People like Ezra Klein and Jonathan Cohn may not like it, and on the merits of the issue they may even be right. Nevertheless, I just don't see how you can sell this to the American public:
Democrat Hillary Rodham Clinton said Sunday she might be willing to garnish the wages of workers who refuse to buy health insurance to achieve coverage for all Americans.
The New York senator has criticized presidential rival Barack Obama for pushing a health plan that would not require universal coverage. Clinton has not always specified the enforcement measures she would embrace, but when pressed on ABC's "This Week," she said: "I think there are a number of mechanisms" that are possible, including "going after people's wages, automatic enrollment."Clinton said such measures would apply only to workers who can afford health coverage but refuse to buy it, which puts undue pressure on hospitals and emergency rooms. With her proposals for subsidies, she said, "it will be affordable for everyone."
Both Obama and Clinton say they want to get us to universal coverage. Obama is doing it in a way that many policy analysts think undermines his chances for success. And from a purely theoretical standpoint, I agree: Hillary's plan is in theory much more likely to create a system that simultaneously reduces costs and increases coverage.
But take that plan out into the real world and I just don't see how you beat back this argument. Mandates require enforcement, and the most likely mechanism for enforcement is to either garnish wages or impose fines. Ezra Klein, Jonathan Cohn, Paul Krugman, and many others have hammered Obama for using "Republican talking points," and if Hillary had a good answer for them, I'd be right there with them. The problem, of course, is that she doesn't. And that, to my mind, makes it a legitimate critique, not a talking point.
I suspect even Obama knows mandates will eventually be necessary. But if you start out by saying "eventually I'll need to impose fines and garnish wages," you'll never get your program passed. That's a sad but nevertheless very true fact about American politics.
As my public policy professor constantly reminds me, there are four criteria policy analysts must consider when creating policy - equity, efficiency, effectiveness, and political feasibility - and sometimes they work at cross-purposes. In theory, I think Clinton's plan has a slight advantage on the first three principles, but on the fourth I fear her plan is sorely lacking.
Our government is dysfunctional. Everyone knows it. Call me crazy, but I don't think now's the best time to start talking about using the power of the federal government to garnish people's wages. Until and unless people begin to believe that government can be a force for good in their lives, you will never get this passed. It's sad, but it's true.
UPDATE: For a slightly different and admittedly better take on what I was trying to say, go read Josh @ The Plank. For a more policy-oriented analysis, check out Dean Baker.
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