Saturday, November 21, 2009

Complexity and Health Care

Kevin drum worries that complexity might kill health care reform (see here, "Will Complexity Kill Health Care Reform"). But there's a sense in which, counter-intuitively, complexity can actually help. Recently in Washington I heard Jon Kingsdale, Executive Director of the Commonwealth Health Insurance Connector (Massachusetts's insurance exchange), say at a TNR-sponsored conference that he thought the only way health care reform would work is if it was so complex that special interests couldn't figure out exactly how they would be affected and therefore wouldn't stand in the way of legislation. You don't want to be see as choosing sides, and you don't want the winners and losers to be too obvious. When reform requires going up against big special interests, some strategic ambiguity can paralyze the lobbyists who'd otherwise monkey-wrench the process.