Ben Smith is reporting that the Deaniacs are now campaigning against the individual mandate, an absolutely central and crucial part of health care reform. This, and assorted nonsense from left-bloggers in high dudgeon, and assorted dilatory narcissism from the likes of Ben Nelson and Roland Burris, calls into question the ability of the Democratic Party to govern this country. (The Republicans have no interest in governing the country, just running it.)
Universal health care is predicated on two mandates: The insurers have to provide it to everyone regardless of a pre-existing conditions. The public–especially healthy members of the public–have to buy into the system; those who can’t afford to pay for it will be subsidized by the government. We can argue about the details, about whether the subsidies are sufficient, about which treatments the insurers will be required to cover, but without these twin mandates there can be no deal. Indeed, I’d argue that there is a civic and moral responsibility involved on both sides here. The moral responsibility of the insurers is obvious. The moral responsibility of individuals to buy in seems obvious as well: If you’re 25 and healthy, and intentionally uninsured, you’re asking the rest of us to pay your way when you have an accident and turn up in a hospital emergency room. Furthermore, if you’re 25 and healthy, you won’t always be. Someday you’ll be 80 and frail–and you’ll be looking to younger, healthier people to expand the pool and keep premium costs relatively low.
There are those who say that Democrats shouldn’t favor any system that continues to include private insurers. Good luck with that. I’ve been covering these issues for 40 years and I’ve come to this conclusion: anything that actually helps people is good, whether or not it fits into an ideological pattern. Covering 30 million more people is good. Preventing private insurers the ability to deny coverage to countless others is also good. Those who stand against these essential principles because of an ideological conceit–whether it be Joe Lieberman’s opposition to a public option, Ben Nelson’s opposition to abortion funding or Democracy for America’s opposition to an individual mandate–are proving a point that conservatives have long made: that Democrats are too feckless to govern.
For the sake of all those lives that will be eased if this legislation passes, I hope that’s not the case. In the meantime, the Deaniacs should be ashamed of themselves.