Tweet This
- The fact that more Americans continue to oppose this misguided law than support it strongly suggests that American voters are far less stupid than progressives like Jonathan Gruber think they are
- The fact that more Americans continue to oppose this misguided law than support it strongly suggests that American voters are far less stupid than progressives like Jonathan Gruber think they are
According to Roger Cohen, in a recent New York Times op-ed, the Iran agreement is the "Obamacare of foreign policy." I'll confess I began reading the piece expecting it to be about the litany of deceptions and false promises being made by President Obama about that agreement. In my mind, that would have made the connection with Obamacare crystal clear. Instead, imagine my shock when I encountered this money quote:
The deal will become the “Obamacare of foreign policy,” Nicholas Burns, a Harvard professor and former under secretary of state, told me. Yes, it will. That is, it will be something sensible (at least in the eyes of most people across the world) to which Republicans will never acquiesce and which they will try to use in every conceivable way to undermine a president they loathe.
Neither Roger Cohen nor Nicholas Burns is an expert in health policy; likewise, I freely concede I am no expert in foreign policy, so I won't squander bandwidth on the merits of this comparison. I will note that the president is elected by the people of the United States and expected to do what they wish, not what "most people across the world" might wish. In that regard, from its inception through today, Obamacare virtually always has been opposed by a majority of the American public.
No one can dispute this inconvenient truth: since November 2009, there hasn't been a single day that the the RealClearPolitics.com poll average has shown that supporters outnumber opponents of the law. Moreover, of the literally hundreds of polls tracked by RealClearPolitics.com over that period, less than a half dozen have shown proponents outnumbering opponents. These polls have been conducted by the most reputable polling organizations in the business, including Gallup, NBC News/Wall Street Journal, CNN/Opinion Research, CBS News/New York Times, ABC News/Washington Post. No one can credibly claim that my conclusion is based on cherry-picked data. Indeed, that's the whole purpose of the RCP poll average: to produce a number that both sides of the aisle can accept (indeed, that's the reason the RCP poll average is being used to determine who gets to participate in the Republican presidential debates).
But Mr. Cohen's' view that Obamacare is a "sensible" law to which Republicans will never acquiesce appears quite representative of the prevailing progressive view. It's certainly the view of Paul Krugman, who has bragged of the "inconceivable success of Obamacare" and who evidently thinks public opinion on the matter has been distorted by an "Obamacare disinformation loop." Without naming names, my own Twitter experience suggests there are plenty of other progressives who concur with this basic view of Obamacare. But those willing to let empirical evidence be their guide now realize that Obamacare deserves an F grade on at least 5 significant promises made for it:
- Universal coverage
- No new taxes on the middle class
- Annual premium savings of $2,500
- No increase in the deficit
- You can keep your plan if you like it
So it led me to wonder: did President Obama really believe "five impossible things before breakfast" (to paraphrase Lewis Carroll)? Or was he knowingly pulling a fast one on the American electorate when he uttered those various promises (some at least three dozen times). In short, was the president delusional to make such grandiose promises for his health plan or was he deliberately deceptive?
The Case for Deception
It's undoubtedly the case that candidate and then President Obama was surrounded by at least some advisors who had no qualms about pulling the wool over the eyes of the public. The videotapes of Jonathan Gruber are proof positive of a pretty contemptuous attitude about "the stupidity of the American voter" and the huge advantage that lack of transparency accorded the bill. Gruber ultimately confessed "Look, I wish Mark was right that we could make it all transparent, but I’d rather have this law than not."
So deliberately making false claims about what the bill would or wouldn't do certainly is consistent with this "whatever it takes" attitude towards ramming through what President Obama from the get-go hoped would be his signature domestic policy achievement. That said, to argue that the president knowingly lied requires strong evidence. Here's three concrete examples:
If You Like Your Plan You Can Keep Your Plan. It's well-known that the president's claim that if you like your plan you can keep your plan eventually was declared Lie of the Year for 2013 by PolitiFact.com. As Politifact.com explained its reasoning:
Obama’s ideas on health care were first offered as general outlines then grew into specific legislation over the course of his presidency. Yet Obama never adjusted his rhetoric to give people a more accurate sense of the law’s real-world repercussions, even as fact-checkers flagged his statements as exaggerated at best. Instead, he fought back against inaccurate attacks with his own oversimplifications, which he repeated even as it became clear his promise was too sweeping.
President Obama ultimately apologized, saying ""We weren’t as clear as we needed to be in terms of the changes that were taking place, and I want to do everything we can to make sure that people are finding themselves in a good position, a better position than they were before this law happened. And I am sorry that they are finding themselves in this situation based on assurances they got from me." But he also claimed "There is no doubt that the way I put that forward unequivocally ended up not being accurate," taking care to add: "It was not because of my intention not to deliver on that commitment and that promise. We put a grandfather clause into the law, but it was insufficient."
Of course to take this claim at face value implies that his own Department of Health and Human Services ran amok in its rule-making, producing a rule that violated the president's own intentions regarding how the law was supposed to work. And yet the president a) expressed no outrage whatsoever at his own agency straying off the reservation in this fashion; b) nor was anyone at DHHS fired or otherwise held to account for this renegade action; c) nor did the president insist on the rule being altered. Instead he tossed the whole can of worms to state insurance commissioners, giving them authority to extend plans (temporarily through October 1, 2016).
The most charitable interpretation one might offer is that the president changed his mind, meaning that he did not willfully engage in deception in making the original promise. But upon having the realities of how the law would have to play out explained by advisors, he reluctantly acceded to having his own promise broken. But even staunch Obama supporter Clarence Page (a Chicago Tribune columnist) had a more hardline view: "I don't feel good about calling out Obama's whopper, because I support most of his policies and programs. But in this instance, he would have to be delusional to think he was telling the truth." Mr. Page clearly does not think President Obama was delusional in making this promise and I have to concur.
Annual Premium Savings of $2,500. The promise that his plan would save the "typical" American $2,500 took a surprisingly similar pattern to the one just described. It began as a flagrantly ridiculous promise made in June 2008: We’ll lower premiums by up to $2,500 for a typical family per year. . . . We’ll do it by the end of my first term. Indeed the advisor who had made the calculation underlying this promise later conceded it was a mistatement: the "correct" claim should have been that his health plan would reduce total health expenditures (as opposed to premiums) by $2500 a year.
As the promise was repeated more than a dozen times thereafter, the assertion that it would happen by the end of his first term disappeared, the core promise was retained. While campaign ads corrected the promise ("Barack's policies will provide health care cost reductions of about $2,500 for the typical family"), Mr. Obama himself continued to insist on using the incorrect "premium savings" formulation throughout the campaign. He did so despite the rebuttals of pro-Obamacare health policy experts such as Larry Leavitt, a senior vice president at the Kaiser Family Foundation:
There's no question premiums are still going to keep going up. There are pieces of reform that will hopefully keep them from going up as fast. But it would be miraculous if premiums actually went down relative to where they are today.
Similarly, then the original promise was made, Factcheck.org charitably deemed the claim as “overly optimistic, misleading and, to some extent, contradicted by one of his own advisers.” The Washington Post less charitably awarded it Two Pinocchios (“Significant omissions or exaggerations”). Yet rather than listen to experts who knew far more about health policy than he did, President Obama on July 16, 2012 essentially doubled-down on his promise, assuring small business owners “your premiums will go down.” He made this assertion notwithstanding the fact that in three separate reports between April 2010 and June 2012, the Medicare actuaries had demonstrated that the ACA wouldincrease health spending. To its credit, the Washington Post dutifully awarded the latter claim Three Pinocchios (“Significant factual error and/or obvious contradictions.”)
So again we see the familiar pattern. A promise that began perhaps as campaign hype eventually morphed into a knowing deception by a president who should have known better.
No New Taxes on the Middle Class. Here again, we have a pretty unequivocal promise whose achievement is readily measurable: “I can make a firm pledge under my plan, no family making less than $250,000 a year will see any form of tax increase. Not your income tax, not your payroll tax, not your capital gains taxes, not any of your taxes.” Anyone with a rudimentary understanding of economics should have understood that the myriad of taxes levied on health insurers, drug manufacturers, pharmaceutical companies, employers (and especially the individual mandate) would ultimately come out of the hides of real families, including middle class taxpayers. I will not waste time here explaining something I've explained in great detail elsewhere. Suffice it to say that when all is said and done, the very families the president assured us wouldn’t see their taxes go up a dime to bankroll health reform will shoulder close to 70 percent of Obamacare’s tax burden.
If the president's defense is that these various taxes are not levied directly on families--even though they assuredly are borne by them--then in my view that represents exactly the same type of deception championed by Jonathan Gruber. It takes advantage of the reality that most Americans are either not well-versed in economics or not paying attention to the details of something they have entrusted their leaders to handle. It surely does not enhance the public's trust in government to have to wonder whether their president is parsing words in the fashion of a former president who convinced himself he wasn't lying because "It depends on what the meaning of the word 'is' is."
The Case for Delusion
Universal Coverage. In contrast, the universal coverage promise was short-lived and arguably a case of delusion rather than deliberate deception. Candidate Obama promised on June 23, 2007: “I will sign a universal health care bill into law by the end of my first term as president that will cover every American.” Recall that throughout the fierce debates with Hillary Clinton, he clung fast to his claim that his plan could achieve that goal without an individual mandate--something that no responsible health policy analyst on either side of the aisle claimed was possible. Bizarrely, Politifact.com views this as a campaign promise kept since President Obama signed into law a plan that included an individual mandate with few exemptions.
Yet the latest CBO projections show that when the law is fully implemented in 2020, there still will be 26 million uninsured representing 9 percent of the non-elderly population. Compare this to the 5.6 to 8.9 percent of the population that CBO estimated was uninsured back in 1978 (a problem judged so severe that it had led to calls by both President Nixon and President Carter for national health insurance!). So while Obamacare assuredly has reduced the number of uninsured--the exact amount being highly contested--no one could credibly claim the "uninsured problem" will be solved by the law in its present form.
No Increase in the Deficit. As best I can tell from the public record, this is one promise the president may well continue to believe, along with numerous defenders of the law. Once again, I have explained in great detail elsewhere just how bogus this claim is. Indeed less than four weeks before the law even passed, Paul Ryan had deftly exposed all the “gimmicks and smoke-and-mirrors” underlying this claim right to the president's face. My own snap judgment from viewing that video repeatedly is that the president was present in the room during that epic takedown, but either couldn't hear what was being said (due to anger or shock) or dismissed it out of hand as being nothing more than Republican obstructionism. That is, I've seen no evidence in the public record that the president has ever actually intellectually engaged the forceful argument being presented in the sense of being able to accurately recount the logic and details of the argument and offering an intellectually coherent rebuttal to it. Others may well have a different view, but my impression is that the president was confronted with a very inconvenient truth that for whatever reason (e.g., avoiding cognitive dissonance) he elected to ignore.
Conclusion
Where does that leave us? I think there's a reasonably strong case that the president has time and again resorted to deliberate deception in trying to sell his health plan to the American public. But in fairness, one cannot rule out the possibility the president was simply delusional about some of the claims he made about his signature domestic policy achievement. Had the public bought these false promises hook, line and sinker, then there's no way Obamacare would continue to be underwater in public opinion polls. The fact that more Americans continue to oppose this misguided law than support it strongly suggests that American voters are far less stupid than progressives like Jonathan Gruber think they are .
READ CHRIS’ BOOK, The American Health Economy Illustrated (AEI Press, 2012), available at Amazon and other major retailers. With generous support from the National Research Initiative at the American Enterprise Institute, an on-line version complete with downloadable Powerpoint slides and companion spreadsheets has been made available through the Medical Industry Leadership Institute’s Open Education Hub.
Follow @ConoverChris on Twitter TWTR -0.67%, and The Apothecary on Facebook. Or, sign up to receive a weekly e-mail digest of articles from The Apothecary.
