POLICY: Jonathan Cohn on the politics of real reform

Jonathan Cohn, who besides being a deliriously happy Red Sox fan is a health care journalist and a senior editor at the moderately liberal New Republic, has been corresponding with me a while. (Does it bug anyone else having to keep The National Review, The New Republic and The Nation straight? Couldn’t the conservatives, the liberals and the real lefties have chosen titles with slightly different alliteration or words beginning with letters not N or R?). Jonathan’s on the book grind himself (and doubtless scared of my review!) and writes regarding my post yesterday as to why things might change in the longer term regarding reform:

Good post today about the politics of health care reform. I’ve been thinking a lot about this myself lately, as part of my book, and am starting to question the conventional wisdom that moderation plays better politically — at least in the context of a presidential campaign. Look at the election we just had. Policy wonks could (and did) make a very good case for incremental reforms like the ones Kerry proposed, and Kerry did fine on the health care issue because voters tend to trust Democrats more than Republicans on the issue if they don’t know any other information. But it’s not like Kerry’s health care plan was a major draw, and part of the reason is that it was so damn complicated it didn’t break through the policy fog.

Now consider single-payer. Put aside the debate over whether it’s really the best policy. I’m starting to wonder if — strictly in political terms — bolder isn’t better. You can explain single-payer three simple words "Medicare for all." And while that
instantly ignites a very hostile opposition, it also arms you with (a) the aura of a popular program, namely "Medicare" (b) the virtue of simplicity (c) the virtue of seeming bold.

Admittedly, selling single-payer gets much harder if you actually get elected and have to start dealing with the legislative process. Maybe you compromise at that point. But I don’t think we’re going to see *any* substantial health reforms until
somebody puts a big, bold idea — and that probably can’t happen outside the context of a presidential campaign.

Meanwhile The Prospect blog had another wild idea–let everyone join the Democratic party and let it start its own health plan. Pity they’d never heard of adverse selection. (Thanks to Jones the Policy Wonk for the tip).

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