Imagine yourself as a regular commentator on public affairs – maybe a paid pundit, maybe a supposed expert in some area, maybe just an opinionated billionaire. You weigh in on a major policy initiative that’s about to happen, making strong predictions of disaster. The Obama stimulus, you declare, will cause soaring interest rates; the Fed’s bond purchases will “debase the dollar” and cause high inflation; the Affordable Care Act will collapse in a vicious circle of declining enrollment and surging costs.
But nothing you predicted actually comes to pass. What do you do?
You might admit that you were wrong, and try to figure out why. But almost nobody does that; we live in an age of unacknowledged error.
Alternatively, you might insist that sinister forces are covering up the grim reality. Quite a few well-known pundits are, or at some point were, “inflation truthers,” claiming that the government is lying about the pace of price increases. There have also been many prominent Obamacare truthers declaring that the White House is cooking the books, that the policies are worthless, and so on.
Finally, there’s a third option: You can pretend that you didn’t make the predictions you did. I see that a lot when it comes to people who issued dire warnings about interest rates and inflation, who now claim that they did no such thing. Where I’m seeing it most, however, is on the health care front. Obamacare is working better than even its supporters expected – but its enemies say that the good news proves nothing, because nobody predicted anything different.
Go back to 2013, before reform went fully into effect, or early 2014, before the numbers on first-year enrollment came in. What were Obamacare’s opponents predicting?
The answer is, utter disaster. Americans, declared a May 2013 report from a House committee, were about to face a devastating “rate shock,” with premiums almost doubling on average.
And it would only get worse: At the beginning of 2014 the right’s favored experts - or maybe that should be “experts” - were warning about a “death spiral” in which only the sickest citizens would sign up, causing premiums to soar even higher and many people to drop out of the program.
What about the overall effect on insurance coverage? Several months into 2014 many leading Republicans – including John Boehner, the speaker of the House – were predicting that more people would lose coverage than gain it. And everyone on the right was predicting that the law would cost far more than projected, adding hundreds of billions if not trillions to budget deficits.
What actually happened? There was no rate shock: average premiums in 2014 were about 16 percent lower than projected. There is no death spiral: On average, premiums for 2015 are between 2 and 4 percent higher than in 2014, which is a much slower rate of increase than the historical norm. The number of Americans without health insurance has fallen by around 15 million, and would have fallen substantially more if so many Republican-controlled states weren’t blocking the expansion of Medicaid. And the overall cost of the program is coming in well below expectations.
One more thing: You sometimes hear complaints about the alleged poor quality of the policies offered to newly insured families. But a new survey by J.D. Power, the market research company, finds that the newly enrolled are very satisfied with their coverage - more satisfied than the average person with conventional, non-Obamacare insurance.
This is what policy success looks like, and it should have the critics engaged in soul-searching about why they got it so wrong. But no. Instead, the new line – exemplified by, but not unique to, a recent op-ed article by the hedge-fund manager Cliff Asness – is that there’s nothing to see here: “That more people would be insured was never in dispute.” Never, I guess, except in everything ever said by anyone in a position of influence on the American right. Oh, and all the good news on costs is just a coincidence.
It’s both easy and entirely appropriate to ridicule this kind of thing. But there are some serious stakes here, and they go beyond the issue of health reform, important as it is.
You see, in a polarized political environment, policy debates always involve more than just the specific issue on the table. They are also clashes of world views. Predictions of debt disaster, a debased dollar, and Obama death spirals reflect the same ideology, and the utter failure of these predictions should inspire major doubts about that ideology.
And there’s also a moral issue involved. Refusing to accept responsibility for past errors is a serious character flaw in one’s private life. It rises to the level of real wrongdoing when policies that affect millions of lives are at stake.
Comments