STOP! NO MORE HEALTH CARE PLANS! I have not yet read John Edwards's health care proposal. I'll trust Ezra that I would basically like it. And I'm very happy that he was willing to talk about raising taxes. But let me go public with the one sure thing I learned from my own miserable six months working on a presidential campaign -- Do Not Put Out A Health Care Plan. Just resist. Put out some clear basic goals, some non-negotiable elements, some basic sense of the mechanisms you would favor, and some examples that show that it can be done. Right now is a great opportunity, because you have so many good examples to cite. Just say, �If a conservative Republican can propose universal coverage, we Democrats should not shy away from it. I think Governor Schwarzenegger's plan has some good ideas, some of them more specific to California; I think Senator Wyden's put out some good ideas; there's a lot that I like in the Medicare For All proposals. As president, I'll take the best of those ideas, and I'll make only one promise: We will make sure that everyone in this country has decent, reliable health care.� There were some particular problems with the health care proposal that Bill Bradley put out in 2000 (that's the campaign I was referring to), which Vice President Gore latched onto to great effect, and I could discuss them at tiresome length. But there will be particular problems with any health care proposal. They all have vulnerabilities, they all create situations in which people might have to accept change or might get less than they currently have. And the people who are most likely to vote based on health care are also people likely to be fearful of losing what they have. It will always be for political opponents to push that fear button. And when they do, the cause of universal health care is set back. Once again, it is seen as an issue with more risk than reward. What is the case for releasing a detailed health policy proposal? Why does Ezra say that �the other candidates [will] have to offer similarly comprehensive proposals�? What would be so bad if they don't? The main argument, as far as I can tell, for releasing a detailed health policy proposal is simply that the people should know what you would do as president about health care. Fair enough, except let's be honest -- the minute you take the oath of office, whatever health plan you put together in the middle of a campaign will be forgotten. And that is as it should be. You now have the full resources of HHS, OMB, NIH, plus every think tank and academic expert at your disposal, and you will use them -- or should. You're not going to simply implement a plan designed by a handful of (brilliant) recent college graduates in your campaign issues shop. Further, you will be the president, but you are not, sorry to say, The Decider, at least not on health care. To get something passed, you will have to deal with the political circumstances of that moment. Will you be able to get some Republicans on your side? Do you have a filibuster-proof majority in the Senate? Will you be able to get the support of some large businesses? Will insurance companies fight any change, or are there some options they could live with? Are you able to sell the tax increase that real reform will require (and that Edwards, to his credit, was unafraid to name)? All these political circumstances will affect the shape of the actual proposal, which is why you need goals and a few non-negotiable elements, not a detailed plan. The real reason, I think, that campaigns feel the need to issue detailed policy plans is simply that that's what we liberals do. Smart people join campaigns and they want to work on �issues.� Issues means plans, policies. No one wants to be accused of being �light on details.� But details are not important politically, they don't help you govern, and they create terrible vulnerabilities, including reinforcing the tendency of Democratic politicians to speak in terms of policy details rather than goals and ideals. So Senators Obama, Clinton, Dodd, et al., please resist. Tell us what you're committed to achieve in health care, but not exactly how you would achieve it. And please make a vow that if you can't resist, you will all at least resist the temptation to rip apart the details of your rivals' health care plans.
-- Mark Schmitt
