No One Has a Monopoly on Liberty

The The New York Times has a wonderful piece on gender gap on health insurance costs. They key lesson of the article:

In a report to be issued this week, the National Women’s Law Center, a research and advocacy group, says that in states that have not banned gender rating, more than 90 percent of the best-selling health plans charge women more than men.(emphasis mine - JMG)

Buttressing this, The Atlantic Wire has great compilation of similar articles all pointing out the same thing: there is a inherent gender disparity in healthcare costs and services, that the current contracetion "debate" only serves to highlight.

I bring this up because I have seen and read a handful of conservative opinions concerning the mandate that all health insurance plans provide for contraception without co-pay. I am not going to take time to delve into the policy specifics right now. Instead I want to make a broader point about conceptions of liberty.

The conservative/libertarian point against a contraception mandate is couched in terms of contractual "liberty". Namely that:

[...] there is no need to be your sister’s keeper when she can keep herself.

What these opinions ignore, or cannot seem to comprehend, is that one class or group of people do not have a monopoly on "liberty".



Some people want the liberty to set the terms of their contract between their health insurer, free of regulatory mandates. I think women should have the liberty to choose the timing, spacing, and numbers of their child births. A freedom they do not have if there are barriers to contraception. I also think a people should be free from economic and medical discrimination based on their gender. A freedom women do not have, as illustrated by the above New York Times and Atlantic Wire articles.



"Liberty" is not some empirically, objectively established concept that one side gets to hold as a cudgel in political debate. It is a concept and a value that requires us to make normative judgments about what is, and is not, important to us as a society and polity.



Just because you want to be "free" from some onerous regulatory mandate does not make you a brave crusader for individual liberty. It just makes you a advocate for your own opinion of what liberty should mean in a regulatory context.

When Ideology Meets Nessessity cont.

Another entry by FrumFourm's "Galatea" has been published, this one taking the issue of healthcare head-on with the title "I Heart Romneycare". I previously commented on "Galatea's" inability to connect her political ideology with the nessessity of heathcare services.

You can read the new piece for yourself, but I am personally underwhelmed by the author's grasp of the issue. The essay is written as an open "letter" to Mitt Romney in a playful, somewhat humorously sexual tone. While it is clear the author was concerned more with entertainment that education in the piece, the policy tidbits are depressingly callow. First she explains:

"Honestly, in this election, Romneycare is [Mitt Romney's] tramp stamp."

While crude, this is a reasonable point. Polling on conservative voters has overwhelmingly shown that past endorsement of an individual mandate-based healthcare reform plan is essentially apostasy. (Although, Romney is not alone in past support of a mandate.) Next, she breaks the core of her argument into two pieces. First:

I mean, at a Constitutional level, Obamacare’s federally-enforced individual mandate destroys Congress’s limitations on regulating interstate commerce since it regulates economic inactivity. (emphasis mine - JMG)

And:

Furthermore, even if it were constitutional, AHCA is not a necessary and proper means for Congress to expand its police powers(which the Court has in the past expressly forbade them from doing)! (emphasis mine - JMG)

Both of these arguments are as well traveled as they are flawed. The first is easily the most popular conservative argument against an individual mandate in general, and the Affordable Care Act specifically. So, it is unfortunate popularity cannot replace coherence; "inactivity" in the health insurance market produces substantially different outcomes than "inactivity" in say, the mobile phone market, or unappealing vegetables market. Or, as DC Appeals Court Justice Laurence Silberman wrote in the Court's November 8th 2-1 ruling that upheld the constitutionality of the law:

It suffices for this case to recognize, as noted earlier, that the health insurance market is a rather unique one, both because virtually everyone will enter or affect it, and because the uninsured inflict a disproportionate harm on the rest of the market as a result of their later consumption of health care services.

The second point on the expansion of "police powers" genuinely confuses me. The law's Wikipedia article has no mention of "police power", nor does the Kaiser Family Foundation's summary. The law itself has the word "police" in it only twice; once one page 724, defining law enforcement terminology and again on page 852, with respect to intervention services. I suspect "Galatea" is referring to the obvious expansion in oversight required to properly enforce a mandate on health insurance purchase. If so, then she is genuinely confused about how the mandate works; it is enforced through a fine. Specifically, as Ezra Klein explained back in March last year:

The law specifically says that no criminal action or liens can be imposed on people who don't pay the fine. If this actually leads to a world in which large numbers of people don't buy insurance and tell the IRS to stuff it, you could see that change. But for now, the penalties are low and the enforcement is non-existent.

Lastly, "Galatea" "thanks" Romney, writing that her coverage under her mother's health insurance "was the best free health care I’ve ever received." Only, it is not free; it is paid for by her mother, her mother's employer and her mother's co-workers. One can only imagine her plight if she did not have the fortune of these people covering her health insurance costs. Perhaps she would no longer have the free time to write terribly misinformed articles.

When Ideology Meets Nessessity

I have been trying to be consistent on the point that there is a big divorce between the political ideology people say they hold and the policy outcomes they prefer. I encounter this quite a bit when writers make passing comments about things they can or cannot do, with little acknowledgement on the political process that allowed whatever outcomes they're discussing. As an example of this, I would like to direct you to this essay on FrumForm.

It's the latest in a series of pieces written by a recently unemployed college graduate writing under the pen name of "Galatea". The author admits to having libertarian sympathies in one of the earlier entries, (which causes some cognitive dissonance when applying for unemployment benefits) but is otherwise silent on the policy implications of her current lack of employment. The latest entry strikes me as most sympathetic so far, if only in recognition of the mental toll long-term unemployment can have on a person. For example, Galatea writes:

I'm breaking out everywhere and getting a rash on my face.

However, the very next sentence, the author breezily recalls that

I'm still on my mother's health insurance, so technically I could see a dermatologist. (bold mine - JMG)

Immediately upon reading this, the glib retort "You can thank the Affordable Care Act for that" ricochets around my head. I don't want to be particularly flippant about this, but the inability for people to make the connections between the material welfare they get to enjoy (even when they're unemployed) and legislative work that went into securing these kinds of benefits is a source of never ending irritation to me.

Politics is more than just partisan gamesmanship. The more this point is obscured, the more disservice we do the democratic ideals that underpin the country as a whole.