Wednesday, September 8, 2010

Health Care vs. Climate

I recently discussed the hypothetical choice between more stimulus and health care, and wound up with a quite interesting comments thread.  I stuck to stimulus vs. health care, because the "choice" that is being discussed today -- health care vs. climate -- seems to me mostly unrealistic.  Matt Yglesias (who would have preferred climate legislation if given a choice) sums up the situation nicely:  Barack Obama and the Democrats in Congress were pushed by the Democratic party coalition to put health care first, but at any rate  the combination of a rejectionist strategy by Republicans and regional differences among Democrats made a climate/energy bill a longshot at best. 

The one thing I'd add to what Yglesias says is just that, at least as I can see, health care really is a far more ideological issue than is climate. Fanciful rhetoric aside, the health care reform debate really was about a "government takeover" -- not of the health care industry, obviously, but of health care as a government obligation.  Establishing health care, in Ted Kennedy's old phrase, as a right, and not a privilege,  really is a big deal; whether or not it's an expansion of government, it's a serious and important expansion of governmental responsibility, and that surely hits along a core liberal/conservative line.  In other words, while it's easy to imagine Republicans modifying existing health care programs to achieve goals that Democrats might agree with, it's impossible to imagine a Republican House, Senate, or president agreeing to anything close to universal health care.  I really don't think climate works that way.  It's easy for me, at least, to imagine a situation in which conservatives and liberals agree that preventing climate change is a legitimate responsibility of government, and then finding some mechanism (and set of goodies for a winning coalition of interests) to make it happen.  (Yes, that does assume that ideology matters at least to some extent to at least some of the relevant actors). 

So, if all that is correct, then it makes sense for Democrats to use their rare supermajority on health care, which they can get in no other way, rather than on climate, which can be achieved in different circumstances.


  1. I don't know about this. You could argue that it's just the reverse, that climate issues are more ideological than health care. It depends on how and at what level you see "ideology" as coming into play.

    Conservative opposition to climate legislation is ultimately rooted in a deeply ideological belief that modern capitalism, including large-scale exploitation of resources, is all good. In fact, this belief is so ideological it's almost theological ("market fundamentalism" and so on), indeed literally theological for End Times Christianists who think using up the planet is God's will. But even the more "moderate" on this issue simply do not want to face -- that is, are ideologically committed to rejecting -- the possibility that you could have a market failure so huge it literally threatens the Earth itself.

    Conversely: On health care, today's conservatives may talk like they're against the government taking responsibility. But obviously they aren't (with a few radical exceptions), because they're big defenders of Medicare, or at least unwilling to oppose it in any significant way. So the real argument isn't (ideologically) over whether health care is a government responsibility, but (as a practical matter) over for whom it is and at what exact tradeoffs.

    Now, health care LOOKS more ideological than this because Republicans and conservatives like to posture as anti-government. But really, one could argue that what's going on is that the right is simply aligning itself against the left -- or against Democrats, even when they're not being very left -- on the political landscape of the moment. If it's 1965 and the issue is government health care per se, then they're against Medicare. If it's 2010 and senior citizens' health-care rights are a settled question, but now the proposal from the left is extending government's protection beyond senior citizens, then they're against THAT, and indeed will wrap themselves in the Medicare mantle if they think this helps them beat it back. So the "ideology" at work isn't actually a principled difference over big questions, but just a determination to stake out a position distinguishable from the other side's.

  2. Jeff,
    The data back up Jon on this one. Health care opinion is correlated with ideology at .41, while environmentalism correlates at .08 (using ANES data). More work than I have time to do could be done to look at partisanship on this, which is obviously different.

  3. Given that public concern about the environment tends to be highest in times of prosperity, when more obvious needs are being satisfied, it's really hard to imagine a climate bill passing in 2009-10 under any circumstances.

  4. Matt: The "data" you refer to are gathered after ideology has been defined a particular way. That's the limitation of data, and maybe of social science in general. As I said, how relatively ideological we take these issues to be depends on how and at what level you assess "ideology." If ideology refers, for instance, to people calling themselves conservatives or liberals, then I'm sure you're right. But if we're talking about deeper, often unconscious assumptions or commitments -- like whether to trust or distrust markets; whether wealth (or market success) is an indicator of virtue; whether government is an instrument of the people or an imposition on them; whether the earth's natural resources belongs to humankind or to the countries, companies and people who are cleverest at finding economic uses for them; whether human activity represents God's will for the planet or potential damage to it; whether illness is an accidental misfortune to be hedged against, or a Darwinian mechanism for separating the weak from the strong; and many other ideas at this level -- then we'd have to look again to see which issue is the more "ideological," i.e. the one where different policy preferences correlate most closely with different sets of underlying assumptions.

  5. If it's 2010 and senior citizens' health-care rights are a settled question, but now the proposal from the left is extending government's protection beyond senior citizens, then they're against THAT, and indeed will wrap themselves in the Medicare mantle if they think this helps them beat it back.

  6. If i were to choose between the two, I'd choose the one for Senior's health care. But we can't blame others if they chose the other one. We have different opinions and still, I hope that sacrificing something for the betterment of others are an exemption.


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