Two different blog entries about health care ended up in my RSS reader at the same time. They argue for diametrically opposite positions based on what appear to be identical principles.
The worst thing about “comprehensive reform” efforts are that they shut the average citizen out of the legislative process by making bills so complicated that it is nearly impossible for the average citizen to properly evaluate whether on balance it is a wise or unwise measure. Who can predict all the effects of a 3,000 page bill spanning all manner of issues? Often times not even the legislature itself. Certainly not the press, which often focuses on bits of the legislation that won’t actually have the most impact, sometimes because legislators themselves are deliberately obscuring what’s actually at stake.
It’s a conservative lesson: we should make “small, piecemeal improvements to public policy, rather than the kind of sweeping efforts that flatter vanities but fail citizens.”
And here Ezra Klein presents an argument from a reader named Lensch, who compares the current reform bill being considered to the old Ptolemaic epicycles in astronomy:
We want a “uniquely American solution.” So we have weak plans, strong plans, coops, exchanges, individual coverage, community ratings, etc., etc., etc. I still haven’t seen we are going to handle the problem of people with pre-existing conditions. If we cover them, people will take out minimal insurance until they get sick and then switch. We need some more epicycles.
If Copernicus were alive today, I am sure he would say, “If you simply give everyone Medicare, you wouldn’t need all this complication, and I’ll bet it would be cheaper, too.”
The practically radical answer turns out to be intellectually conservative; it’s a back-of-the-envelope solution.
I don’t think one answer trumps or refutes the other. I think there’s another meaning of “simple” here, which both arguments ignore. The health care proposal floated in the House, is intellectually complex not only because it’s designed to please different legislators and constituencies, but because it’s designed to have a minimal impact on most people, particularly those who already have some kind of health care. If by a stroke of law, we switched everyone from private insurance to Medicare tomorrow, it would be chaos. That’s why you get epicycles – because it turns out that asking the earth to move in this case might actually make it change its orbit.
And really, the same thing could be said about the plan to make Congress read their bills out loud and then take a day to deliberate about them. It would actually introduce a great number of brand-new complications into the legislative process, not just for them, but for us, particularly if we actually cared enough to pay attention. You mean, my politicians actually want me to pay attention to what they do and weigh in on complex issues and hold them accountable? Wouldn’t it be easier just to complain that they’re all crooks who don’t represent my interests?