Tuesday, March 7, 2017

Obamacare and Trumpcare: The Trouble with Facts

This morning on NPR some voice mentioned that only 9% of Americans get their insurance through Obamacare.  This stunned me because, to listen to President Trump talk about it, to hear the Republicans rant, as they voted over 60 times to kill Obamacare, I thought for sure this must be the dominant form of healthcare insurance in this country, like the National Health Service in England.

So I asked Professor Google about this.

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And, it turns out, the voice was correct, but actually I heard it wrong. She must have said "3%" not "9%."  It's 9 million people.  Somehow we always hear the number 22 million will lose their healthcare if ACA were killed today.
Either way, we are only talking about insuring a small segment of the population.




Now, I realize 2.9% still comes out to be a big number--9 million--but that 2.9%/9 million includes my son.
Still, we are not talking a program the size of Medicare here.
Maybe we should be. Maybe, as Bernie Sanders suggests, we should be offering Medicare for anyone who wants to sign up for it. 
You might see a stampede away from employer based health insurance. Or maybe not.   People might see they get better coverage through private insurance,as some unions have negotiated "Cadillac policies" for their members. But private insurance companies are scared to death of having to compete with Medicare, which is, for the most part, beloved because it serves its beneficiaries well.

But these substantive arguments, about numbers of people affected, dollars and cents, costs and benefits are tough to keep in mind. 

Trump simplifies things. The Republicans sympathize things. Of course, they have had that luxury because governing is complex; complaining is simple.
Trump doesn't get caught up in all those difficult numbers. He just emotes.

I've been reading Jacob Hacker's and Paul Pierson's  wonderful book "Winner Take All Politics" in which they  note most people cannot retain in their minds the numbers and evidence which policy wonks, politicians (except Trump) marshal to substantiate their arguments.  Most people can only retain the conclusions. That's all President Trump gives us:  Oh, it'll be great. It'll be great coverage for less money and you'll be so happy.

On the other hand, some liberal politicians have been able to crystallize their points effectively; some liberals can avoid getting bogged down in details and give the summary in understandable language, like this speaker:

"For too many of us the political equality we once had was meaningless in the face of economic inequality. A small group had concentrated in their own hands an almost complete control over other people's property, other people's money, other people's labor--other people's lives. For too many of us life was no longer free; liberty no longer real; men could no longer follow the pursuit of happiness. Against economic tyranny such as this, the American citizen could appeal only to the organized power of Government."

This is not Bernie Sanders. This is Franklin Delano Roosevelt speaking.
We need someone like him now, or we will have Trump, McConnell, Ryan, Rand Paul and Rush Limbaugh.






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