Commentary Magazine


Done In by the Numbers

Support for President Obama’s overhaul of the American health-care system is dropping because he’s not doing enough to “sell” the effort, according to a growing number of liberal voices. The public is deeply sympathetic to what Obama and Democrats want to do; the task for them is simply to instruct the unknowing masses on what is best for them (see Andrea Mitchell’s commentary here). In fact, the problem with Obama’s effort isn’t a failure to communicate; it is his inability to refute health-care facts and figures that, as they become more salient, are undermining his effort.

The most important facts are related to health-care costs. Barack Obama made “bending the curve” the cornerstone of his efforts. The status quo is unacceptable when it comes to the increasing cost of health care, Obama insists; his plan will make health care cheaper. On the contrary, it will dramatically increase costs. According to the Congressional Budget Office, the House bill would cost in excess of $1.2 trillion over the next decade; the Senate Finance Committee bill, around $1 trillion over 10 years. In the words of the CBO, “relative to current law, the [House] proposal would probably generate substantial increases in federal budget deficits during the decade beyond the current 10-year budget window.”

The second set of figures has to do with the number of people insured in America — 85 percent, according to the 2007 Census — and the vast majority’s (83 percent, according to a recent Washington Post–ABC News poll) being either “somewhat” or “very” satisfied with the health care they receive, with 81 percent feeling the same way about their insurance. The same poll also found that 84 percent of respondents said they were “very” or “somewhat” concerned that reform would increase their health-care costs, 82 percent worried it would reduce their health-insurance coverage, and 81 percent worried it would hurt the quality of their care.

President Obama is predicating his overhaul of health care on the assumption that most people are profoundly unhappy with the health care they are receiving. But when an overwhelming majority of the nation are more or less pleased with the product they are receiving, a radical redesign of the system becomes problematic.

The third set of figures has to do with the uninsured. As George Will pointed out in a recent column, there are 45.7 million uninsured.

But about 21 percent — 9.7 million — of the uninsured are not citizens. Up to 14 million are eligible for existing government programs – Medicare, Medicaid, SCHIP, veterans’ benefits, etc. — but have not enrolled. And 9.1 million have household incomes of at least $75,000 and could afford to purchase insurance. Those last two cohorts make up more than half of the 45.7 million.

Insuring the perhaps 20 million persons who are protractedly uninsured because they cannot afford insurance is conceptually simple: give them money – (refundable) tax credits or debit cards (which have replaced food stamps) loaded with a particular value. This would empower people rather than render them dependent. Unfortunately, advocates of a government option would see such an outcome as a defect. Which is why the simple idea of the dependency agenda cuts like a razor through the complexities of this debate.

A fourth set of numbers has to do with people who are currently on a private plan but who would — in some cases willingly and, contrary to the assurances of the president, in many cases unwillingly — join a government plan. According to the nonpartisan Lewin Group, a leading national health-care consulting firm, of the 158.1 million Americans with employer-based coverage, 88.1 million people would be shifted out of their current insurance and end up in the public option if the House plan were adopted.

These facts account for a fifth set of numbers. According to the most recent NPR poll, more Americans oppose Obama’s health-care efforts than support them — and more significantly, 39 percent strongly oppose ObamaCare, while only 25 percent strongly support it.

Does all this mean that Obama’s health-care plan is doomed? Not necessarily. Obama and Democrats in Congress, desperate to pass legislation, may well cobble together something they call “health-care reform” — even though it might be a profoundly different, watered-down version of what Obama has in mind.

Much will depend on what members of Congress hear from their constituents during the August recess (if these developments are a foreshadowing of things to come, it will be a hot August for Democrats). Obama and Democrats, knowing that this is the signature issue of the Obama presidency, will pull out all stops to pass health-care reform. This play is only in the second act; a lot has yet to unfold. But what we can say so far is that in the first summer of his presidency, Barack Obama’s effort, predicated on false promises and false figures, is badly faltering.

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