Am I going to have to include Brad DeLong in this category?

A clever former intern of mine (who says things like “aboot”) puckishly notes that the date by which Massachusetts residents are legally required to obtain health insurance falls on Canada Day.

I’m sure it’s just a coincidence.

In his post on the differences over energy policy between the (conservative) Heritage Foundation and the (libertarian) Cato Institute, Jerry Taylor mentions that the two Washington think tanks also have differences regarding health care. For those who are curious, here’s where I see the biggest differences between Cato scholars and Heritage scholars on health policy:

The Heritage Foundation’s health policy team generally supports having the government force people to buy health insurance. Cato scholars generally do not. A couple of weeks ago, Heritage’s director of health policy studies Bob Moffit wrote in the San Diego Union-Tribune:

[M]y Heritage Foundation colleagues and I support the “personal responsibility principle.” It’s a simple idea: All adults have a responsibility to buy their own health insurance, pay their own health care bills, and not shift those costs to others.…

People who can reasonably afford it have a responsibility to buy health insurance to protect themselves and their families against the financial devastation of catastrophic illness.…

People who do not wish to buy health insurance for whatever reason should be free to do so. But, in exchange, they must demonstrate in some tangible way that they are really going to pay their own hospital bills. 

My Cato colleagues and I generally differ, for a number of reasons: such “individual mandates” are impractical, ineffective, and expand government power beyond its legitimate scope. Government should and does require people to pay their debts, meaning that patients already are legally responsible for their medical bills. The Heritage “personal responsibility principle,” on the other hand, would hold a Christian Scientist responsible for debts that he will never incur.

In addition, Heritage scholars embrace the idea that government should pursue “universal coverage.” Meanwhile, I do things like start the Anti-Universal Coverage Club (whose membership is growing).

There are many areas where Cato and Heritage scholars agree. I personally respect every member of their health policy team. Why, just yesterday Cato hosted Heritage’s Ed Haislmaier at a forum where we released a study critical of the Heritage-backed Massachusetts health plan. 

Where we disagree, we criticize. But I consider such criticism a form of praise. The only reason we bother to criticize is because what Heritage scholars say matters. A lot.

This Cato-Heritage disagreement over health care goes back more than a decade. It contributes to the free-market movement’s lack of direction on health care reform. The movement cannot move on in a unified manner until that disagreement is resolved.

In a 4 + 1/2 to 4 decision, the U.S. Supreme Court struck down today the race-based public school student assignment programs in Seattle and Jefferson County, Kentucky.

Both districts had argued that assigning students to schools based on race was necessary to ensure diversity and improve achievement among minority students. The ruling majority – the Court’s four conservatives plus Anthony Kennedy – said they failed to make that case.

The reason it was a 4.5 to 4 verdict, and not a vanilla 5 to 4, is that Kennedy hedged his bets, subscribing only to part of the majority’s opinion. Kennedy diverged from the conservatives in maintaining that race could theoretically be used for some purposes under some circumstances, and even suggested a few examples. None of them, however, were much like the racial assignment programs at issue in this case.

Pundits may make a big deal out of Kennedy’s “dissentagreement” (tm), but so far many seem to be missing one of its crucial elements. He, like the conservatives, believes that a district needs to prove there is no racially neutral way of advancing the goals of diversity and minority student achievement before they can start moving black and white faces around like pawns on a chessboard.

And you know what? There IS a racially neutral alternative: school choice.

I went through the key relevant evidence on this when oral arguments were heard. The same still applies. A good school choice program including public and private schools would improve residential integration, increase meaningful integration within schools, improve minority student achievement, and improve minority student attainment (i.e., highest level of education achieved). All that in a racially neutral program that benefits all students. Let’s hope it doesn’t take too much longer for policymakers to realize this, for kids’ sake.

Today, Cato releases a new paper on the Massachusetts health plan by David Hyman, a Cato adjunct scholar and professor of law & medicine at the University of Illinois. Hyman’s paper is titled, “The Massachusetts Health Plan: The Good, the Bad, and the Ugly.” 

Here’s an excerpt:

Although the legislation, as Stuart Altman put it, “is not a typical Massachusetts-Taxachusetts, oh-just-crazy-liberal plan,” there is enough “bad” and “ugly” in the mix to raise serious concerns, particularly when the desire to overregulate the health insurance market appears to be hard-wired into Massachusetts policymakers’ DNA…

If we want to make health insurance more affordable and avoid the “bad” and the “ugly” of the Massachusetts plan, Congress—or, barring that, individual states—should consider a “regulatory federalism” approach.

Here’s a link to an audio interview I did on Healthy Competition for a Tampa-based newspaper called — I love this — Creative Loafing.

Inspired by National Review’s recent editorial and Andrew Sullivan’s embrace of same (as well as by Greg Mankiw), I have decided it would be fun and educational to keep tally of those who reject the idea that federal or state governments should strive to provide every American with health insurance. Call it the Anti-Universal Coverage Club.

Here are the guiding principles of the Anti-Universal Coverage Club:

1. Health policy should focus on making health care of ever-increasing quality available to an ever-increasing number of people.
2. To achieve “universal coverage” would require either having the government provide health insurance to everyone or forcing everyone to buy it. Government provision is undesirable, because government does a poor job of improving quality or efficiency. Forcing people to get insurance would lead to a worse health-care system for everyone, because it would necessitate so much more government intervention.
3. In a free country, people should have the right to refuse health insurance.
4. If governments must subsidize those who cannot afford medical care, they should be free to experiment with different types of subsidies (cash, vouchers, insurance, public clinics & hospitals, uncompensated care payments, etc.) and tax exemptions, rather than be forced by a policy of “universal coverage” to subsidize people via “insurance.”

If you’d like to join the Anti-Universal Coverage Club, let me know by posting something to your own blog, or by emailing me here. Feel free to forward items from other like-minded individuals.

I predict that neither the American Medical Association, nor the Federation of American Hospitals, nor America’s Health Insurance Plans will join the Anti-Universal Coverage Club.