The Individual Mandate: An Example of the Importance of Framing the Debate

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Most of the objections to the "individual mandate" provision of the Affordable Care Act has been cast in libertarian terms.  Its critics frequently invoke somewhat Romantic notions of "individual freedom" and "liberty" as means of rallying their troops.  What these critics fail to recognize, however, is that the problems sought to be solved by the Affordable Care Act is a collective action problem that spills over state borders.  Indeed, the problems of free riding and adverse selection are not confined to any one state alone; indeed, as states offer versions of healthcare that differ in generosity, people from less generous states can and may move to other states to benefit from more favorable healthcare provisions.  Therefore, the healthcare question should not be framed as whether the Commerce Clause may reach "inaction" or should strictly be confined to "action."  Indeed, the healthcare question should be framed as whether the government may be empowered to act in instances of market failures that span across state lines.  The answer is surely yes, since the problems that the Affordable Care Act seeks to address are economic in nature, and they do cross state lines.  As such, they should be covered by the Commerce Act.

This little example illustrates the importance of framing a debate.  The supporters of the Affordable Care Act ignore the federalism dimension to the healthcare problem to their detriment, and focus too narrowly on the libertarian arguments that draw deeply on people's emotional and visceral reaction to anything that smacks of a deprivation of their freedom.  Perhaps this example also shows how libertarian arguments have hijacked most of our debates that concern economic matters, and how perhaps we need to invoke other notions -- such as individual obligations in a well functioning and just society -- to pave the basis for a richer conversation.
This may be a bit invidious, but much of the libertarian arguments that rests of some version of substantive due process -- contractual rights equals freedom -- actually privileges the freedoms of some people over the freedoms of others.  This runs against the vein of utilitarianism, on which many libertarians purport to cite as foundations for their beliefs, which presupposes the equality of all.
Okay, I promise the next post will involve food.