POLITICS: Mandate Confusion

The very first day we started this blog, in March, we wrote about the mandate war between Hillary Clinton and Barack Obama, and how it was obscuring their many areas of agreement on health care. With the two Democratic candidates again beating each other up about health policy it's worth checking out Jacob Hacker's piece on The New York Times web site today (it's also available on NewAmerica.net). Hacker, a Yale political scientist and New America fellow, urges the two candidates to cool it because their health care rhetoric is only confusing voters. Hacker writes:

"So what's the main story: (1) a basic Democratic consensus about what should be done, or (2) a widening policy divide fueled by presidential ambitions? The answer is (1), but unfortunately, the reality of (2) is increasingly upstaging this welcome development. And, unfortunately, this unnecessary and self-defeating conflict could ultimately derail efforts at reform, confusing and turning off the very voters Democrats need to woo."

Clinton and Obama (and John Edwards, who was the first of his Democratic rivals to propose a health care plan) agree on an awful lot. The big difference: Clinton wants an individual mandate that everyone must have insurance. She argues that you have to get everyone into the insurance system, the healthy and the sick alike, if you are going to reform insurance markets and control costs. Obama mandates coverage only for children, although he said he wanted to take other steps that would lead to much higher rates of adult coverage. Hacker writes, "His decision seem[s] to have reflected fear of the potential backlash against an individual mandate, as well as a belief that few people would shun coverage if it were affordable and available." He also concludes that both plans would cover "all or virtually all" Americans for a relatively modest cost.

John McCain is making health care his campaign theme this week. He stresses cost containment more than coverage, and his coverage proposals are market-based. We can't have a national debate about health reform unless both sides are participating so we welcome his voice.