Lying About Health Reform
You can always tell that a person is losing an argument when he throws reason, logic and factual evidence aside and starts personally attacking his opponent. That’s the modus operandi of Paul Krugman, liberal columnist for The New York Times.
Opponents of ObamaCare are telling “lies,” wrote Krugman the other day. In fact he used the word “lie” three times to characterize the critics in the space of a single column. Those who disagree with him “make stuff up” and concoct “completely fraudulent” statements, he adds.
While he’s ranting and raving about people he calls “the enemy,” Krugman tells a few whoppers of his own, however. This is his defense of ObamaCare:
The fact is that individual health insurance, as currently constituted, just doesn’t work. If insurers are left free to deny coverage at will — as they are in, say, California — they offer cheap policies to the young and healthy (and try to yank coverage if you get sick) but refuse to cover anyone likely to need expensive care.
Now anyone who knows anything about the health insurance business knows that it is illegal under federal law for an insurance company “to yank” (cancel) someone’s insurance because he or she gets sick. That’s not only illegal; it’s been illegal for the past 16 years!
I thought by now you’d realize
There ain’t no way to hide your lyin’ eyes
What about insurance companies refusing to sell insurance to people because they need expensive care? It happens. But this is a problem that is turning out to be relatively minor and not very expensive to fix. If Krugman is going to write about health care, he should have known that fact as well.
One of the most interesting parts of ObamaCare is the new federal risk pools that offer coverage to the very people Krugman is talking about. Anyone denied insurance because of a pre-existing condition can buy insurance in Pre-Existing Condition Insurance Plan (PCIP) risk pools for the same premium that would be paid by healthy people.
So how many people have signed up? Only 49,000. Think about that. We are in the process of nationalizing the entire health care system. The federal government is going to tell 300 million Americans what kind of health insurance they must have. We are going to create 159 new regulatory agencies and spend close to $1.8 trillion over the next 10 years getting it done. Yet the primary reason for doing all of this — according to Krugman — is to solve the problem of 49,000 people!
As for criticizing ObamaCare, the critics have no reason to lie. The reality is ugly enough. There are three big problems in health care: cost, quality and access. Health care is too expensive. The quality of care many patients receive is less than optimal. And too many Americans have difficulty getting care. So for its $1.8 trillion price tag, what will ObamaCare do about these three problems? It will most likely make all three of them worse.
- Almost every serious analysis predicts that spending will be higher, not lower, under ObamaCare.
- The results of pilot programs and demonstration projects leave us no reason to believe that the quality of care will improve; and perverse incentives are likely to make the quality of care patients receive worse, not better.
- Access to care for our most vulnerable populations is likely to go down, not up — despite the fact that more people will have health insurance.
On this last point, ObamaCare makes the same mistake nationally as health reform in Massachusetts, which President Obama cites as the model for his reform. In both cases, more people get insurance, but there are no more doctors to deliver any additional care.
In Massachusetts, more people are going to hospital emergency rooms than ever before — presumably because they can’t find a doctor who will see them. The wait to see a new doctor in Boston is about two months — longer than in any other U.S. city. In a sense, people in Boston have less access to care than people living anywhere else!
ObamaCare will greatly expand the demand for health care while doing nothing to increase its supply. That implies a huge rationing problem, and anyone who is in a health plan that pays doctors and hospitals less than what others are paying will be pushed to the rear of the waiting lines. Who are those people? They are the elderly and the disabled on Medicare, poor people on Medicaid, and (if Massachusetts is the model) low income families getting subsidized insurance in the newly created health insurance exchanges.
ObamaCare will impose its harshest impact on the most vulnerable populations.
Postscript: Just when I thought there is no way to top this hysteria, Krugman out does himself with a new column about the Republican Party in general and Mitt Romney in particular in which he uses the term “lie” three times, “crazy” three times, “paranoia” five times (including the title), refers to Mitt Romney’s position as “nuts” and accuses the Republican party of losing “what’s left of its mind.”
And what provoked this bout of ranting and raving, you might ask? Mitt Romney’s suggestion that the Democratic Party in general and President Obama in particular actually want gas prices to be high.
Wakeup call to Krugman: Not just high. As high as they are in Europe. Maybe even higher. That the Democratic Party is a wholly owned subsidiary of radical environmentalists on issues of energy policy is not a conspiracy theory. It’s a fact.
Krugman obviously does not understand the issues, and his irrational behavior reminds me of a child having a temper tantrum. These tantrums are often brought on through frustration in not understanding the issues. Perhaps what he should be doing is reaching out and asking for an education.
Krugman is like an adolescent who throws a temper tantrum in his bedroom if he doesn’t get his way. This permanent adolescence seems to be a growing phenom with people who never leave academia
A recent blog post used a diagram to illustrate all the economists Krugman had disparaged with personal attacks – either by name or with enough details that other economists knew to whom he was referring. I wish I could remember where it came from — it was classic Krugman.
Hi John:
Tempered rhetoric on all sides would yield enormous strides forward. Even better, if we were to de-politicize the debate, and stop making health care a political football. Illness and injury strike without regard to party affiliation. The nation needs to come together on this issue, as neighbors, not as partisans. That is why the Patient-Physician Alliance is staunchly a-political and expressly not a legislative advocacy group. Politics divide people. We need to unite them to build a critical mass because we believe we can reform health care from the grassroots up–not the top down.
Cheers,
Charlie Bond
This is a good piece by John Goodman and a great example of the Progressive’s tactics in trying to get their way (and not just with regard to healthcare). Personal attacks are effective with many of the sleeping pop culture crowd (check out the audiences of Bill Maher, Jon Stewart and others). Personal ridicule is “hip” and funny, and the pop culture folks fear nothing more than being “unhip”.
I think Krugman’s attitude displays the Progressive’s obsession to establish the liberal elite’s rightful position as the benevolent ruling class. After all, it’s very difficult when one’s unruly wards continue to question the motivations and worthiness of these generous projects. I am sure as parents many of us can identify with Mr. Krugman’s refusal to “negotiate” with ungrateful dependents on the merits of the issues.
Charlie Bond, you make a good point about reforming healthcare from the grassroots up – not the top down. The problem is the advocates of the “top down” approach have already politicized the process, and they are determined to make sure we are barred from “grassroots reform”. Consequently a political victory is necessary in order for us to have a grassroots reform.
As one of those who have been helping individuals find health insurance for 10+ years know, the reason for the lack of participation in PCIPs is the poor eligibility design. I’m dissapointed that you did not disclose that fact. As you know you must be without any major medical policy for six months to qualify. At the end of six months you will likely be broke and unable to afford a plan at any cost. Hence the low program participation. With a little tweeking the program could be designed to address the vast majority the sad stories out there and not destroy the entire health insurance market. In addition it would cost far less than the several trillion dollars and the thousands of jobs ObamaCare with cost including mine.
John –
Thanks for your article. I had read the Krugman editorial and shook my head at its stereotypical insurance bashing. It’s not just Krugman and the libs. The State of Texas has passed countless laws over the past 20 years regulating insurers and adding mandated benefits, and most of these laws are due to misinformation passed by insurance haters. The sad thing is that people like Krugman actually believe that California insurers were simply cancelling sick people’s insurance policies. It didn’t happen. It’s an urban myth, but laws — like Obamacare — get passed based on these myths. That’s scary stuff.
Remember all of Pelosi’s comments that with Obamacare, your insurer can’t cancel you or turn you down for pre-existing conditions? At the time Pelosi was making those comments, no insurer could cancel you due to both state and federal laws, and the only situations in which insurers could turn you down for pre-ex were individual policies. Group insurers can’t turn down anyone for health conditions. They can only charge the employer a higher rate.
Krugman’s incorrect statements bother me, but not as much as incorrect statements made from our supposed allies on the right. We must be careful not to spread lies and urban legends, because they undermine the conservative cause, just as Krugman’s bad facts undermine his cause. That is why I am thankful for all that you do to spread truth and logic.
Full disclosure: I am an insurance agent.
Blake Woodard
I would expect that the majority of the relatively few cases where insurance was canceled after someone “got sick” were that the insurer discovered that there was misrepresentation or fraud on the app. Does anyone have numbers on that?
At some point down the road after Obamacare has had an opportunity to work for a while, the poor/vulnerable population will take notice of their plight (being pushed to the back of the line).
I don’t know exactly how it will happen, but I can see people politically mobilizing on a class-level to ensure that people get “equal access to healthcare” down the road. That, of course, would lead to additional healthcare “reforms”, giving the government more control of the industry and leading to a degradation in quality and possibly a degradation in access.
@Charlie Bond
Well said.
Re: the post, there has certainly been plenty of demagoguery, much of it misleading or downright false, coming from the opponents of the law. There are certainly legitimate critiques as well, but I don’t think Krugman is remiss in pointing out that some of the most popular criticisms of the law are based on faulty (or fraudulent) premises.
Eric, I wonder if you could give us examples of some of the “more popular criticisms” of the ACA that are based on faulty (or fraudulent) premises?
Perhaps you could start with John Goodman’s three presumptions above. If you don’t think these are faulty premises, then we must assume that you also support the repeal of the law. If we don’t obtain better quality, access and lower costs, how could anyone support the law?
Hey John,
I woudn’t expect anything else from Paul Krugman. I can’t believe you would either.
Keep on truckin.
Al
@Frank
For faulty premises, I’ll begin with the 2009 and 2010 Politifact lies of the year, both of which were popular partisan arguments against the bill. 2009 was the “death panel” canard, and 2010 was the whopper about the bill being a “government takeover” of health care.
I’ll add in the demagoguing about reimbursement for end-of-life counseling (which initially had the support of at least one prominent Republican) using whoppers such as “unplugging Grandma” (Grassley) and IPAB (“rationing board”, even though it is explicitly prohibited from rationing care).
As for John’s 3 premises, I wouldn’t put them in the category of “lying”, but that doesn’t mean I’m accepting them on faith. This is in large part because I don’t think those premises are as definitive as John seems to assert. I’ve seen enough variation in projections in cost, quality, and access to make me wary to accept any one of them, and I would be skeptical of the objectivity of one who makes such definitive statements when so much remains uncertain.
John,
The system is so screwed up that you can challenge anything anyone makes a statement. Just remember the incident in South Carolina when a person in the audience screemed “You are a LIAR” to President Obama. Or do you remember when Rick Santorum called Romney a liar. Unfortunately in dirty politics, anyone can say anything without being chastised or reprimanded. Why can’t we take all of the best from the two parties and come up with a workable. Remember Kramer’s rule of seven. When will they let medicine be defined by those of us who really care about the practice of medicine??
Dr Bob Kramer
214 676 5692 office
214 522 8040 fax
drbobkramer@pol.net
Eric, it doesn’t take a Rhodes Scholar to connect the dots from the appointing of the “Independent” Payment Advisory Board (IPAB) (which doesn’t answer to the Legislature) to reduced allowables for medical charges, to the shortage of health professionals, to long waits for services, to Ipso Facto rationing (regardless of provisions to the contrary in the PPACA). In the real world what other possible outcome could be realized? How is this aspect in and of itself not evidence of a government takeover of healthcare?
With all this do you really believe that ultimately financial decisions will not be made by Medicare that discriminate against life saving treatment for certain of the elderly?
The promises made by the politicians promoting this legislation simply defy all educated logic associated with economics, human nature and the historical impact of this type of legislation.
Frank,
If healthcare will be rationed because more people will be insured, wouldn’t the answer be to encourage more students to go to medical school to support the growing demand for care? DHHS already has a program in place to encourage doctors coming out of school to spend time working in many of the underserved areas of our country for the benefit of receiving assistance with their huge school debt.
John and Friends….
The ACA starts with the wrong “it.” It assumes that the healthcare delivery system is not to be monkeyed with too much, so the way to get more access is to work on insurance coverage. That will do these things: 1) put more money into a healthcare system that can readily absorb it, in contrast to the assumption that it will hold the line on the share of the GDP devoted to healthcare, 2) add to a state’s costs for Medicaid when many are already stressed out paying for the program they have today, so it will soon be a case of “The Lord giveith, and the lord taketh away;” and 3) individual policies are the hardest for the consumer to buy and manage, and the most subject to fly by night insurers who see a way to defraud a lot of individuals who won’t know the difference until they find their claims not paid.
People in policy positions, educated, clean, barbered and well-housed, do not remind themselves that 40% of the population is functionally illiterate, do not have bank accounts from which to pay for individual policies, and have lifestyles that do not do anything to keep them healthy.
The right way is an assemblage of delivery solutions that fit the various kids of communities and people in this country, followed by a menu of ways to pay for them. We have that now, in a rich variety of options; what we do not have is a practical planning process to magnify those efforts where they fall short. For the record, I’d like to see:
* More community health centers,
* More team care with nurse practitioners
* More longitudinal case managaement for those with risks of chronic disease, maximizing social media for patient contact where feasible, and
* More honest reimbursement schedules for doctors so we will have enough and so they will be willing to take government patients.
* More attention to the great redesign strides being made by healthcare systems, especially in California.
* More attention to adoption of new science in genetics and brain function.
That’s all possible without the ACA. It is the worst legislation in healthcare history and will turn our healthcare system into a nest of dishonest people, scrabbling for adequate revenue to operate. Hospitals will close, doctors will retire, and a major industry will be guided by an incompetent national “Board of Trustees,” in the person of Congress.
Rational people need to speak loudly on this travesty.
Wanda J. Jones
President
New Century Healthcare Institute
San Francisco
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Elaine, you have emphasized my point. I’ll try a medical analogy. At the end of his life Elvis Presley was taking downers to get to sleep to offset the uppers he was taking to make it through his day. He could not function without drugs that he had become dependent upon, and in the end they effectively destroyed his system. I think it is fair to say he should have never taken the drugs in the first place.
You are suggesting that the government compound the original error of creating a shortage of healthcare professionals (through price controls) by using monetary incentives (taxpayer funded of course)to manipulate a “managed” solution. This simply cannot work as historically demonstrated by the Soviet Union, Cuba, etc.
The collectivists lost the cold war and we won because of our free market system. Why on earth would we want to make the same mistakes? Yes, we have to make adjustments to accommodate the realities of our society, but ACA completely undermines the basic requirements for the free market to function.
Studebaker: Is it this diagram? “Paul Krugman vs. the World” at Bloomberg.
http://www.businessweek.com/magazine/paul-krugman-vs-the-world-02092012-gfx.html
At TCSDaily (now something else), economist Arnold Kling wrote an open letter to Krugman years ago about his personal attacks.