The Consequences of Overpromising on Obamacare

October 07, 2016

Dear Reader (particularly those of you in need of a hug),

I'm having a case of the Mondays on a Friday. I keep poking at the computer screen like an orangutan with a Speak-and-Spell. (For the kids out there, a Speak-and-Spell is what my generation called an iPad.) I'm taking a much-needed vacation day from writing about that whole presidential-election thing. But, when I look at the all the other headlines, I kind of feel like I'm visiting a museum after the zombie apocalypse. It's not that these things aren't important, they just seem like they're from another time.

You have to stare at the painting or the sculpture for a few minutes until you can conjure the memory of why this stuff matters.

Take, for example, the dawning realization that Obamacare is like a Claymation version of Wagner's Der Ring Des Nibelungen staged entirely with characters sculpted out of fecal matter: The mother of all sh*t shows.

I know what you're thinking: "Drew Brees is an immortal who actually served as the 19th president of the United States." The interesting thing is that this means he and Alec Baldwin, who coincidentally served as the 13th president, may have to fight with swords because there can be only one.

Oh no wait, that's what I was thinking.

You're thinking: "Great, now Jonah is going to do a highly detailed uber-wonky analysis of risk corridors and premium-support efforts with a special focus on Kentucky's failure to make Kynect work." But fear not, as Bill Clinton said when they tried to get him to attend a sex-addiction support group, I'm not going there.

It's difficult to exaggerate how arrogant supporters of Obamacare were back in 2009–10. Imagine trying to exaggerate the heat of the sun to the point where people would say, "Look, I know the sun is hot. But come on, it's not that hot." It's the same thing with the arrogance of Obamacare pushers. The English language simply doesn't provide the adjectives required to overstate the smugness of the Smart Set during the fights over the Affordable Care Act. It wasn't just that they knew they were right, they acted as if critics were flat-earthers, birthers, know-nothings, cranks, weirdos, and maroons. This was necessary because the "reformers" were the protagonists in our MacGuffinized political discourse. They had to be heroes and their opponents villains.

Obamacare was going to extend life-expectancies, save money, wildly expand the number of people getting insurance coverage, improve health care generally, lower premium costs, help small business become more competitive, bring back Firefly, restore Shoeless Joe Jackson's reputation, transform pizza and beer into carb-free fare, and make Bill Clinton's mysterious cold sore disappear. Okay, I made up those last few. But they were just as unlikely to come to pass.

I will admit, I was premature in my Obamacare grave dance in 2013 when I wrote this, uh, rhetorically excessive gloat-o-rama. I read too much into the fact that President Obama had hired the finest computer programmers the Amish community has ever produced to design the Obamacare website. It turned out that the lethal internal contradictions of Obamacare needed more time to play themselves out, like a man stabbed with a Strontium-90 tipped umbrella or a victim of the Five Point Palm Exploding Heart Technique.

But here we are. Take Kim Strassel in the Wall Street Journal:

States are reporting premium increases of 60%, 70%, 80%. Insurers, sagging under losses, are fleeing. Nearly a third of U.S. counties are now down to a single ObamaCare plan. Seventeen of 23 ObamaCare co-ops have imploded. Tennessee's insurance commissioner warns her state's exchange market is "very near collapse."

Brother Geraghty has more here.

Even Bill Clinton couldn't stop himself from lamenting the plight of hardworking Americans who "wind up with their premiums doubled and their coverage cut in half and it's the craziest thing in the world."

But at least those obstreperous elderly nuns will have to pay for birth control!

No, Obamacare will not collapse imminently — or maybe not even ever. But that is not because it is "working" as a public policy. Countries around the world have carried the husk of their far more socialized health-care systems for generations. Rent control, the minimum wage, and countless other economically ridiculous policies endure because they satisfy the political needs of politicians, bureaucrats, and a whole phylum of remora-like rent-seekers. That's why Milton Friedman said, "Nothing is so permanent as a temporary government program." He should know, given how it was basically his idea to implement tax-withholding from paychecks as a wartime measure.

You might say that these programs also help real people too. And that is true. But wealth distribution efforts always help someone. And those someones become vested interests who demand perpetuation of the status quo. If the federal government implemented a program to give every left-handed person in the country $20,000 a year free and clear (no doubt to compensate for the fact that such people are witches), you can be sure the Left Handed Association of America would work assiduously to protect their entitlement.

The VA health-care system is a moral outrage, but it resists actual reform because the interests of the VA bureaucracy and their associated allies are more important than the interests of vets in need of quality health care.

So it may be with Obamacare. For political and psychological reasons, liberals are invested in the idea that Obamacare is working. To the extent they are willing to concede it has problems, they are problems that can only be remedied by giving the government more power and control. Indeed, for many supporters, like Barney Frank, Obamacare was always supposed to be a stepping stone to single-payer health care. This is the essence of modern progressivism, the ratchet can only turn in one direction — towards more power and control for the people in charge.

The Way the World Works

One of the major themes of the book I'm working on should be familiar to longtime readers of this "news"letter. It boils down to a simple insight: Complexity is a subsidy. The more complex you make the rules, the more you reward people with the cognitive, material, or social resources necessary to get around them. Big corporations tend not to object to more burdensome regulations because they can afford to comply with them. Dodd-Frank was great for the "too big to fail" crowd. But it has been murder on community banks that don't have the resources to comply. As Lloyd Blankfein, the CEO of Goldman Sachs, put it:

It's very hard for outside entrants to come in and disrupt our business simply because we're so regulated. We hear people in our industry talk about the regulation, and they talk about it with a sigh about the burdensome of regulation. But in fact in some cases the burdensome regulation acts as a bit of a moat around our business.

But you've been hearing this stuff from me for years. Let's get back to the arrogance thing. It seems to me a big part of the problem with progressive elites these days is that they lack self-awareness. That elites arrange affairs for their own self-interest is an insight that was already ancient when Robert Michels penned his Iron Law of Oligarchy. But ever since the progressives concocted their theories of "disinterestedness," they've convinced themselves that they are not in fact a self-serving elite. Give feudal aristocrats their due: They were a self-dealing crop of rent-seekers and exploiters, but at least they were open about the fact that they believed they had a divine right to sit atop the social pyramid. Today's progressive aristocracy is largely blind to the fact that their cult of expertise isn't really about expertise; it's about organizing society in a way that reinforces their status and power.

Well, most of them are blind to it. Occasionally the mask slips. Jonathan Gruber, one of the chief architects and financial beneficiaries of the health-care "reform," told audiences that Obamacare was designed "in a tortured way" to hide the fact that "healthy people pay in and sick people get money." They had to do it this way to get around the inconvenient "stupidity of the American voter." A feudal lord who talked this way about his serfs wouldn't get any grief for it. But in America such honesty gets you rendered an un-person.

The Death of Trust

This is a much larger phenomenon than health-care policy. It manifests itself throughout the media and the New Class generally. I promised not to talk about the election, but I will make a glancing reference just to illustrate the point. Mark Hemingway had a fantastic tweetstorm yesterday (followed up by an article on the same topic). Dean Baquet, the editor of the New York Times, was asked about the press' problems covering Donald Trump. He said:

I think that everybody went in a little bit shell-shocked in the beginning, about how you cover a guy [Trump] who makes news constantly. It's not just his outrageous stuff . . . he says things that are just demonstrably false.

I think that he's challenged our language. He will have changed journalism, he really will have. I was either editor or managing editor of the L.A. Times during the Swift Boat incident. Newspapers did not know — we did not quite know how to do it. I remember struggling with the reporter, Jim Rainey, who covers the media now, trying to get him to write the paragraph that laid out why the Swift Boat allegation was false . . . We didn't know how to write the paragraph that said, "This is just false."

As Mark lays out, this is outrageous nonsense. The Swift Vets may have indulged in rhetorical overkill at times, but the simple fact is that John Kerry was an outrageous, self-promoting, and slanderous liar about his military service. The media, led by the New York Times, circled the wagons around Kerry and turned "swift-boating" into an adjective for political calumny. The proper definition of swift-boating should be: "To raise inconvenient facts about a politician who lied." As Mark writes:

And so we have the editor of the New York Times citing the Swift Vets as "just false" in the process of wondering why Americans don't trust the media in the Age of Trump. The answer is that media organizations such as the Times eroded all their credibility trying to elect previous Democratic candidates by telling readers things were definitively false when readers damn well knew that there were substantive facts they were actively choosing to ignore. In fact, "Swift Vets" is now some sort of media pejorative, even though the term is an Orwellian attempt to recast and simplify events so as to obscure discomfiting and politically consequential debates that New York Times editors don't want to have.

I've written about the media's cry-wolf problem before. The relevance here is that I don't think most of the reporters and editors who carried water for every Democratic presidential candidate for the last 50 years believe that's what they were doing. They convinced themselves that they were being objective or "disinterested." They served as praetorian guards for the progressive elite without understanding just how many buckets of water they schlepped up from the river bank. This is why I shed so few tears for the dying of the myth of the "objective media." Partisan newspapers are as old as newspapers. What was new — and now dying — is this warmed over Lippmannesque B.S. that there's some kind of science to journalism that immunizes it from partisanship. At least 19th-century newspapers were honest with their readers about where they were coming from. Newspapers like the New York Times suffer from the same delusions that blind the progressive elites generally. They think they're just telling the hard truths, when in fact they are telling the truths (and occasional lies) that support their own self-serving narrative.

Various & Sundry

My column today is on one of my perennial peeves: the laziness and frequent idiocy of generational stereotyping.

My first column this week was about you-know-who's gift for self-sabotage, with a bonus anecdote about the mash note he sent.

If you're feeling Trump-deprived, I did a long interview with Seth Stevenson at Slate about why I won't ever support Hillary Clinton.

Thanks for all the kind words from the folks who saw my gig on Turner Classic Movies this week. I'd post the video, but that's apparently beyond the technological ken or Barbie of the web monkeys. I'm told you can see it on demand or through the TCM app. I have to say I've been surprised by how many people have never seen A Face in the Crowd, certainly one of the five best movies on politics and media ever made.

I was co-host for a book party for my old friend Tevi Troy last night. His Shall We Wake the President is a really insightful and interesting read on the role of presidents and disasters. It's a very accessible, a non-partisan sort of mix of history and policy. Unfortunately, he didn't include a chapter on what to do when the president him or herself is the disaster. Maybe he'll update it for the paperback.

Canine Update: So Zoë has had a good run. She caught another squirrel this week outside my house. And by "caught" I mean she killed it. (She's not one for letting squirrels off with a warning for their outrageous squirreliness.) Then, a couple days later, our indispensable dog-walker Kirsten reported that on the trail Zoë caught a chipmunk and dispatched it as well (for suspected collusion with the squirrel menace). Fortunately, she seems to have grown out of the habit of swallowing smaller vermin whole. Instead she dropped it on the ground and then rolled around on it for a good five minutes. On the other hand, she's acquired a troubling taste for baseballs. She likes to lay on the end of the bed while the humans are sleeping and strip the leather cover off. Then, as best we can tell, she eats it. We were worried that she might get some intestinal blockage or some other gastric distress from doing this, but apparently she's outsourced that to Pippa who's spent the week with persistent case of stewed bowels.

One important note: As I have said many times, I do not really like it when Zoë kills cute things. I'm a big wuss about such matters, and even if I weren't, disposing of small mammal carcasses is not one of my favorite pastimes. Still, this is what dingoes do. And it's not like squirrels are an endangered species. The city is overrun with them because of the lack of natural predators (which might also explain the epidemic of scary clowns around the country). But whenever I write or tweet about such things, a handful of people get angry with me and ask, "Why do you let your dog kill squirrels?" I think this is hilarious. Zoë kills squirrels for the same reason that water seeks its own level, birds fly south for the winter, and Sidney Blumenthal installs a secret soundproofed room in every house he moves into: It's her nature. I no more "allow" her to kill squirrels than I forbid her to do long division or speak in German. The Dingo's got to dingo. Maybe I'll get some T-shirts made.

Debby's Friday links

Smartphones replaced with butter

Putting big things in perspective

Mean Girls recreated with dogs

A real-life Doug from Up

Building human towers

How much TV stars make

Back to the Future self-lacing sneakers are now real

The rise and the fall of the Roman Empire, in dynamic map form

How the president orders nuclear war

Are these the movies with the most on-screen kills?

How likely you are to crash into a deer based on where you live