Public Policy is Positive-Sum

It occurs to me that supporters of the Affordable Care Act have been making two arguments that many people find inconsistent. On the one hand, we want to say that this is a very moderate political program that’s built on an architecture with an essentially conservative heritage—it’s what moderate Republicans put forward as an alternative to Bill Clinton’s health care plan, it’s what Mitt Romney signed in Massachusetts, it was touted in a 2003 Reason article, etc. But on the other hand, we also want to say that it’s the biggest progressive legislative victory in decades. How can it be both?

There are a number of ins and outs to this that could be explored (look how much less conservative the MA GOP is than the national party). But the basic overall point is simply that while electoral politics is a zero-sum competition for a fixed number of slots, public policy is positive sum. Americans don’t have higher living standards than Nigerians “from a conservative point of view” or “from a liberal point of view,” we just actually do have higher living standards and steps that made Nigeria more like the United States would just be good. Similarly, Greg Mankiw, who’s considerably more conservative than me, thinks that 100 percent auction of carbon emissions permits would be better than what Waxman-Markey does. But so does Brad Johnson who’s well to my left. For that matter, so do I. We all agree because we’re right—it rally would be better to auction the permits.

Which is just to say that it’s more than possible to produce a bill that’s very good for the uninsured and very good for pharmaceutical companies and also okay for insurance companies. At the same time, interest groups involved in the debate can be polar opposites on one aspect of the issue (unions like the public option, insurers hate it) and allies on another aspect (neither like the excise tax).

Good ideas leave most people mostly better-off than they were before—that’s what makes them so good.