George Will and Megan McArdle take issue with the Census Bureau's figure from 2008 that 46 million Americans are in need of health insurance. They also disagree with President Obama's statement in his speech to Congress last week that there are "more than 30 million American citizens who cannot get coverage." Will estimates that there are "perhaps 20 million persons who are protractedly uninsured." McArdle suggests that a better statistic would be "more than 15 million" Americans.
Anthony Wright has a good response on TNR. I pretty much agree with him and frankly don't have much to add to what he says.
The debate over these statistics can be a red herring. There's a reason why conservatives and libertarians are taking a different stance on how to interpret the statistics than liberals. You can't interpret the data without expressing your ideology. If you're a liberal, you're likely to view the number of Americans without insurance as a crucial fact, maybe the most important fact in the whole health-care debate. If you're a conservative, you're likely to see that statistic as a smokescreen covering up the reality of the situation.
For instance, Will thinks the statistics are misleading because they gloss over the transitory nature of being insured. He says the 46 million figure is just
a "snapshot" of a nation in which more than 20 million working Americans change jobs every year. Many of them are briefly uninsured between jobs. If all the uninsured were assembled for a group photograph, and six months later the then-uninsured were assembled for another photograph, about half the people in the photos would be different.But Will bizarrely implies that his observation only mitigates the problem. It's arguably worse than the statistics suggest, since a "snapshot" fails to convey the fact that people who are insured right now need to worry about whether they'll be insured in the future. Wright points out:
When just looking at a two-year period, far more people--nearly 1 in 3--find themselves uninsured.It's understandable that opponents of health-care reform want to make the number of uninsured seem as insignificant as possible by quibbling over which ones we should really be counting. (Illegal immigrants? Legal immigrants? Poor people who aren't on Medicaid? Households making $75,000? $50,000?) It might be comforting, as Wright puts it, "to "think of the uninsured as a discrete population, one that can be marginalized." But the real problem is much broader: our health care is contingent on something as unreliable as employment, with only an incomplete safety net for Americans in need. Those of us who feel strongly that this is a grave problem aren't going to have our minds changed by the pseudo-statistical debate over how many uninsured Americans actually matter.
5 comments:
Those of us who feel strongly that this is a grave problem aren't going to have our minds changed by the pseudo-statistical debate over how many uninsured Americans actually matter.
If the government can't figure out how many people don't have insurance, or understand the nuances of the types of people without insurance, how can it be trusted to produce complicated laws governing insurance, or calculate the eventual costs of those laws?
how can it be trusted to produce complicated laws governing insurance
The current system already involves the government making complicated laws that govern insurance. The question is just whether to stay with this status quo or reform the system. Government regulation is involved either way.
JAC: The question is just whether to stay with this status quo or reform the system.
This is where I would say you have made an error. I can see how you would come to this belief as it is espoused by many politicians, but very often when people tell you there are only so many options, there are in fact more. They limit the options on purpose to increase the chances that you pick the one they favor.
Many people who are in opposition to Obama's five or six different health care bills are in favor of reform, but targeted reform. They assume the government is incompetent and that this incompetence will only be exacerbated by passing giant, complicated bills. They want to see issues examined one at a time, with input from all the parties who have information. They don't want to see back-room deals where entire industries are given special treatment for agreeing to keep their mouths shut. They want to examine results and see experimentation. They don't want to see one big bill passed with the promise that no more health care reform bills will ever be needed again.
They want options, and more than just two.
Oh, I didn't mean to say that there are only two options: the status quo or the specific pending reform. I was really just saying a truism: we can either stay with what we have, or change. I think anyone debating this issue should decide which of those paths they prefer and then affirmatively justify that choice. Of course you're right that one valid position would be "The system needs a major reform, but not the one being proposed." But far too many opponents of the health-care bills spend almost all their energy attacking what they're against ("Obamacare") without making a compelling case for what they're for (with the striking exception of tort reform, which they apparently love to talk about).
I agree that it was silly for Obama to promise that after he's done with the issue no more reform will be needed again. The line in his speech about how he isn't the first but will be the last president to deal with this issue was clumsy and implausible. But if his rhetoric can be overly grandiose at times, that's not what worries me most about health care in America.
JAC:Of course you're right that one valid position would be "The system needs a major reform, but not the one being proposed."
Make it "The system needs major reforms, but maybe not all the ones being proposed."
But far too many opponents of the health-care bills spend almost all their energy attacking what they're against ("Obamacare") without making a compelling case for what they're for (with the striking exception of tort reform, which they apparently love to talk about).
Many of the people against Obamacare do like the system we have, or at least they can see positives. If we have a bad system and you come up with a reform which is equally bad, it isn't my responsibility to come up with better reforms, but yours.
Remember what happened to the CEO of Whole Foods? They didn't debate his ideas in Congress. Much of what we have on this debate, from both sides, is rhetoric, and that is all most people seem to care about.
But if his rhetoric can be overly grandiose at times, that's not what worries me most about health care in America.
People like Megan McArdle are trying to get you to worry about more things. And the point of this discussion is to get people to understand why people like her are debating the numbers. If the numbers suck and the government uses those numbers to plan healthcare, then maybe one of the reasons its plans have problems is bad data.
I find it troublesome that opponents of "the one giant healthcare bill" have very specific complaints (sometimes reading directly from bills in question) and all they get back is rhetoric; or even worse, their complaints at first get dismissed and then hurriedly addressed, as if legislators had no idea what is going on.
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