Opinion

The utter fantasy of a grand health-care compromise

How does anyone think Republicans and Democrats can agree on a sweeping health-care bill?

The persistent lionization of political centrism is one of the more mystifying facts about America's political climate. At a time of greater political polarization than at any time since Reconstruction at least, a few influential rich centrists keep insisting that negotiation, bipartisanship, and compromise are the way forward. And their pals in the centrist media can't help but cheer them on for guiding America down this Righteous and True Path.

Witness Michael Bloomberg, the billionaire former mayor of New York City, who argues in a column that now that the Republican effort to reform health care has spectacularly collapsed, the parties should stop bickering and come together for another bipartisan try.

This is monumentally stupid, and a demonstration of the absolute uselessness of political centrism at this moment.

The first mistake here is a jaw-dropping misread of political reality. Republicans and Democrats disagree very strongly about health-care policy; their ideas could not be more diametrically opposed. Republicans — as seen by the contents of their health-care bill — want to slash subsidies and coverage so rich people can have a big tax cut. Democrats want the precise opposite policy direction, be it single-payer or just a more modest strengthening of the ObamaCare formula.

Centrists routinely bend the facts around their substantive preference for compromise and moderation. That's why Bloomberg has to deny there is total substantive disagreement here, and that Republican ideas like high-risk pools and cutting the employer tax benefit for providing insurance would address problems with ObamaCare like ongoing lack of insurance, excessive premiums, and lack of insurer choice in some markets.

Those are indeed problems with ObamaCare, but neither of those Republican ideas would fix them. High-risk pools — where you take all the people with really expensive conditions and lump them together in one insurance market — would indeed lower premiums for non-sick people. But the sick people in the high-risk pool would require a huge subsidy to be able to afford coverage. That would, of necessity, have to come from the healthy people.

All high-risk pools would do is change the label by which the chronically ill receive their subsidy. Premiums would go down for healthy people, but taxes would go up by an equivalent amount. But worse, Republicans have shown no sign whatsoever of funding such pools at a level which makes them actually affordable, because they hate subsidizing people who aren't rich. The high-risk pools that have actually been tried end up being hideously expensive for their enrollees.

Capping the employer tax exclusion would make that tax subsidy somewhat less generous to the rich, perhaps nudge a few employers away from offering that benefit, and raise some money. It barely has anything to do with ObamaCare; it would affect it only insofar as it pushed a few more people onto the exchanges.

All this means is that the best outcome for Democrats is very obviously to just stop whatever Republicans want to do. But Bloomberg is so convinced of the possibility of compromise he didn't bother to see if the Republican ideas he mentioned were even connected to the problems he supposedly wants to solve.

Moreover, Bloomberg's desire for governance through bipartisan negotiation and compromise is not inherently superior to a partisan-only model. The American public is getting a pretty clear idea of which party is for what ideas on health care — and if the tidal wave of outrage that rolled over Republican members of Congress during the health-care negotiation is any sign, people are none too impressed with the conservative variety. That's how democracy is supposed to work. Put your ideas out there, and the let the voters judge.

But the extremely wealthy have often been rather suspicious of too much democracy. The mid-20th-century days when bipartisan compromise was routine did have a more responsive federal government. But it was also a time when a profoundly elitist permanent Washington establishment set the parameters of policymaking, and the broader public had only a hazy idea of what was going on in the government.

At any rate, those days are dead, dead, dead. It's true that, due to our antiquated Constitution, America is not dealing so well with this new era of rigid partisanship and political polarization. But simply wishing for a time when it was somewhat easier for the Michael Bloombergs of the world to buy the policies they want won't make it so.

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