Monday, June 18, 2012

Robert Samuelson Blows Smoke on "Obamacare"

A few quick words about Robert Samuelson's latest drivel on the Affordable Care Act:
  1. " It increases uncertainty and decreases confidence when recovery from the Great Recession requires more confidence and less uncertainty " - The fact that Samuelson's first "support" for this claim is that "44 percent of Americans now view [the ACA] unfavorably", something completely irrelevant to his argument, tells you something. The fact that his first point is one he cannot actually support tells you another. Samuelson is acting as a stenographer for a common right-wing talking point, yet he can find no evidence to support his argument.

  2. " The ACA discourages job creation by raising the price of hiring " - Samuelson's complaint is not actually about the ACA. It's about employer-sponsored health care in general. And within that larger context he's correct. But he's not honest enough to admit that if this is the huge problem he claims, one easy fix would be to simply create universal health coverage independent of employment and take the cost of insurance off of the nation's payrolls. Also, there are many laws that impose thresholds for enforcement, and yet as a matter of course businesses grow their way into federal anti-discrimination laws, the ADA, the FMLA, and similar laws and regulations. To pretend that the ACA will cause employers to stop growing their businesses once they have 49 employees is counter-factual demagoguery.

  3. " Uncontrolled health spending is the U.S. system’s main problem " - Here, Samuelson is stating that the "real problem" is that if sick people have insurance, they go to see doctors. It's safe to note at this juncture both that Samuelson has really good health insurance and has plenty of access to medical care for himself and his family - it's only a problem when other people see doctors. If Samuelson were truly concerned with lowering healthcare cost as a percentage of GDP he could point us to one of many industrialized nations that have universal or near-universal health care and pay less than we do at present for that care, and advise us to emulate. But, if it needs to be said, that's not what Samuelson actually cares about.

  4. " Obama’s program also worsens the federal budget problem " - Samuelson offers prattle that if tax increases and budget cuts used to pay for the ACA were used elsewhere, with no new spending program like the ACA's attempt to insure more Americans, the deficit would be reduced. If it needs to be said, that's true of any government spending. Samuelson appears to be agreeing that there is a net savings, but that it could be larger if we didn't fund health insurance? Well, duh. It would also be larger if we didn't fund wars of choice - but recall, when Samuelson supports a multi-billion dollar unfunded expenditure it's "pocket change".

  5. " The ACA discriminates against the young in favor of the old " - The crux of Samuelson's argument here is that as younger people tend to be healthier, if young people have health insurance it will tend to go toward the medical care incurred by people older than themselves. But he's again taking something that is not unique to the ACA and pretending that it's a new issue - his complaint is true about health insurance right now: the healthy subsidize the sick. Samuelson also pretends that there are no sick young people who can't get insurance under the present system, and that young people can't suffer catastrophic injuries that are costly to treat, such that even young people can benefit from having insurance. Does Samuelson have even the slightest inkling of how insurance is supposed to work? (In fairness, his piece is so bad that I have to write it off as shameless demagoguery - he can't possibly believe what he's writing.)

Samuelson then claims "Cost control should have been Obama’s priority", apparently forgetting that he just criticized the ACA for imposing serious cost-saving and revenue-generating measures and then applying them to fund insurance. Had the ACA included even more cost-saving measures, Samuelson would be doubling down on that complaint.

If you operate from Samuelson's apparent premise, that only the wealthy deserve good health care, that everybody else should struggle to get what they can pay for out-of-pocket, and that it doesn't matter if huge numbers of people are uninsured, it's easy to sneer that an attempt to achieve universality is an exercise in presidential vanity, or a sop to the "liberals". If you or your loved ones have struggled to obtain and maintain decent insurance and to pay medical bills, you probably have a different perspective - and I, personally, would agree with that perspective - but you're not the type of person Robert Samuelson cares about.

1 comment:

  1. Another thing about insurance: the young / healthy person "subsidizing" the old / sickly person today is eventually going to be older and sicker. It's not like things never balance out -- unless you allow free riders, Samuelson style.