Killing Health Reform With Kindness


Ezra Klein observes that Arlen Specter says he’s for the Wyden-Bennett approach to health care reform but also says he’s against eliminating the tax exemption for employer provided health care. Inconveniently, eliminating said deduction is part of the Wyden-Bennett plan. That’s how you pay for it.

My great fear is that this is how health care reform is going to die. A handful of very conservative members of congress may position themselves as “against” reform. But many people on the center and the right are going to say that they’re all for reform. They’re just going to be against particular things such that reform is impossible. When Barack Obama proposed reducing tax deductions for wealthy taxpayers, that idea died a swift and sudden death on the Hill. And you also don’t see Senators who are eager to start taxing health benefits. Nor do I see Senators who are eager to pay for health reform with steep cuts in defense spending or a new VAT or by raising income tax rates to above their Clinton-era levels. But I’m having trouble thinking of any other possible sources of revenue.

In other words, with all that stuff off the table, health reform dies.

Insofar as I’ve heard this discussed at all, it’s sort of been in the form of concern-trolling where people say progressives shouldn’t be expending so much energy on defending the idea of a public plan. But we should be clear on who the real villains are here—Senators in the center who killed the Obama administration’s revenue concept without either putting a new revenue concept on the table or admitting that their actions are imperiling health reform. Thus far, people have been very eager to build “momentum” for reform by trumpeting all the different people and groups who say they’re for reform. But you need to watch out for a scenario in which reform’s false friends kill it with kindness. If there’s a battle between white hats and black hats we can fight the battle and perhaps win. But if we let too many black hats inside the tent, then reform’s false friends can kill universal health care with kindness. In other words, as far as I’m concerned anyone who’s “for” health reform but “against” all the ways of paying for it is against reform. Someone who’s really for reform—like me—is for paying for reform through any reasonable measures.