Here’s the shorter of everything that is going to follow from here: if you are looking for death panels, to a pretty damn good approximation you can find one in the Republican caucus of the US House of Representatives.
What follows is a retelling of what we all already know: health care reform repeal is a ticket back to a system that was long ago recognized as a disaster, a ride powered by zombie lies and a damn good media machine.
That said, in all of this, I detect just a glimmer of hope — if not for the persons of the uninsured still at risk, then perhaps for the body politic.
For example, today, as the House GOP seems about to succeed succeed in passing their repeal of last year’s health care reform act, that psalter of Village worship, The Washington Post notes that despite having run on “Repeal and Replace,” (italics added, obviously), there will be no replacement. Rather, as the headline writer demurely announces, “The GOP lacks clear health care plan.“
If you’ve lost the Post…
No worries, mate, says the GOP. We don’t need no stinking plan.*
After all, the chorus dins, the consequences of continued survival of the health care reform would be catastrophic enought to merit repeal even without anything to put in its place. Look! — we are told, The Worst Bill Ever will cost us 650,000 jobs.
That is, or would be a half percent bump to the unemployment rate, except, of course, it isn’t. The AP just came out with a fact check, tracking back to the CBO research on which the GOP spinmeisters based their claim. That bit of actual journalism revealed that the reason most of those who would not be working because of health care reform are doing so because they would no longer need to work — or as the AP reported:
What CBO actually said is that the impact of the health care law on supply and demand for labor would be small. Most of it would come from people who no longer have to work, or can downshift to less demanding employment, because insurance will be available outside the job.
“The legislation, on net, will reduce the amount of labor used in the economy by a small amount — roughly half a percent — primarily by reducing the amount of labor that workers choose to supply,” budget office number crunchers said in a report from last year.
Which is to say, that half a percent change in the labor supply is not a half percent shift in unemployment: you are only unemployed if you are seeking work and cannot find it.
Instead of acquiescing in a matter of labor-statistical fact well known to everyone in the business, the GOP chose to do what they do so well: make some stuff up, and then support what is technically known as bullsh*t by a bit of mathiness. That 650,000 jobs “killed” number? Some staffer took the total current employment number of roughly 130 million Americans and divided it by 200. Hey presto! — an Obamafashist Jobapocalypse. (See also this McClatchy debunking.)
But of course, everyone here knows about this kind of tactic, employed here in a mere skirmish in the long, long GOP War on Logic. All I want to do in this early morning rant is to remind everyone of what the Republicans in the House of Representatives are actually trying to do with this attempt at repeal.
They propose to destroy a law that will reduce the deficit by a small but welcome amount; extend health care coverage to approximately 70% of the currently uninsured; establish a number of pilot programs intended to explore both health care improvements and potential cost containment; and ensure that Americans in the time of greatest need cannot be denied coverage, despite suffering from “preexisting conditions.”
And in its place, the Republicans offer?….Nothing.
So the one message I want to keep hammering is that we need to remember exactly what the GOP says they want:
A system in which the GOP is, apparently, happy for the rest of us to continue to bear the burden of covering the unreimbursed costs of care for the uninsured — which is, in essence, a hidden $30 billion tax on you and me. (That figure comes from a paper by MIT health care economist Jonathan Gruber.) They don’t seem to care about the larger economic context in which lack of portable, reliable health care is a drag on labor mobility and entrepeneurial ambition.
Worst of all, they are willing to accept that all 47 million uninsured remain so — many of whom are employed and who thus form examples of what Gruber terms the modal uninsured individual, the “working-class poor.” That translates into exactly what John earlier today reminded us was what Alan Grayson was drummed out of respectable conversation for saying:
The GOP plan for health coverage for the uninsured is: die.
Back to Gruber’s paper, in a passage worth quoting at length:
A recent (October 2005) Institute of Medicine (IOM)*** study reviewed hundreds studies documenting the health problems associated with uninsurance. The IOM estimated that uninsured individuals use only half as much medical care as the insured, and have a mortality risk that is 25% higher, with over 18,000 people dying each year because of lack of insurance.9 The studies reviewed by the IOM, however, were mostly observational analyses documenting a correlation between a lack of health insurance and poor health, perhaps controlling for other correlates of insurance and health. Few, if any, of these studies dealt with the endogeneity of health insurance coverage with respect to health status.
Several other studies have used careful empirical methods to more carefully document a causal impact of health insurance on health. Hanratty (1996) studied the impact of the staggered introduction of national health insurance in Canada across the nation’s provinces, and found that it was associated with a 4% decline in the infant mortality rate and an 8.9% decrease in the incidence of low birth weight among single mothers. Lurie et al. (1984) studied the removal of eligibility for public insurance for a large group of individuals in California (due to a fiscal crisis in that state in the early 1980s that forced the state to cut back its insurance coverage), and found that health deteriorated significantly after losing public insurance. For example, blood pressure rose among hypertensive patients, leading to 40% increased risk of dying: overall, 5 of the 186 patients who had lost insurance had subsequently died, compared to zero of the 109 patients in a comparable group of individuals who did not lose insurance coverage. Currie and Gruber (1996a, b) studied the expansion of public insurance across and within the U.S. states in the 1980s and 1990s. They found that this expansion led to an 8.5% reduction in infant mortality and a 5% reduction in child mortality.
The shorter of all that: being uninsured is hazardous — and worse — to your health.
Like John, I’m infuriated by the fact that so far, the GOP has paid no political price for the barge loads of night soil they’ve dumped on this debate, and on us.
Unlike John, I’m just slightly hopeful that this will change. The AP piece even more than the McClatchy one seems to me like a straw in the wind. (When you’ve lost the Associated Press….)
I’m probably just playing Charlie Brown to the Lucy of the MSM, but maybe, just maybe, Boehner and his merry band of locksteppers will find it a little harder sledding than they thought. It’s slow work, but it seems to me that the one thing we can do here in the media weeds is to keep offering the counter narrative — or rather, shout the real story loud and often enough to water the tender shoots we see in media coverage of the nonsense that is GOP governance.
Crappy metaphor. But hell – I haven’t even made it half way through my first cup of coffee.
*Yeah I know that’s not the actual quote. Pedants.
**That link takes you to an NBER working paper by Gruber. The figure referenced comes in Part 6 of the (unpaginated) paper.
***The IOM is the branch of the National Academies that deals with medicine.
Images: Jan Steen, The Doctor’s Visit, before 1679.
Egon Schiele, Death and the Woman, 1915.
Update: anyone care to tell my why I can’t get good line spacing on a bunch of paragraphs (both of the two block quotes and several in the text) and why the insert-a-return-with-a-doubletap-on-the–underline-trick doesn’t work? FYWP