Partisanship And The Health Care Debate

Cross-posted from The Agenda on National Review Online.

I’ve previously praised Maggie Mahar as a knowledgeable health-care analyst who conservatives can engage on empirical issues. She’s disappointed me with her discussion of Donald Berwick.

In a discussion of Ezra Klein’s contention that conservatives should be happy with Berwick’s recess appointment, she calls attention to one of the deficiencies in the health care debate of the last year:

What I like about Klein’s argument is that it follows one of the first rules of combat: “Confuse your enemies.” Make no mistake, the battle between health care reformers and hard-line conservatives has just begun, and Klein’s column must have left many conservatives scratching their heads.

I appreciate that people on both the left and right tend to think of their political opponents as “enemies,” but this approach had a destructive effect on the production of the Patient Protection and Affordable Care Act. Health care policy is extremely complex, and we’re all capable of getting things wrong. If those who disagree with Mahar are the enemy, it is unnecessary for her to address their criticisms, incorporate their salutary ideas, or find areas of bipartisan agreement. Conservatives, in Mahar’s view, “tend to be wary of science” and “prefer that medicine remain mired in custom” rather than empiricism. Quite the opposite is true: conservative critiques of liberal health-care policy revolve, in large part, around its lack of empirical rigor.

I was reminded, in reading Mahar’s remarks, of Jonathan Cohn’s valedictory column closing out The New Republic’s health-care blog. Cohn expressed regret that TNR had published articles critical of the Clinton health care effort in 1993; his new editor, Franklin Foer, “wanted universal health care to become the magazine’s new crusade.” This time around, Cohn and his allies would deploy campaign-style rapid-response articles against adverse news and analysis. Sympathetic reporters would similarly ignore the arguments of skeptics, until the bill was safely signed into law.

TNR is a journal of opinion, and its writers have every right to their point of view. There will always be passionate philosophical differences between the right and left on health care. But those who engage health care questions in a partisan and uncritical fashion are likely to get the answers wrong, at great cost to the country. The last 45 years are proof enough of that.