{"id":2728,"date":"2015-04-02T09:24:21","date_gmt":"2015-04-02T14:24:21","guid":{"rendered":"http:\/\/napervilledemocrats.org\/ntdo\/?p=2728"},"modified":"2015-04-02T09:29:57","modified_gmt":"2015-04-02T14:29:57","slug":"wildly-successful-government-program-still-unpopular-because-lies","status":"publish","type":"post","link":"https:\/\/napervilledemocrats.org\/ntdo\/wildly-successful-government-program-still-unpopular-because-lies\/","title":{"rendered":"Wildly Successful Government Program Still Unpopular Because … Well-Funded Lies"},"content":{"rendered":"

A determined and unscrupulous actor can, given enough funding, create a completely false impression in the public mind. \u00a0Despite the popularity of its individual features<\/a>, “Obamacare” as a notion\u00a0continues to be\u00a0unpopular. \u00a0In fact, at this point all of the other anti-Obamacare arguments have been proven false and all opponents\u00a0have left is the negative general impression they have labored so hard (and spent so much<\/a>!) to create.<\/p>\n

Jonathan Chait observes<\/a>:<\/p>\n

It is telling that, having lost every substantive argument about the law\u2019s operation, their\u00a0sole remaining refuge is an argument about its perception. It\u2019s true: Their lies got halfway around the world before the truth could get its pants on. Indeed, if you google most of the factual disputes I discuss above, you\u2019ll get a lot more hits from conservatives making hysterical and false predictions than you will find from reports showing those predictions failed to come true. Those myths still hold enormous sway over public opinion. Far more<\/a> Americans believe Obamacare has death panels, which is false, than believe its costs have come in under projections, which is true. Conservatives have won the propaganda war over Obamacare. The trouble is that they think this is an indictment of Obamacare, when in fact it\u2019s an indictment of them.<\/strong><\/p><\/blockquote>\n

Here’s Chait’s\u00a0whole piece:<\/p>\n

\n
\n

The Obamacare Doomsday Cult Struggles to Adapt to World That Did Not End<\/a><\/h3>\n

By Jonathan Chait<\/a><\/span><\/p><\/blockquote>\n<\/header>\n

\n
\n
\n
\"\"<\/div>
Photo: Eric Liebowitz\/Netflix<\/cite><\/figcaption><\/figure>\n

As Obamacare continues to operate successfully, conservative elites have renewed their pleas for the party to develop an alternative beyond demanding the law\u2019s repeal. The trouble is that anti-Obamacare dogma sits so deeply at the GOP\u2019s core that any discussion of health care must pay fealty to their belief that the law has failed utterly. The Republican Party in the Obamacare era is a doomsday cult after the world failed to end. Its entire analysis of the issue is built upon a foundation of falsehoods.<\/p>\n

Michael Tanner, a health-care analyst at the Cato Institute, has a column<\/a> for National Review<\/i> usefully summarizing the most current iteration of anti-Obamacare talking points. Most of Tanner\u2019s piece is devoted to arguing for alternative proposals, but he begins with the ritual incantation of Obamacare doomsaying. Tanner does not argue that Obamacare is wrong because conservatives philosophically object to using taxation and regulation to transfer resources from the rich and healthy to the poor and sick. Instead he makes eight substantive claims about the law\u2019s impact on health-care access. Every single one of them is overblown or demonstrably wrong.<\/p>\n

Here\u2019s Tanner\u2019s litany of failure:<\/p>\n

Millions of Americans were forced to change insurance plans, and others found themselves pushed into smaller networks with few choices of providers. Premiums rose. Businesses, laboring under the higher costs imposed by the law, have slowed growth; many have delayed hiring, or shifted workers from full- to part-time. The potential impact on the quality of care remains troubling.<\/p>\n

Let\u2019s take these claims in order.<\/p>\n

1.\u201cMillions of Americans were forced to change insurance plans.\u201d The specter of mass dislocation was a major anti-Obamacare talking point at the end of 2013 and 2014. The new health-care regulations banned a lot of unpopular practices, like lifetime limits on how much an insurer would pay, or discriminating against preexisting conditions. So it is true that many people who held insurers in the old, barely regulated insurance market needed to find new plans. On the other hand, that market had enormous year-to-year churn anyway. The main way for insurers to make money was to exclude customers who were likely to get sick, so they threw people off their insurance all the time.<\/p>\n

We now know that the new churn created by Obamacare was much smaller than conservatives insisted at the time. A recent study<\/a> by the Urban Institute found that policy cancellations were not \u201cmillions,\u201d butunder a million<\/a>. As the authors explain:<\/p>\n

These estimates suggest that policy cancellations caused by noncompliance with the ACA were uncommon in 2014 in both the nongroup and ESI markets, and the number and rate of cancellations in the nongroup market in 2014 was far smaller than in 2013. The nongroup market has historically been characterized by high volatility: an analysis of pre-ACA nongroup coverage patterns from 2008\u201311 shows that only 42 percent of nongroup enrollees retained their coverage after 12 months.<\/p>\n

2. \u201c … and others found themselves pushed into smaller networks with few choices of providers.\u201d It is true that many people who enrolled in the new exchanges have insurance plans that limit their choice of doctors and hospitals, which is called \u201cnarrow networks.\u201d There is no evidence that Obamacare caused this. The law overwhelmingly covers people who had no insurance to begin with. You can\u2019t be \u201cpushed\u201d into a \u201csmaller\u201d network when your previous network was nonexistent.<\/p>\n

As Jonathan Cohn<\/a> laid out in an excellent and balanced explainer on this issue, insurers have been using narrow networks to control costs for decades. \u201cThat\u2019s been the case for decades,\u201d Larry Levitt told him, \u201cThe only real connection to the Affordable Care Act is that the health reform law is making insurers compete for customers more aggressively.\u201d<\/p>\n

If narrow networks are spreading, it is because the Obamacare exchanges are bringing consumer choice into the system. Overwhelmingly, the customers enrolling in plans with narrow networks are not being \u201cpushed\u201d so much as they are choosing them. As a McKinsey study<\/a> from last year found, 90 percent of eligible customers have access to broader networks of doctors and hospitals. But most customers choose plans with narrow networks because they would rather not pay the higher premiums required to access broader networks. If we think narrow networks are inadequate, one response would be to require insurers to include more doctors and hospitals in their plans, but this would add to costs \u2014 an odd argument for a conservative to make.<\/p>\n

\n
\"President<\/div>
President Barack Obama delivers remarks on the 5th Anniversary of the Affordable Care Act, on 25 March 2015. Photo: Shawn Thew\/epa\/Corbis<\/cite><\/figcaption><\/figure>\n

3. \u201cPremiums rose.\u201d It is true that some people will pay higher premiums. If you previously held a catastrophic plan that covered little to none of your medical expenses, you may now be paying higher premiums in return for having insurance that covers the cost of medical care. Likewise, if you were uninsured and now have coverage, your new premiums are now higher than your old premiums, which were zero. This is exactly what the law intended to do.<\/p>\n

The argument between the law\u2019s supporters and critics centered on whether it would succeed or fail at its goal of restraining health care inflation. Historically, the cost of health care has grown at a much faster rate than the cost of other goods. Since Obamacare has taken effect, that trend has sharply reversed itself. Analysts debate the degree to which this enormous success is the result of the new law\u2019s reforms versus outside factors. But the cost of Obamacare insurance premiums has come in well under official projections<\/a>.<\/p>\n

Tanner himself asserted that Obamacare would absolutely increase the cost of health care. \u201cWhile we were once told that health-care reform would \u201cbend the cost curve down,\u201d we now know that Obamacare will actually increase U.S. health-care spending,\u201d he wrote in 2012. This has been proven false. The federal government is spending less, even with the coverage expansions provided by Obamacare, than it was projected to spending before Obamacare became law:<\/p>\n

\n
\"\"<\/div>\n<\/figure>\n

4. \u201cBusinesses, laboring under the higher costs imposed by the law … \u201d This is the opposite of the truth. The cost of providing health care to employees for business, after years of rapid growth, has stayed unusually flat<\/a>:<\/p>\n

\n
\"\"<\/div>\n<\/figure>\n

5. \u201c … have slowed growth.\u201d Actually, 2014, the first year of Obamacare\u2019s implementation coincided with the fastest growth<\/a> in GDP since the start of the recession.<\/p>\n

6. \u201cmany have delayed hiring \u2026 \u201d In fact, 2014 was also the best year for job creation, not only since the recession but since 1999<\/a>.<\/p>\n

\n
\"\"<\/div>\n<\/figure>\n

7. \u201cor shifted workers from full- to part-time.\u201d Nope, the share of part-time workers has also fallen<\/a> since Obamacare took effect.<\/p>\n

8. \u201cThe potential impact on the quality of care remains troubling.\u201d This is a really vague statement. Measuring the quality of health care is nearly impossible in general. What\u2019s more, tanner\u2019s formulation has not one but two weasel words (\u201cpotential,\u201d \u201ctroubling\u201d) that distance him from any verifiable claim.<\/p>\n

That said, there\u2019s plenty of evidence that the Affordable Care Act is improving the quality of care. The percentage of Americans delaying medical care for financial reasons has dropped sharply<\/a>. The rate of hospital-acquired infections (a key target of the law, which changed hospitals\u2019 financial incentive in order to drive down infections) has fallen<\/a>. Customers who bought insurance through the exchanges report<\/a> high levels of satisfaction with the quality of their care. One study<\/a> found that Obamacare is saving around 50,000 lives a year; after President Obama cited the figure, Washington Post<\/em> fact-checker Glenn Kessler set out to debunk the claim, only to determine that it checked out<\/a>.<\/p>\n

**<\/p>\n

This is the reality that the entire Republican Party has failed to come to grips with. The American health-care system before Obamacare was an utter disaster \u2014 the most expensive in the world and also the only one that denied access to millions of its own citizens. Obamacare set out to change those things, and it has worked.<\/p>\n

There is one remaining indictment of the law that Tanner makes, and it\u2019s true. \u201cThe law remains extraordinarily unpopular, with opponents topping supporters by nearly 11 percentage points, according to the latest Real Clear Politics average,\u201d he argues. It is notable that opponents of Obamacare have fixated on the law\u2019s poor polling. In a recent column, Reason\u2019s Peter Suderman<\/a> quibbles halfheartedly with the law\u2019s demonstrable success in carrying out its goals \u2014 suggesting that the astonishing drop in medical inflation may be owed to outside forces \u2014 before reveling for six paragraphs in his major point, which is continued lack of public approval. \u201cObamacare is simply not well liked,\u201d he concludes, \u201cThis is the political reality \u2014 and President Obama still refuses to embrace it.\u201d<\/p>\n

It is telling that, having lost every substantive argument about the law\u2019s operation, their sole remaining refuge is an argument about its perception. It\u2019s true: Their lies got halfway around the world before the truth could get its pants on. Indeed, if you google most of the factual disputes I discuss above, you\u2019ll get a lot more hits from conservatives making hysterical and false predictions than you will find from reports showing those predictions failed to come true. Those myths still hold enormous sway over public opinion. Far more<\/a> Americans believe Obamacare has death panels, which is false, than believe its costs have come in under projections, which is true. Conservatives have won the propaganda war over Obamacare. The trouble is that they think this is an indictment of Obamacare, when in fact it\u2019s an indictment of them.<\/p><\/blockquote>\n<\/div>\n