Krugman on health care reform … after only six months of operation, it’s all working. Even it’s most ardent supporters know only time will tell. Any objective person will come up with a logical definition of success … or maybe not if you are a Nobel prize winner. However, Krugman defined himself below quite accurately, “It’s about politics and ideology, not analysis.”
I wrote this post long before it was released on my blog, in fact the same day Krugman published his piece, but on June 27 Chris Conover in Forbes wrote a rebuttal to Krugman along the same lines; take a look.
“To err is human,” wrote Seneca. “To persist is diabolical.” Everyone makes incorrect predictions. But to be that consistently, grossly wrong takes special effort. So what’s this all about?
Many readers won’t be surprised by the answer: It’s about politics and ideology, not analysis. But while this observation isn’t particularly startling, it’s worth pointing out just how completely ideology has trumped evidence in the health policy debate.
And I’m not just talking about the politicians; I’m talking about the wonks. It’s remarkable how many supposed experts on health care made claims about Obamacare that were clearly unsupportable. For example, remember “rate shock”? Last fall, when we got our first information about insurance premiums, conservative health care analysts raced to claim that consumers were facing a huge increase in their expenses. It was obvious, even at the time, that these claims were misleading; we now know that the great majority of Americans buying insurance through the new exchanges are getting coverage quite cheaply. [Didn’t you forget that’s only because of tax subsidies and higher deductibles and co-payments?]
Or remember claims that young people wouldn’t sign up, so that Obamacare would experience a “death spiral” of surging costs and shrinking enrollment? It’s not happening: a new survey by Gallup finds both that a lot of people have gained insurance through the program and that the age mix of the new enrollees looks pretty good. [And you have yet to learn of the actual claims experience]
What was especially odd about the incessant predictions of health-reform disaster was that we already knew, or should have known, that a program along the lines of the Affordable Care Act was likely to work. Obamacare was closely modeled on Romneycare, which has been working in Massachusetts since 2006, and it bears a strong family resemblance to successful systems abroad, for example in Switzerland. Why should the system have been unworkable for America? [Work? Nobody knows if the Affordable Care Act will work and more importantly, we don’t even know what “work” even means]. [Switzerland? Well, by some measures the Swiss do have a working system, but costs are still a problem, basic coverage is generally supported by supplemental coverage most people buy for things like not being in a hospital ward, hospitalization is limited to the area in which you live and there are still deductibles and co-pays. In other words, pluses and minuses, some which may not be acceptable to Americans.]
But a firm conviction that the government can’t do anything useful — a dogmatic belief in public-sector incompetence — is now a central part of American conservatism, and the incompetence dogma has evidently made rational analysis of policy issues impossible. [ Do you mean incompetence like managing the VA and fraud under Medicare or perhaps ignoring the warnings about the solvency of Social Security and Medicare that the Trustees mention in their report each year?]