I like Don Taylor, I like reading him as I know that there is a very high probability of reading something that he writes that will make me think long and hard about something that I thought I knew but now need to reexamine, or something that I knew that I did not know. He is a good high value read on health policy. However, I think he has a blind spot on health policy, and that is his tendency to encourage conservative wonks without enough criticism:
From RBC on 8/14/14 regarding Avik Roy’s Manhattan Institute proposal:
I am not going to go all post-modern literary critic on this (only deconstruct), in part because a lot of it lines up nicely with things I have been writing about/calling for over the past few years, in search of a political deal that could move the policy ahead….
The biggest question facing Avik’s proposal is not in policy terms or what supporters of the ACA will think, but whether any elected Republicans will be willing and able to shift gears and begin trying to move health reform ahead instead of simply looking for what helps in the next election….
I commend Avik for offering this plan, and think there is a plenty to like in the proposal itself, as we look for the next step in health reform.
A serious deconstruction of the plan shows that Roy is fundamentally trying to occupy the wonky spot that Paul Ryan has been attempting to occupy as a legislative leader — that of the wonky Serious, Honest Conservative. If that is the bar that needs to be passed, then we need to evaluate the wonkiness and honesty of the plan. Anything else is just the soft bigotry of low expectations that a conservative can write 60 pages of not seemingly gibberish with a couple of graphs and references to complex modeling.
A deeper examination (Part 1, Part 2, Part 3, Part 4) allows one to determine if Roy is proposing something out of good faith albeit coming from a different weighing of “ought to be”/moral factors, or if he is attempting to pull a fast one by engaging in significant and easily detectable instances of truthiness and misdirection. I think Roy is repackaging bog-standard conservative health care plans with a few technocratic policies (hospital consolidation trust busting for instance) and hoping that the later is sufficient to buy his reputation as the honest, wonky reformicon that liberals can work with even if they have massively different weights on what moral values should be expressed in new healthcare law.
We know that Roy knows or should know about the methodological power issues about the Oregon study. We know that Roy knows or should know about the Massachusetts insurance study. We know that Roy knows or should know that the critical lifespan changes for Medicare finance are not life spans from birth but life spans during working age years (for income purposes) and life spans after eligibility to collect Medicare (for expenditure purposes). We know Roy knows or should know that premium age banding is for 21 to 64 year olds. Those are some of the obvious things that we know Roy should know about and consider in his writing, but he does not.
The charitable conclusion is that he is trying to pull a fast one. The less charitable conclusion is that he is lazy as a stoned senior a week before graduation.
I agree with Don that in the long run, the United States is much better off if there are significant factions within the Republican Party that are interested in weighing policies, making explicit choices with positive benefits and negative impacts, and then engaging in horse trading with Democratic factions that are applying their own moral, ideological and interest group preferences on the same problem set but in different manners and getting to something that has a committed backing to work or at least to make it work eventually for most people. That is a good thing but right now and in the medium term, this country is still going on blind dates where the preferred dish of one party is still tire rims gently sauced with anthrax.
However, as liberals, we barely have any influence on internal Republican factional polictics, and we do not serve ourselves well by not being critical and engaging when there is a conservative policy proposal that is either lazy or misleading as hell in its core tenets despite there being a few, minor areas of agreement and a few more areas of secondary importance that could be sites of productive horse trading.
We owe it to ourselves to be critical and aggressively probe policy proposals for their explicit and implicit assumptions, the probable outcomes generated, and the evidence used to argue to those outcomes. Being a liberterian or reformicon should not mean that person’s policy proposal receives a gentleman’s C nor a participation ribbon.