PCA instead of Sotomayor

I’m convinced that Republicans should be talking about healthcare instead of Sonia Sotomayor. Re: Sotomayor: the role of a circuit court judge is different from than of a Supreme Court justice. If Stephen Reinhardt were on the Supreme Court, he’d be more adventurous. So that’s an issue. But all evidence suggests that Sotomayor is a Ginsburg and not a Brennan — to the left of Souter on some economic issues, but well within the contemporary center-left mainstream. This is a case of bad incentives for Sotomayor opponents: say something “interesting,” get attention. Not very edifying, not very surprising.

On healthcare, however, Republicans have an opportunity. Yglesias points us to Steve Benen who points us to a fascinating CNN poll result:

But Americans appear to be split over raising taxes to increase coverage. Forty-seven percent of those questioned support raising taxes in order to provide health insurance to all Americans. An equal amount back the idea of keeping taxes at current levels but not providing health insurance for all Americans.

As this Washington Post editorial explains, Obama will square this political circle very neatly:

But the administration’s proposal, even before Congress gets to work, is to spend $100 billion more on coverage while finding cost-saving measures worth only about a third as much. Another third would be paid for by tax increases. The last third, so far, isn’t paid for at all. That’s three times as much sweetener as medicine, in other words — and Congress will be tempted to jettison some of the savings and all of the tax increases.

Why? Obama, like George W. Bush, has absorbed the lessons of Ronald Reagan’s Medicare Catastrophic Coverage Act, recounted in Eric Patashnik’s Reforms at Risk. I summarized it a few weeks back based on Patashnik’s account.

Under the law, all Medicare users faced a slight increase in their monthly premiums—to the tune of $4 a month—but affluent Medicare recipients had to pay an additional surcharge that amounted to a few hundred dollars a year. A large majority of seniors would be better off under the program, and the savings on so-called Medigap policies dwarfed the increase in Medicare premiums. Opponents of the MCCA, many of whom profited from the old Medigap regime, launched a massive public campaign that misled millions of elderly voters into believing that they had to pay the maximum surcharge.

To keep the new program financially sound, benefits were phased in gradually while the premium increases were put in place immediately. The obvious result was that seniors felt the pain of premium increases without getting immediate bang for the buck. Within 16 months of the enactment of the MCCA, the legislation was repealed.

The next time Congress moved to expand Medicare, in 2003, Bush and the Republicans in Congress had learned an important lesson from the failure of the MCCA: You can expand an entitlement program, but it is crucially important that you don’t actually pay for it.

So what does this have to do with the Patients’ Choice Act? As opposed to the fight against the Clinton healthcare plan, Republicans have a cheaper alternative that will correct some of the most egregious failings of the current system. They can reasonably highlight the cost consequences of the Obama approach without offering nothing in return.

I’d rather the PCA include a reinsurance component, and I think we’ll need to raise a significant amount of revenue regardless of how we proceed. But politically speaking, talking about healthcare is a much smarter bet than talking about the ins and outs of Puerto Rican cuisine.

Perhaps I’m being unfair. The issues are incommensurable, and the news cycle demands that we talk about Sotomayor. I understand. But what if every conservative talking head simply said — “With regard to Sotomayor’s qualifications, that remains to be seen. We’ll ask tough questions. Did you know that the president’s healthcare plan will cost X over Y years?”

I live in a fantasy world.