one question left unanswered from his article though: If a forced individual mandate gets you to 98% coverage and working on the affordability/eligibility side of the equation gets you something only marginally better than the present 85-90% (or whatever it comes to), why is it so utterly worth the risk of backlash to move the needle so little? Mark my words, you'll either end up with a mandate as thin and empty as the current mandate on auto insurance (and hence, no significant increase in % coverage), or you push too hard on the force required to see that people are signed up (and then end up being voted out of office and seeing the whole enchilada repealed after the next election).

Obama's already left a bit of wiggle room on the question of a mandate. He's not opposed to it on principle, I guess. But he's at least got the ordering relatively right for any health care fix: take care of affordability and eligibility and you get pretty far down the road. I think there's loads of room for him to go even further and talk about the business structure of the industry. But I can also understand the reluctance to do so. I guess.

The one kicker in Cohn's article that I loathe the most is his point that Obama is playing to the GOP frame, basically. I swear, I hated that argument when it came to Joe Lieberman and it's only made more comical here. Sometimes, people actually believe things. In this case, I hope that Obama is sincere that an individual mandate shouldn't be the first step (and ideally, not even a needed one at any step) toward making health care affordable and accessible to all.