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Choosing the Target


It seems to me that those of us who oppose the Democrats’ health-care legislation in principle — who believe, that is, that it takes our system of financing health care in the wrong direction rather than that it moves too fast — should start concentrating less of our fire on the “public option” and more of it on the individual mandate. I’ve made my case against the mandate on NR and NRO before. [Update: See here for example.] Here are my reasons for thinking that it makes political sense for conservatives to dwell on the issue.

First, the basic outline of Obamacare can survive ditching the public option. It can’t survive ditching the individual mandate. You can’t, for example, have a ban on insurers’ taking account of pre-existing conditions without such a mandate.

Second, the polling on an individual mandate suggests that it’s less popular than the public option — and just plain unpopular. I keep pointing out that Obama was able to win the Democratic presidential primaries without embracing a mandate, which ought to tell us something about the politics of the issue.

Third, my impression from talking to Republican congressmen about the issue is that to the extent they support this idea, that support is an inch deep. It rests on misunderstandings that are easy to clear up (notably the notion that a mandate would reduce insurance premiums by making the uninsured pay their fair share).

Fourth, we have already made our case on the public option, and we haven’t made it on the mandate.

Fifth, there are interest groups willing to keep making the case on the public option — but most of these interest groups are for the mandate since it would improve their bottom lines (at least in the short term).