Paul Krugman has decided to fight fiction with fiction in the health care debate, and when the opposition spreads BS, he will spread BS twice as hard. Waddya expect from a former Enron adviser?
He correctly notes this Republican miscue:
Given this evidence, what’s a virulent opponent of reform to do? The answer is, make stuff up.
For now, however, most of the disinformation involves claims about costs. Each new report from the Congressional Budget Office is touted as proof that the true cost of Obamacare is exploding, even when — as was the case with the latest report — the document says on its very first page that projected costs have actually fallen slightly. Nor are we talking about random pundits making these false claims. We are, instead, talking about people like the chairman of the House Republican Policy Committee, who issued a completely fraudulent press release after the latest budget office report.
Jonathan Cohn takes us through the math; his gist is that the CBO was re-estimating the cost of one portion of the program over a different time period, not the cost of the whole program net of taxes and Medicare savings. Is Rush listening?
However, since Krugman is citing the new CBO report, his opening salvo is intellectually inexplicable:
To understand the lies, you first have to understand the truth. How would ObamaRomneycare change American health care?
For most people the answer is, not at all. In particular, those receiving good health benefits from employers would keep them.
CBO and JCT's Key Findings
CBO and JCT continue to expect that the ACA will lead to a small reduction in employment-based health insurance.
A "small reduction"? Here in investigative blogging land we call that a clue. We can glean more from the full report; this is from their lead paragraph on the very first page:
As reflected in CBO’s latest baseline projections, the two agencies now anticipate that,
because of the ACA, about 3 million to 5 million fewer people, on net, will obtain coverage through their employer each year from 2019 through 2022 than would have been the case under prior law.
Another clue! Despite citing the "very first page", Krugman seems to have overlooked both the key findings and the opening of the full report. And the phrase "on net" is fraught - in summary, CBO projects (using 2019 for illustrative purposes) that about 11 million people will lose their employer-based coverage as employers drop out; another 3 million will elect to drop their employer coverage and join a subsidized exchange. As a partial offset, about 9 milion people who formerly lacked employer-based coaverage will get it. On net, 5 million lose their coverage, but 11 million are on the broken end of the promise that their coverage would not be affected.
The gory details, also seemingly overlooked by Krugman:
CBO and JCT’s Current Estimates of the Effects of the ACA on Employment-Based Health Insurance Coverage
CBO and JCT now estimate that, because of the ACA, about 3 million to 5 million fewer people, on net, will obtain coverage through their employer each year from 2019 through 2022 than would have been the case under prior law. (That estimate is reflected in CBO’s latest baseline projections.) That projected change in the number of people with employment-based insurance is the net result of several shifts in coverage, which can be illustrated using the estimates for 2019. For that year, CBO and JCT estimate a net decline of 5 million in the number of people obtaining coverage through their employer, as a result of the following changes:
■ About 11 million people who would have had an offer of employment-based coverage under prior law will not have an offer under the ACA. That estimate represents about 7 percent of the roughly 161 million people projected to have employment-based coverage under prior law.5 The businesses that choose not to offer coverage as a result of the ACA will tend to be smaller employers and employers with predominantly lower-wage workers; those workers and their families are more likely to be eligible for Medicaid, CHIP, or subsidies through the health insurance exchanges.
■ Another 3 million people who would have had employment-based insurance under prior law and will still have an offer of such coverage under the ACA will instead choose to obtain coverage from another source. Under the legislation, workers with an offer of employment-based coverage will generally be ineligible for exchange subsidies, but that “firewall” will presumably be enforced imperfectly, and an explicit exception to it will be made for workers whose offer of employment-based coverage is deemed unaffordable.
■ About 9 million people who would not have been covered by an employment-based plan under prior law will have that coverage under the ACA. That change reflects the combined impact of the insurance mandate, the penalties that will be imposed on employers who do not offer insurance, and the tax credits for certain small employers who provide insurance for their workers— which will lead some employers who would not have offered coverage in the absence of the ACA to offer it and will lead some people who would not have taken up their employer’s offer of insurance to do so.
Well - this was covered by The Hill and Politico, including the gross and net impact (Jonathan noted the net impact). One marvels that Krugman and his (laugh with me) editors missed this. Is he lying, or did he fail to read the reports he cited? Tough call.
Since Times columnists don't have to correct their "opinions", I suppose Krugman can insist that 11 million people, representing 7% of the current insured, are too close to zero to count.
Oh, well - a million here, a million there, and pretty soon it adds up to real people - but not for Krugman.
ERRATA: I like this from Krugman:
We all know how the act’s proposal that Medicare evaluate medical procedures for effectiveness became, in the fevered imagination of the right, an evil plan to create death panels. And rest assured, this lie will be back in force once the general election campaign is in full swing.
Do we all know how that started? And is it a lie? Is Krugman himself aware of the Obama interview with David Leonhardt of the Times, which included Obama's rumination on health care cost control and end-of-life care?
THE PRESIDENT: So that’s where I think you just get into some very difficult moral issues. But that’s also a huge driver of cost, right?
I mean, the chronically ill and those toward the end of their lives are accounting for potentially 80 percent of the total health care bill out here.
LEONHARDT: So how do you — how do we deal with it?
THE PRESIDENT: Well, I think that there is going to have to be a conversation that is guided by doctors, scientists, ethicists. And then there is going to have to be a very difficult democratic conversation that takes place. It is very difficult to imagine the country making those decisions just through the normal political channels. And that’s part of why you have to have some independent group that can give you guidance. It’s not determinative, but I think has to be able to give you some guidance. And that’s part of what I suspect you’ll see emerging out of the various health care conversations that are taking place on the Hill right now.
Some independent group that can give guidance about end-of-life care with an eye to cost-effectiveness. OK, I doubt Team Obama would have chosen "death panel" to market that concept, but what is he talking about?
To be fair, an earnest lib who relied on the Times might well be oblivious to that Obama interview. Can't help those who want to stay in the bubble.