THE TREATMENT JULY 30, 2009
Harold Pollack is a professor at the
University of Chicago School of Social Service Administration and
Special Correspondent for The Treatment.
Tevi Troy, conservative thinker/strategist and former Bush Administration official, takes some shots at me over at the National Review online. First he writes
Harold Pollack even contributed "What We Lose When We Get Wonky," in which he tells his fellow liberals "In conceding ground to a dry policy discourse that downplays the moral urgency of collective obligation, we unilaterally surrender some of the best moral and political arguments for health reform." It leads one to wonder if liberals are backing away from the details of the health debate because they appear to be losing the arguments on the technical questions.
On the contrary, if the health reform debate entirely hinged on the technical questions of cost-containment, liberals would do pretty well. We would have a strong public plan putting downward pressure on prices, employer and employee mandates, and a strong national insurance exchange. Yeah we might also have greater taxation of employer-provided health plans (see below), at least on generous plans for high-income people.
My real point was different. I think liberals should be more willing to make straight-up moral and political arguments when these are what really lead us to support the positions we do. Of course we should make strong policy-analytic arguments, too. I spend much of my work day trying to do precisely that. Yet on issues such as mass incarceration, needle exchange, and universal coverage, we shouldn't hide behind technocratic arguments when our true motivations arise from contested--and contestable--moral and ideological views. Policy analysis still matters. Many studies indicate that needle exchange prevents HIV. If the studies had come in the other way, we would have needed to shelve these interventions. If strong studies find that mass incarceration sharply lowers crime, attention must be paid. Yet normative judgments and analysis matter too. These should be presented and
debated with the same transparency and rigor one expects from a technical report.
I disagree with Troy's above take, although I can understand why he sees the value of staying wonky at TNR. But Troy goes on to mischaracterize what I said.
Another recent article by Pollack calls for keeping the taxpayer exclusion on employer provided health plans, which is uncapped, and therefore helps subsidize the so-called "cadillac" plans that unions want to preserve. I opened the article with interest, wondering if I would find a policy case that I had not considered for maintaining the uncapped exclusion. Instead, I found that Pollack's primary reason for keeping it as is was that he thought the president would be "wise to remember who his friends really are. He might be Senator Obama right now, were it not for the massive support he received from organized labor in the 2008 campaign." Really? That's the key reason? Even when Pollack deigned to talk about policy details, the reasoning was uncharacteristically weak for TNR, as Pollack said that "employer-based coverage solves real problems of efficiency and risk-pooling for millions of people." Here we agree, but putting a cap on that exclusion does not mean the end of the employer-based system. And even if it did, Pollack does not offer any substantive arguments making the case that capping the exclusion would have that effect.
I'm puzzled by Troy's own reasoning, because my article favors....putting a cap on that exclusion. Here is my key passage:
...Most Americans, certainly most union members, would benefit from policies that impose modest taxes on generous employer-provided plans for affluent Americans. There are ways to do this that honor unions' core concerns. One proposed option would CAP the deduction at $6,780 for individuals and $17,280 for families beginning in 2013--but would only apply the cap on individuals with incomes exceeding $100,000 or families with incomes exceeding $200,000.
Such measures would hit a minority of union members--for example teachers married to high-earners in New Jersey. By and large, though, these are progressive tax increases on affluent professionals, and would impose very little additional tax on most rank-and-file union members. Even this highly constrained cap on the affluent would raise some serious cash, an estimated $162 billion over the next decade.
Note the word "cap," which I now capitalize and bold. For reasons of coalition politics, I don't go as far as Troy or many economists would. I would only impose this cap on high-income people. Yet my basic point was that Democrats should be open to compromise regarding the taxation of health coverage and the benefit cap. Hence my title: "Don't Take the Exclusion off the Table."
Dr. Troy is an accomplished guy, but this is annoying.