UPDATE: My response to Ezra’s Response
Reader and sometime commenter Adam Ozimek passes along this note
Three days ago Ezra Klein claims he can’t see a mechanism whereby the public option increases the debt, because as it is it reduces the deficit, and making it more costly would require bills that would be filibustered unless congress is somehow more liberal in the future, which it won’t be.
Yesterday, he counters the concern that the bill is too modest from a liberal perspective by arguing that Medicare and Medicaid started out modest and then expanded over time, and " it is not hard to imagine health-care reform following a similar path." He then lays out all kinds of expansions that could happen, like "the public plan could be strengthened…Subsidies could expand, and new funds could be used to encourage the development of integrated care organizations".
Does he not see the disconnect here? He cannot imagine how the public option could increase the debt when arguing for the modesty of the plan, but when arguing for the liberal achievement of it he can foresee it expanding like Medicare and Medicaid.
Specifically, I tend to think that Klein is being coy about the deficit. He knows that Health Care Reform is likely to be more popular as an existing entitlement than as a proposal. This is why he sees it as a launching pad for future change.
And, since health reform will be more popular in the future it won’t have much difficulty finding votes for unfunded expansion.
From a geek perspective this introduces and interesting issue about rate of time preference inconsistency in politics. Suppose I am a blue dog who is concerned about the deficit. I might like to vote for health care reform because the bill I see before me is good. However, I know that once this bill is in place I will not be able to resist voting for expansion. What then is my optimal vote now?
How do I weigh the differing preferences of two would-be future selves?