The Obama campaign offers a weird attack on Paul Krugman, calling him inconsistent in his attacks on Obama's health care plan. Krugman is perfectly consistent, as Ezra notes. It's a strange fight to pick, since it forces Krugman into a position where either his credibility is damaged or he responds. More to the point, Krugman isn't running for office. Is Obama looking for more opponents or something?
Anyway, in reading to prep for this post, I ran across this article by Jonathan Cohn, and I think I identified what worries me so much about mandates.
One person who has done so is Sherry Glied, a Columbia University economist. She has co-written what appears to be the most definitive paper on the subject, in a recent issue of the journal Health Affairs. Surveying the evidence, not just from the examples I just described but also other types of government mandates (like childhood vaccinations), she and her co-authors concluded "mandates can be an effective tool in expanding health insurance coverage, but the devil is in the details."
Legislative complexity advantages Republicans and insurance companies, since they have a lot more capital to deploy on lobbyists, think tanks, and ideological political groups. Simplicity advantages the public, which is why we won the Social Security fight in 2005. We simply don't play the insider game very well, and they don't play the public support game very well.
A mandate is very complicated to explain, with lots of easy fear-mongering tools built into it the right can use (collection agencies, wage garnishment, etc). And once the Village gets its mind set on mandates, any mandate will do. That means that the likely outcome of this debate is going to be not just a universal mandate, but the worst possible universal mandate. While I don't know what that would look like, with mandates, the "devil is in the details". I think I now get why lots of wonks like the mandate plan, because they enjoy details, especially clever ones. That could be something of a blind spot.