The Man Behind Health Care Reform
Jacob Hacker talks with Campus Progress about ideological battles, why health care isn’t our only worry, and how academics should engage in the political debate.
By Matt Zeitlin
August 11, 2009
Dr. Jacob Hacker, Professor and Co-Director of the Berkeley Center on Health, Economic, and Family Security, University of California Berkeley, testifies at a hearing regarding the Tri-Committee Draft Proposal for Health Care Reform. (Flickr/House Committee on Education and Labor)It’s not an accident that the health care debate is viciously taking place in Congress or in town hall meetings around the country today. Health care reform started quietly back in 2007 with an Economic Policy Institute paper written by Jacob Hacker, a political scientist at Yale University, that outlined a health care plan that would enable universal coverage. Hacker envisioned “a new public insurance pool modeled after Medicare,” which anyone without sufficient employer-provided coverage or Medicare could buy into. The basics of his plan—the public option, the employers payroll tax contribution, an individual mandate—are now the chief tenants of reforms proposed by House and Senate committees. But Hacker is more than just health care wonk; he’s basically the model for a politically engaged academic. He’s authored or co-authored five books that cover a wide range of social and public policy issues. Hacker talked with Campus Progress about the modern conservative movement, why we should worry about more than health care reform, and how academics should engage in policy debates.
In Off Center, you and your co-author Paul Pierson talk about how the conservative movement had built up this interlocking, effective political machine that allowed it to promote and pass policies well to the right of public opinion. In light of Obama’s victory and the more progressives in Congress, does this thesis still hold up? Is the conservative movement still so powerful?
I think that the conservative movement has taken some very serious hits, but, as health care bill troubles suggest, there is a powerful conservative shop that is constantly putting out negative and misleading things about [President Barack] Obama and the legislative majority.
The point of Off Center is not that it’s illegitimate to use the power of the majority to pursue policy changes; we think that legislative majorities should pass their policy agendas. One of the complaints of Off Center is that Senate is a counter majoritarian institution, and you shouldn’t have to have to worry about a tiny minority of senators blocking reforms. Our concerns were that the reforms being pursued were way to the right of public sentiment.
In your book the Great Risk Shift, you talk about how Americans are now experience a lot more volatility in their incomes, and how we need a better safety net to account for this change. Health care is obviously a big part of that, what other types of safety net issues should we be talking about?
Besides health care, [the focus needs to be] on employment, financial markets and retirement savings.
On employment, [we] need to deal with the jobs crisis. I fear that there’s a sense that the stimulus bill was the beginning and the end of the effort to deal with the unemployment crisis. The problem isn’t just high levels of unemployment; we’ve seen a real shift towards risky kinds of unemployment where people are out of the workforce for a long time and have to retool their skills. In a globalized economy, that’s the [kind of] unemployment we have to deal with. There’s a need to make unemployment insurance longer and couple it with ways to get people back into the workforce and train them with new skills. I’m a little disappointed that with the enormity of the unemployment problem. We’re not having that debate.
On the financial side, the housing problem drove the crisis. There’s been very little effective effort to improve the housing market situation of many Americans. We need to get people into mortgages they can afford. We need strict new regulations and there has to be direct assistance to help people get into homes.
The third area is retirement savings. There’s a hint that the White House will move forward [on that issue]. We see from the financial crisis that 401(k) is not an optimal [retirement] savings system. We need to shore up social security and make private savings work as a supplement to social security. It’s just disgraceful that so few workers have access to a private pension plan and that those plans they do have offer so few protections. If we don’t deal with this now, we’re going to have to deal with it when there are millions of baby boomers retiring, which will make it much more difficult. Reforming and improving 401(k)s should be as much a priority as reforming and shoring up social security.
You’re a political scientist who works at a university and yet are a very active participant in policy debates. Why are so few political scientists involved in public debates?
I clearly do have distinctive view, and I think academics shouldn’t have to drop their views at the door. Instead, academics have a responsibility to back up those views with facts and evidence. I’m not the only academic to have views and play a role in political debate. It’s just rare in political science.
The distinctive scope of political science is what government does and how it matters for the lives of citizens, but we, as political scientists, pay little attention to the actual exercise of governmental authority. We pay much more attention to the input of the politics process, elections, opinion polls, and legislative procedure. Once Congress passes a law, political science heads to lunch. The effects of policy and how it affects future policy is mostly left to economists and experts in public policy schools who are usually economists. This can and should be fixed.
One of the most promising areas of research is research on the policy effects of public policy. The way that they affect future politics and how they change people’s views of government and how they change interest group behaviors. There is also new and growing interesting in inequality, which is great because you see political scientists getting involved with how polices actually affect people’s lives.
Matt Zeitlin is a staff writer with Campus Progress and a sophomore at Northwestern University.
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