What to Do When a High-Profile U.Chicago Economist Says the Airline, Telephone and Package-Shipping Industries Prohibit Use by Preexisting Flyers, Callers and Shippers: If you’re a liberal, take this ball and run with it!
There’s no question that the Affordable Care Act’s rollout has been “rocky,” to borrow the common parlance of the Beltway. The Web site troubles and shifting health coverage for some Americans, despite over-assurances from President Obama during the 2010 political debate, have naturally turned off some people. A much-ballyhooed poll from CNN yesterday shows that support for “Obamacare” has dropped to an all-time low.
But conservatives toasting the apparent turn in public opinion ought to look a little closer at the polling data. It’s true that only 35 percent of Americans favor the law, while 43 percent oppose it. But there’s a crucial third group: 15 percent oppose the ACA because it’s “not liberal enough.” That means that 50 percent of Americans either support the law or want policy changes that shift leftward.
— Should Democrats press the public option?, George Zornick, The Plum Line, Washington Post, Dec. 24
Wow. A man after my own heart. It’s a recognition that, with the single exception of the disastrous rollout of Healthcare.com, which is purely a technology issue, the high-profile issues concerning Obamacare since Oct. 1 highlight not generic problems with government involvement in healthcare insurance but instead the problems of a system that piggybacks on the for-profit private insurance industry and neo-federalism-structured federal programs that rely heavily or entirely upon cooperation of state governments.
Zornick, whom I had never heard of before last week when he began a stint as one of the short-term, rotating Plum Line bloggers–and who in my opinion is fabulous–is a liberal. And what’s happening, suddenly, is something I predicted in recent posts here: That the individual-market insurance industry’s fall-of-living-dangerously, during which (led apparently by the various Blue Cross companies) it drastically overplayed its hand in the last three months by, for example, telling premium-holders, falsely, that their cancelled policies could be replaced only by vastly-more-expensive policies, would trigger reinvigorated calls for a “public option for the single-payer market and maybe even for a single-payer option across the board.
But something else is happening, as well: The right is recognizing that the problems with Obamacare, rather than broadening the appeal of a return to the status quo, is instead more likely to dramatically broaden the appeal of a public option. And, because employers that provide healthcare coverage are scapegoating Obamacare for their unrelated decisions to further limit their already-increasingly-limited premium contributions and the like, the formerly unthinkable–a single-payer-for-all option–may well soon become the very thinkable.
Zornick broaches the possibility, writing:
So what if Democrats pushed for it? A public option would save $100 billion over 10 years, according to the Congressional Budget Office, and could offer respite from the plan cancellations and rate hikes that still persist with private insurers with the ACA in place.
There’s essentially no chance President Obama will take another bite at the health-care apple, especially with so many other priorities to tackle: his professed desire to combat climate change and income inequality before he leaves office, along with getting comprehensive immigration reform passed. But strategists on 2016 presidential campaigns ought to take heed.
Imagine a candidate who comes out early, and strong, for adding a public option to the ACA exchanges. It could become a signature issue with the liberal grass roots during the primaries, and it wouldn’t be a bad general election issue either — the polls in 2010 showed support for a public option among Republicans and independents as well as Democrats. As Ezra Klein has noted, the sudden disappearance of the public option from Democratic politics has been “a bit curious,” but perhaps its day is coming.
I do disagree with Zornick in one respect. I do not think this issue must or necessarily will wait until the 2016 Democratic presidential primary campaign gets underway. I think it should and may well be an issue in some congressional and Senate elections in 2014. And apparently, so does rightwing University of Chicago economist John H. Cochrane, whom I had never heard of until I began reading Paul Krugman’s NYT blog regularly.
In a cringe-inducing yet revealingly panicky Wall Street Journal oped published yesterday, Cochrane acknowledges that the substantive problems with Obamacare probably are making a single-payer option or a single-payer system attractive to a broad swath of people because, well, the status quo is becoming untenable and because Obamacare has shown that major changes in the role and manner of healthcare insurance in this country are actually possible. Yes! Here in this country! Just as they were in every other advanced society in the world!
Cochrane’s piece is titled “What to Do When ObamaCare Unravels: Health insurance should be individual, portable across jobs, states and providers, and lifelong and renewable.” The premise for his prescription is as transparently ludicrous as that prescription–the right’s favorite–has always been. The answer, he claims, is … complete nationwide deregulation of the insurance industry! Release the for-profit insurance companies to compete nationwide, and deliverance will come! Because, of course, it is the lack of nationwide competition that is what’s compelled the industry to dramatically raise premiums annually for decades now, and to create and increasingly limit “provider networks,” and to blacklist from the individual market anyone who once had a hangnail, and to spontaneously cancel policies or greatly increase the premiums of people when they do need medical care, and to have lifetime claim limits.
He does not offer an explanation for why nationwide competition would change any of this when statewide competition, even in very large states, has, suffice it to say, not. What he does instead is point to the deregulation of the telecom and airline industries, and to the competition that FedEx and UPS provide vis-a-vis the post office–the latter a.k.a. “the public option.” Specifically, he says:
On Dec. 3, President Obama himself said that “the only alternative that Obamacare’s critics have, is, well, let’s just go back to the status quo.” Not so.
What about the homeless guy who has a heart attack? Yes, there must be private and government-provided charity care for the very poor. What if people don’t get enough checkups? Send them vouchers. To solve these problems we do not need a federal takeover of health care and insurance for you, me, and every American.
No other country has a free health market, you may object. The rest of the world is closer to single payer, and spends less.
Sure. We can have a single government-run airline too. We can ban FedEx and UPS, and have a single-payer post office. We can have government-run telephones and TV. Thirty years ago every other country had all of these, and worthies said that markets couldn’t work for travel, package delivery, the “natural monopoly” of telephones and TV. Until we tried it. That the rest of the world spends less just shows how dysfunctional our current system is, not how a free market would work.
What? No mention of the cable companies? Comcast, Cox Communications and Time Warner Cable must be offended at the slight. (They’re people, remember.) But, setting aside the possibility that Cochrane is simply employing the modern right’s hallmark treatment of rightwing ideology as tangible fact, he seems to be claiming that AT&T, Verizon and Sprint preclude access to their service by people who may use it a lot; that airlines charge exorbitant surcharges for frequent flyers; and that FedEx and UPS keep narrowing the number of places you can use their service to ship to, and have a lifetime limit on the amount of diesel fuel your packages can consume–leaving you to the mercy of the public option for shipping and mailing.
The “natural monopoly” of telephones was in fact exactly that–a natural monopoly–until the advancement of technology made it no longer so. Same with the highly-regulated TV industry in this and other modern democracies. We, and other countries, deregulated these industries–i.e., “tried it”–when dramatic advancements in technology removed the need for regulated monopoly of those industries. I guess Cochrane thinks that fact will escape us all. Or else he thinks technology is about to replace human medical practitioners and expensive diagnostic apparatus, and that we shouldn’t bother to wait until this transformation is completed to switch from a state-by-state insurance free market to a national one.
I also guess that the WSJ headline writer thinks no one will read the full article. That subtitle, it turns out, should read, “Catastrophic health insurance should be individual, portable across jobs, states and providers, and lifelong and renewable.” That is what Cochrane says in the article.
That the rest of the world spends less shows how dysfunctional our current system is; we now have the stamp of authenticity of that fact from one of the horses’ mouths. And since our insurance system has always been a free-market one, it indeed shows how a national free market would work: the same as the current state-by-state free market here works. Which is to say, dysfunctionally. The fact that the rest of the advanced world spends less, and covers all its citizens, and–almost to a nation–achieves better results overall, shows how terrifically functional our system could be.
Much to the surprise of, I’d guess, just about everyone, the private healthcare insurance industry is employing Obamacare to unwittingly promote single-payer in one or another form. And Professor Cochrane, who knows this, has now given the prerequisite permission to the mainstream centrist punditry to acknowledge this as well. Thanks, AnthemBlueCross! And, thanks, Professor Cochrane.
Out of the mouths of babes …. (No apt metaphor left behind. That’s my motto!)