Health Care Policy by Fake Anecdote: Thursday Focus: February 27, 2014
Kevin Drum makes an interesting catch:
Kevin Drum: Has Anyone in America Actually Been Harmed by Obamacare?: “I’m beginning to think there’s not actually a single person in America who’s been harmed by Obamacare.
I know that seems unlikely, but… look at the latest AFP ad… [which] features Julie Boonstra… insurance was canceled… diagnosed with leukemia… now, she says, her treatment is unaffordable. “This is serious,” she says. “It’s not a game.” But… Glenn Kessler… found[:]…. Boonstra… found a plan… [that] allowed her to keep her doctor.. [is] s still being treated. Her old plan cost $13,200 per year plus “low” out-of-pocket expenses. Her new plan costs a maximum of $13,202 per year…. Boonstra kept her doctor. Her new plan is… less expensive… presumably she’s no longer required to compromise on the type of chemotherapy she receives…. Boonstra herself is naturally unavailable for comment, and the best an unctuous AFP spokesperson could do to defend this ad is to point out that Boonstra’s costs are a little more variable than in the past. Instead of paying a flat $1,100 per month plus low out-of-pocket costs, she sometimes pays more in a single month until she hits her annual out-of-pocket max. That’s it.
This ad implies that Boonstra… can’t afford coverage… could no longer see her old doctor… Obamacare is killing her. None of this is true. Boonstra’s care is better and cheaper than it was before. The only downside is that her payments are slightly more erratic…. So here’s my question: if this is the best AFP can do, does that mean that no one is truly being harmed by Obamacare?… Why is it that every single hard luck story like this falls apart under the barest scrutiny? Why can’t AFP find someone whose premiums really have doubled and who really did lose her doctor and who really is having a hard time getting the care she used to get? If this is happening to a lot of people, finding a dozen or so of them shouldn’t be hard. But apparently it is. So maybe it’s not actually happening to very many people at all?
Actually, it is much worse than Kevin describes. ObamaCare is supposed to do three things that do have downsides:
- Reduce the rate of growth of Medicare spending by making Medicare a less wasteful shopper.
- Push people into narrower networks that can do more to eliminate wasteful and harmful treatment by standardizing care.
- Push people out of employer-sponsored insurance into the individual-market pool.
And all three of these things do have downsides–although the thinking of the ObamaCare designers was that they had much larger and much more powerful upsides as well.
The problem is that all three of these were much more strongly at the core of Republican health care-reform proposals than of Democratic ones up until, well, up until the fall of 2009–when the memo came down: the memo that said that all Republicans and conservatives were not just opposed to ObamaCare if it included a robust public option but imposed to ObamaCare root-and-branch, no matter how close it came to what had been Republican policy proposals up until September 2009.
The Republican policy intellectuals and politicians did indeed make the switch, in a manner that could not help but remind the rest of us of the famous passage in George Orwell’s 1984.[1] But they will have to switch back, won’t they? Health care-reform proposals like Coburn, Burr, Hatch do involve more and a more rapid churn of the insured out of employer-sponsored insurance and into the individual exchange, don’t they? The private score does say that CBH achieves better net budget performance by pushing people into smaller networks with better cost controls, right? Or it did achieve better net budget performance until they started backing away from the tax increases designed to churn insurance away from employer-sponsored modes, right?
Well, no, organizations like the Koch-funded Freedomworks–the one that paid Dick Armey $8 million to go away–are all-in in opposition to CBH. What do they propose instead? Let me give the microphone to FreedomWorks VP Dean Clancy:
Dean Clancy: The Coburn-Burr-Hatch plan doesn’t deliver market-based health reform: “the Patient OPTION Act authored by Representative Paul Broun (R-Georgia)… allows consumers to purchase insurance policies across state lines, eliminating a major barrier to competition… [makes] Medicare benefits voluntary for seniors… provides 100 percent deductibility on all health-care expenses…. Broun’s plan is not the only one out there that offers a real conservative alternative… there is no shortage of ideas regarding a true market-based approach to health-care reform…. What is clear is that CBH is wrong not only for Republicans, but for America.
But tax cuts and replacing state with federal regulation of insurance are not going to solve any of our health policy dilemmas–much as some insurance companies with large Washington lobbying arms might benefit. And the conservative ideas that might help? Clancy doesn’t mention any of them, or even sketch what they might be.
[1] A passage based on the reversals of line of the British and American Communist Parties in 1939 with the signing of the Hitler-Stalin pact and in 1941 with Hitler’s invasion of the Soviet.