Deep Blue plays health care reform by mattsteinglass
February 25, 2009, 10:28 am
Filed under: Uncategorized

One of the things that chess grand masters encounter when they play machines like Deep Blue that can’t be beaten by humans is that the machine sometimes makes moves that don’t appear to make any sense. Humans play chess by “clustering” classes of moves that tend to work well according to higher-level strategic insights built up over long experience in playing the game. Machines play chess by calculating, with brute force computation, which moves lead to the best possible outcomes over the next hundred-odd rounds of play. So machine moves occasionally look weird, from a human point of view; humans simply can’t calculate far enough out to see why they work.

When Obama was running against Clinton and Edwards in the primaries and adopted the position that mandates were a bad idea, many health policy wonks were baffled. At the time (January 2008), a theory occurred to me, which I proposed to a journalist friend over dinner. Everyone knows that the problem with instituting community rating (i.e. everyone pays the same price for health insurance) without mandates is that healthy young people will opt out of buying health insurance. This in turn makes health insurance more expensive, leading yet more healthy people to opt out, creating a gradual death spiral for insurance companies. Meanwhile, if, as in Obama’s plan, a government-funded insurance plan has been set up that offers taxpayer-subsidized affordable coverage, private insurers will soon be unable to compete. So, if you institute community rating and a public plan without mandates, who will start pressing you to institute mandates? The private insurance companies. You shift the political landscape so that your enemies start to use their strength in the service of your goals. Jujitsu! And meanwhile, since the public mostly opposes”mandates” because they sound mean, you can use your anti-mandate stance to beat your primary opponents. Double jujitsu!

Of course, this seemed too conspiratorial and deep to be an actual explanation for what Obama was doing. But now I see that Matthew Yglesias has for some time held the same view of what Obama was doing with his opposition to mandates, and I assume the view became more widespread at the time than I’d thought. I recognize that these “it’s all part of Obama’s deep plan” explanations entail a certain emotional-fantasy element of which one ought to be wary. But I think we are starting to get a lot of evidence of how Obama views politics, and one thing he does religiously is to not get out ahead of his constituency. Another thing he does is to try to rearrange conflicts so that interests are aligned with each other, not freezing each other into gridlock — so that his side can win without having to beat anyone. Anyway, Obama is now saying mandates are going to be a part of the health care solution proposed in the upcoming budget bill. Apparently he now thinks he has the political strength to do the whole reform at once, universal care, mandates, and all. Maybe he’s wrong, but he hasn’t been wrong yet.


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