Why Won't The Stupid Voters Listen When We Tell Them What They Want?

Apparently mystified by persistent public opposition to his health care law, President Obama is blaming himself, not for signing a bill that started out unpopular and grew more so throughout the process of its passage, but for failing to sell it well enough. Obama continues to argue that the reason people don't like the law is because they aren't aware of all the benefits it will bring them. But as Reason's Peter Suderman points out, there's a simpler and empirically better supported explanation - that the public is aware of the law's benefits, which contrary to what the President thinks the Democrats have talked up to no end, but is also aware of its costs, which the Democrats have rather assiduously avoided discussing, and does not consider the former worth the price of the latter.

I haven't been polled, but I certainly fall into this category. I'm all for ensuring that people with pre-existing conditions can receive subsidized medical treatment for them if they can't afford it themselves, making health care plans more portable between places of employment, and the like. What I'm not for? The massive, cost-spiraling distortion in the health insurance market that forcing insurance companies to issue policies on which they are guaranteed to lose money will create. The higher taxes that will raise the price of new treatments and stunt medical innovation. The almost certain budget busting costs. The giant middle finger to personal freedom and constitutional rights that is the individual mandate. The unsavory backroom dealing that went into drafting the law. And most of all, the vast array of statistical gimmicks, euphemisms, blandishments, and outright lies via which the Democrats have tried to obscure all of this. I don't know how representative I am, but I know why I don't like the law, even though as a young person with a checkered travel history I stand to benefit from it in some ways, and it's not because I don't know what it's in. I'm not sure which is more offensive, the Democrats' arrogance in ramming this law through against the popular will, or their condescension in assuming that people oppose it because they're too stupid to know what's good for them.

It's widely expected that the Democrats will get hammered in the upcoming midterm elections, and very likely lose their governing majority in at least one house of Congress. I suspect that much of that is a result of the fact that the economy continues to sputter. But if health care does prove to be a salient issue in this campaign and hurts the Democrats as it almost certainly will if that's the case, they deserve it. Whatever the merits, or lack therof, of the particular laws they pass, parties that overinterpret their mandate and/or take the electorate for a pliable mass of idiots need to suffer for it.

Oh, Please

In a move that will surprise absolutely no one with either half a functioning brain or a shred of intellectual honesty, the C.B.O. has upped its cost estimate on Obamacare to more than $1 trillion over the first ten years. The additional costs reflect the expenses of implementing the overhaul - setting up the insurance exchanges, assembling an enforcement apparatus for the individual mandate (20,000 more IRS Agents, whoopee!), and so on. As a result, the magical "savings" we were going to realize as part of enacting a massive, expensive new entitlement have already begun to evaporate, before the bill even takes effect. Never fear, however - Slate.com's resident Obamacare apologist/B.S. monger Timothy Noah tells us not to worry. It might cost more than we were told it would, but it's still a great deal! And it's not going to get any more expensive - really! This sentence is particularly dishonest:

But given the roughly $113 billion in government spending it currently
looks like the bill will save, it seems a safe bet that Obamacare will be able
to finance itself over the next decade.

Before the C.B.O.'s readjustment, it "looked like" the bill was going to save more than that. The fact is, what it "looks like" something will cost before it is actually implemented is a completely meaningless number. The C.B.O. acknowledged that its initial estimate of the price tag of Obamacare did not reflect the costs of unspecified "discretionary spending" included in the bill to fund its implementation, which essentially means that the estimate is worth precisely nothing to anyone trying to predict how much it actually will end up costing. Obamacare opponents, meanwhile, spent months prior to the bill's passage hammering precisely the point that the program was likely to cost more than projected, along with the related point that it would make it far more difficult to reduce the budget deficit by making some of the few cuts to government service that are politically feasible and using the proceeds not to pay down the debt but to offset new spending. The vast majority of Obamacare isn't even law yet, and already the critics have been proven right on both counts. If Noah thinks it's a safe bet that Obamacare is actually going to save the government $113 billion over the first ten years, he's welcome to put his own money down on it. Personally I'd opt for something with better odds - PowerBall tickets, maybe.

Is The Health Insurance Individual Mandate Constitutional?

I don't think so, and neither does Jacob Sullum of Reason Magazine, who pretty much states the case better than I could. Unfortunately, at this point the meaning of the phrase "interstate commerce" has been so warped by decades of successive court rulings expanding Federal power that I don't expect the Supreme Court to agree. A fellow can dream, though.

Welcome to Obamacare

Well, as everyone knows by now, it passed. For better or worse, the U.S. has now joined the rest of the industrialized world in voting to allow the national government more-or-less run the health care sector. Will it have all the wonderful benefits progressives are insisting it will? Count me highly skeptical.

1.)I don't think it will have the magical effect on American life expectancy statistics that Nicholas Kristof of the New York Times anticipates. As Jonah Goldberg points out in this smart fisking, it appears that there are a number of factors that account for the (overstated) difference in life expectancy between the U.S. and other western democracies, and the presence of universal health coverage doesn't appear to be among the most important. If American life expectancies fail to leap upwards by five or more years as Kristof predicts, I expect him to acknowledge how wrong he was. On the other hand, maybe having health insurance will stop teenagers from dying in car crashes or gunfights and lowering the average American lifespan.

2.)I don't see any reason to expect it to control costs. It's economics 101 - you can't add a bunch of prohibitively expensive new beneficiaries to an insurance pool, and expect costs to go down for everyone. How anyone could be stupid enough to believe the Democrats when they claim this boggles my mind. Furthermore, given that accounting gimmicks can only produce savings on a balance sheet, not in the real world, I find the claim that this bill is going to be "deficit neutral" laughable on its face.

3.)I fully effect the bill to have deleterious effects on the rate of medical innovation and the willingness of doctors to continue practicing medicine. Since the bill actually taxes medical devices in addition to disincentivizing innovation, and does nothing to address the extraordinary cost of obtaining a medical license or the artificially restricted supply of practicing physicians, these effects will be even worse.

All this is leaves aside the, to be charitable shall we say, dubious, constitutionality of an act of Congress that will force private citizens to purchase a product from a private entity regardless of whether they want it or not. And the fact that the Democrats have just created a gigantic corporate-government nexus for waste, corruption and malfeasance that will give the military-industrial complex a run for its money on its worst day. While this legislation will have a few benefits - covering the uninsured and freeing individuals from healthcare-induced "job lock" - they are not remotely worth the astronomical costs we are going to pay, and could have been achieved with simpler, more market-friendly reforms. I hope to God I'm wrong, but I think that this legislation is going to be a colossally expensive failure.

I received an email from Barack Obama this morning thanking me for my support. I replied telling him to take me off his mailing list, because the candidate I voted for, the guy who seemed to understand how market economies and the Constitution and such actually work, and respect that those realities can't be changed by legislating them, is not the President I got, and I do not support the President I got. I will be voting for Republicans in the fall, for Senate and House. Hopefully Mr. Obama can be forced to lead from the center by the constraints of a divided government.

Misreading The Polls From Both Directions

Pivoting off of what I wrote yesterday about the health care reform bill, I'd like to further examine the role of public opinion polling in the debate. Conservatives point to the fact that while the polls have fluctuated somewhat, a consistent majority of the public seems to be in opposition. Liberals (those that concede that the polling is valid, that is) counter that individual components of Obama's plan poll extremely well, and that the only reason people oppose the bill as a whole is because of Republican scaremongering and flim-flammery. Who's right?

In my view, both groups are interpreting the data somewhat self-servingly. While opposition is clearly significant, it has fluctuated wildly, and people with experience in polling know that widely divergent results can result from wording the same question in a poll two different ways. Furthermore, it's not clear that a majority of the public is even aware of what's in the bill, as the fact that at one point a majority of people favored a "public option" with a majority of those not even knowing what a "public option" was. Hence, Republican claims that public opposition is "overwhelming", "massive", or the like are very likely overstated.

However, of the two sides I have to conclude that it's the liberals who are being more disingenuous, perhaps because they're the party in power and they're attempting to shill their own policy. The claim that most provisions of Obamacare poll well is superficially true, but when you subject it to even mild scrutiny it becomes essentially meaningless. Sure, vast majorities of people favor extending coverage to the uninsured, reducing the number of medically-induced bankruptcies, preventing insurance companies from discrimanating against people with pre-existing conditions or dropping insurees who develop expensive medical problems for dubious reasons, etc. - when these things are asked about in a cost-free vacuum. In the real world, such measures cost money, and the parts of the bill that aim to offset those costs - the individual mandate, the tax on existing high-end plans, the Medicare cuts, etc. - happen to be the parts of the bill that are unpopular. I love chocolate chip cookies, and if you ask me if I am in favor of receiving one for dessert, sure, I'll say yes. Tell me I'll have to pay $50 for it, and I'll pass. The same appears to be true of a great segment of the public when it comes to the goodies in the healthcare bill. Furthermore, for all the Democrats' talk of "bending the cost curve", many voters remain rightly skeptical of the notion that a massive, expensive new entitlement is somehow going to end up costing taxpayers less money. Advocates for the bill have been claiming since the beginning that it will save money, completely ignoring the facts that their pricetag estimates assume that as-of-yet theoretical cost containment measures will work perfectly in practice, and that the decade-long window they chose to focus on includes a full ten years' worth of taxes but only six years' of payouts. The history of government entitlement spending, not just in the U.S. but everywhere, indicates that such programs almost never end up costing less than the sticker price, and often end up costing a lot, lot more, and of course the C.B.O., when they actually had some solid numbers to crunch, agreed. They still haven't released numbers on the newer version of the bill the House is attempting to pass on to the Senate for reconciliation, possibly because they're still trying to finesse the numbers to get a defensible score, and for voters alarmed about the size of the deficit, that's hardly reassuring. The fiscal aspects of this bill just can't be ignored or massaged away with fuzzy, highly speculative math, but that is overwhelmingly what liberals seem to want to do. In short, there are many components to this bill about which the public is either dubious or staunchly unenthusiastic, so it's not necessary to invoke the power of Republican messaging voodoo to explain why the public opposes it as a whole in spite of the popularity of several of the individual components. I suspect that a bill that would give everyone in the U.S. a free house, a new car, a private jet, and six months of vacation a year, but also mandate that everyone commit suicide on their 30th birthday, would be unlikely to be very popular even though "most" of the individual provisions would be. The same logic applies here.

Both sides are convinced that the public actually agrees with them, even when there is evidence to the contrary. I suppose if the bill passes, we'll find out in November.

Volunteering (Others) For A Suicide Mission

I usually enjoy William Saletan's take on things, but this piece makes a terrible, terrible argument. Saletan argues that wavering Democrats ought to vote for the health care bill that's currently on the table, even if their constituents have made it abundantly clear that they oppose it and will punish an affirmative vote at the polls this fall. Failure to do so, he claims, would be undemocratic:

Democracy isn't about doing what might sell in the next election. It's about
doing what you promised in the last one. If you're in Congress, and if you think
this bill is good for the country, vote for it. Even if it costs you your job.

This is, to put it delicately, pure poppycock. Firstly, it's easy for a pundit, who will still be employed regardless of whether this bill passes, to argue that embattled legislators ought to jump on an electoral grenade to pass it. It's easy to dismiss the importance of someone else's career when you view it as an obstacle to something you want, but the view of said legislators is likely justifiably different. Secondly, the assertion that ObamaCare as it is currently proposed is what the Democrats "promised" in the last election is absurd. To begin with, I see little persuasive evidence that the Democrats' 2008 victories were a sudden endorsement of the progressive platform rather than merely a repudiation of Bush-era Republicanism. Many of the so-called "blue dogs" won their seats by running as DINOs who distanced themselves as much as they reasonably could from the progressive agenda, including expensive entitlement expansions. Furthermore the health care reform Obama promised in his campaign is different from the bill that is actually on the table. For one, he opposed the (extremely unpopular) insurance mandate when he was elected, but has now come around to endorsing it, and the bill includes it. Even if one accepts the dubious proposition that the public elected Democrats because they want "health care reform", it's pretty clear the reform they want is not the reform they're being offered. Moderate democrats in swing districts, not being morons without a shred of political self-preservation instinct, are aware of this discrepancy. It appears Saletan is not.

Here's a historical analogy. In 1941, Jeannette Rankin of Montana was the only member of Congress to vote against declaring war on Japan after the attack on Pearl Harbor, on the grounds of her pacifist, isolationist principles. When she was elected in 1940, the prevalent mood of the country, and of her constitutuents particularly, was similarly pacifistic and isolationist, and she was clearly voting on the promise she'd made during the 1940 campaign to keep America out of the war. In the interim, however, an attack by a foreign power had radically shifted the national mood, and her vote, while principled, could hardly be said to represent the will of the people. The healthcare debate presents a similar, though much less dramatic, situation. In 2008, people were voting on somewhat different issues. While the economy had already begun to crash, it hadn't been rattling along in a ditch for eighteen months already, the war in Iraq was a bigger concern, and "healthcare reform" was just a vague phrase that everyone was free to interpret as meaning "the specific changes in healthcare that I personally want". Those circumstances no longer hold, and legislators are responding to that.

Saletan concludes by saying this:

...this is too big a vote to cast on the basis of politics. Every so often, a
bill comes along that's bigger than anything your predecessor got to touch.
You're the lucky bastard who had your seat in 2010, when that bill reached the
floor. And here you are, worrying about your career, when the purpose of your
career is staring you in the face.

For a journalist who is unabashedly enthusiastic about ObamaCare, it's clear that passing it is the purpose of any Democratic legislator's career. Unfortunately for hesitant Democratic legislators themselves, that's more difficult to determine.