Untruths and Half-truths from the Left on Health Care Reform

First, it's frustrating to hear people on the left continually invoking the public plan as the key to expanding health care coverage.

It's true that a "strong" public option would be able to offer lower premiums than its private competitors. However, a "weak" public option -- one that competes on a level playing field with private insurers -- probably wouldn't. Here is how the Congressional Budget Office describes that public plan that would be set up under the health care legislation that recently passed the House:

[A] public plan paying negotiated rates would attract a broad network of providers but would typically have premiums that are somewhat higher than the average premiums for the private plans in the exchanges. The rates the public plan pays to providers would, on average, probably be comparable to the rates paid by private insurers participating in the
exchanges. The public plan would have lower administrative costs than those private plans but would probably engage in less management of utilization by its enrollees and attract a less healthy pool of enrollees.

A public plan does not automatically expand coverage. Federal subsidies expand coverage, and those subsidies are not tied to the public option, unless it is a "strong" public option.

Second, it's not clear that a majority of Americans favor the public option. Unfortunately, polling on this subject is very complicated. Some respondents who voice support for the public option probably couldn't tell you what it is. In fact, many Americans cannot even connect the term "public option" to health care. All we can really say for certain is that people respond positively to the word "option," but less positively to terms like "government-run" or "government-controlled" health care.

Third, as Peter Suderman points out, the health care legislation under consideration is unlikely to "reduce" the national debt, as many on the left claim. The CBO (typically) only makes cost projections within a 10-year period, and the spending in this bill is extremely back-loaded.

Suderman writes:

When the Congressional Budget Office scores a bill, its looks at the budgetary effects over the immediate ten year window. So on the health care bill, the headline cost of $849 billion covers the period between 2010 and 2019. Problem is, it's a misleading figure since most of the new programs don't actually kick in until 2014, and, as a result, most of the spending—99 percent, according to the CBO—doesn't occur until the final six years. That means it's not actually a very good reflection of how much it's going to cost to run the bill's new programs over a decade-long period.

I've given up on expecting honesty from the right . . . but a little more honesty from the left would be nice.

Sullivan and Public Policy Polling

Today, Andrew Sullivan linked to this survey from Public Policy Polling, which seems to show that 52 percent of Republicans believe ACORN stole the election for President Obama. I've written to Sullivan before criticizing the results of another survey from Public Policy Polling.

A few points:

First, Public Policy Polling isn't exactly an independent polling agency. Josh Krausharr of Politico writes:

Though there’s little to indicate the firm’s Democratic affiliation on its website — clients are listed, but without partisan identification — [pollster Tom Jensen] said PPP makes no secret of its politics.

This certainly doesn't mean that Public Policy Polling is doing anything nefarious. But shouldn't this conflict of interest be noted? What if the situation were reversed, and a Republican Party-affiliated pollster found that 52 percent of Democrats believed that the Republican National Committee manipulated the election results?

Second, Public Policy Polling often gets results that are out of line with other mainstream pollsters.

For example, in the very same survey that Sullivan links to, Public Policy Polling reports that only 77 percent of African-Americans approve of the job that President Obama is doing. Gallup currently puts the figure at 95 percent for this demographic group (with a monthly average of approximately 92 percent, and a comparable yearly average).

Third, only 33 percent of the 1066 respondents in this survey identified themselves as Republicans. Thus, the sample size for Republicans is about 352, and the sampling error around 52 percent is +/- 5 percentage points. Public Policy Polling notes that "[o]ter factors, such as refusal to be interviewed and weighting, may introduce additional error that is more difficult to quantify." So, the overall margin of error around the 52 percent figure could potentially be quite high.

Perhaps more importantly, Public Policy Polling uses Interactive Voice Response (IVR) technology to conduct its telephone interviews. As Brian Schaffner of Pollster points out, the use of IVR technology in polling is still quite controversial.

Schaffner explains:

[O]ne of the reasons for concerns with IVR polling is that citizens with only a cell phone cannot be reached by these pollsters and these citizens now comprise at least one-fifth of the population. Yet, while the cell-only problem may generally be an issue for IVR technology (and for live interview pollsters who aren't calling cell phones), it is less of a problem for polling on elections, and particularly in low turnout elections.

. . .

Where these polls may run into greater challenges is when they attempt to make inferences about the American public rather than registered (or likely) voters.

I think Sullivan should really consider some of these points before he links to another survey from Public Policy Polling without providing any context.

Update: The NYT will not publish the results of IVR polls.

He's Back, Baby

Ross Douthat has a new blog -- "Evaluations" -- which I'll be adding to my blog roll.

I'm glad that Ross has finally started blogging again. We need more intelligent conservative voices in the blogosphere. (I'm sure that Conor Friedersdorf is ecstatic, as well.)

Here is a taste:

I’ve argued before that while the eventual health care legislation is likely to be a boondoggle, it at least holds out the hope of partially remedying the present system’s worst injustice: Namely, the way the current mix of semi-free markets, tax breaks and government subsidies interact to price millions of Americans — some of them lower-middle class, some of them sick, some of them employees of small businesses, some of them self-employed — out of the insurance market entirely. Obamacare, in whatever form it eventually takes, will pile further regulations, subsidies and perverse incentives atop the existing mess, and probably make our already-dysfunctional system more byzantine and more expensive. But it does promise to make it more equitable along the way.

For some people, at least. The trouble is that for millions of uninsured Americans, the reforms will make the system seem more unjust, not less. So, for instance, while the coverage of the Center for Medicare and Medicaid Services’s assessment of the House health care bill has mainly focused, understandably, on the memo’s predictions about the impact of the projected cuts to Medicare, to my mind the more damning figure is the one that Keith Hennessey flags here — the projection that in 2019, the bill will leave 18 million Americans uninsured and paying a penalty for the privilege.

Request For the Day

If anybody has any interesting ideas on how to reform Social Security that do not involve a) transitioning to private accounts or b) mass murder, I'd love to hear them . . . .

What is Paul Krugman Talking About?

I just reread Paul Krugman's old post on why there is no problem with the Social Security Trust Fund assets.

His argument:

The Social Security system won’t be in trouble: it will, in fact, still have a growing trust fund, because of the interest that the trust earns on its accumulated surplus. The only way Social Security gets in trouble is if Congress votes not to honor U.S. government bonds held by Social Security. That’s not going to happen. So legally, mechanically, 2018 has no meaning.

. . .

What we really have is a looming crisis in the General Fund. Social Security, with its own dedicated tax, has been run responsibly; the rest of the government has not. So why are we talking about a Social Security crisis?

To be honest, I don't really understand Krugman's point.

The assets in the Social Security Trust Funds represent a claim against the United States Treasury. In other words, Treasury has borrowed from the Social Security Trust Funds to finance its current spending, and it will eventually have to repay that debt.

When the Social Security program begins to cash in those assets (probably some time in 2016), Congress has three (potentially interchangeable) options to finance the repayment of its debt: raise taxes, cut spending, or add to the already unsustainable deficit.

None of these options is particuarly appealing. The combined Trust Funds contain approximately $2.6 trillion in assets, which means that the federal government will have to find $2.6 trillion in revenue over the next few decades.

Krugman wants to reframe the problem as a crisis in the General Fund rather than the Social Security Trust Fund itself. And, technically, he's probably right. But how does this really change anything? The federal government still has to make a series of difficult choices ahead. Choosing the wrong path could still place the Social Security system and the entire federal budget in jeopardy.

Viewing the problem this way may be politically appealing to Krugman, but it's not exactly helpful.

Are Black Republicans 'Sellouts'?

CNN's Roland Martin defends black Republicans against charges that they are traitors to their race:

As someone who has voted for Democrats, Republicans and independents, I’m focused on the issues.

. . .

Listening to one another and making a determination on what a person is saying, as opposed to depending on labels, is vital. So I would hope that black voters in Texas actually listen to Michael Williams, chairman of the Texas Railroad Commission, as he campaigns as a Republican for the U.S. Senate seat being vacated by Sen. Kay Bailey Hutchison. He deserves an audience, just like anyone else.

It's a shame that CNN is getting destroyed in the ratings by its partisan rivals, Fox News and MSNBC. CNN really is the superior cable news network, and it has the most sensible commentators.

Time To Move On . . .

I went to Wordle today to get an idea of what I've been talking about for the past week:


[Click to enlarge]

I think I need to move on to a new topic . . .

Carrie Prejean

I'm ashamed of myself for watching this, but it's kind of fascinating.

I hate to be so mean, but Carrie Prejean has to be among the dumbest people I've ever seen on television.

Stupak and the NYT

In criticizing the Stupak Amendment this past Monday, the NYT Editorial Board wrote:

The bill brought to the floor already included a careful compromise that should have satisfied reasonable legislators on both sides of the abortion issue. The vast majority of people expected to buy policies on the new exchanges would pay part of the premium and receive government tax credits to pay for the rest. The compromise would have prohibited the use of the tax subsidies to pay for almost all abortions, but it would have allowed the segregation and use of premium contributions and co-payments to pay for such coverage.

I'm opposed to the Stupak Amendment and broadly in favor of abortion rights, but I don’t see how this original compromise could be considered “reasonable.” Money is fungible. There is no way to 'segregate' the tax subsidies from the abortion coverage. Either the federal government funds abortion or it doesn't.

This seems a rather obvious point. In fact, read what the NYT Editorial Board wrote just over a year ago in its commentary ('Money Really is Fungible') on executive pay caps:

Just weeks after the Treasury Department gave nine of the nation’s top banks $125 billion in taxpayer dollars to save them from unprecedented calamity, bank executives are salting money away in billionaire bonus pools to reward themselves for their performance.

Outraged? The bankers (who didn’t anticipate the subprime crisis) were ready for that. So they are assuring everyone that this self-directed largess won’t be paid with the same dollars they got from taxpayers. They’ll use other ones.

What we want to know is will they be marking the bills so they can be sure which is which?

Is there any real difference between these two situations, other than the fact that the former involves abortion and the latter involves greedy bank executives? How can you recognize the absurdity of one scenario, and consider the other “reasonable”?

If the NYT Editorial Board was honest, it would make the case that abortions should be publically funded. Instead, it has decided to chastise abortion opponents who refused to accept an illogical compromise.

Update: Conor Friedersdorf responds to Ann Friedman's post on the Stupak Amendment:

There are many women in the United States who oppose abortion, and if asked would agree that federal money shouldn’t fund it, so the assertion that the amendment throws 50 percent of the population under the bus isn’t accurate, unless one takes the position that these anti-abortion women are suffering from false consciousness.

Friedman's reply:

Actually, no matter what their beliefs about abortion, every woman in this country is indeed screwed over by this amendment. Many, many women who are opposed abortion rights have exercised those rights themselves -- whether for health reasons or because, when it came right down to it, they simply found themselves making a different choice than they thought they would in that situation.

Megan McArdle is concerned with Friedman's argument:

[A]s a response, this seems to trivialize the preferences of pro-life women in a way that I find pretty disturbing from feminists. In what other area of life is it okay to pat the little lady on the head and tell her that she doesn't really want what she says she wants, because she might regret it later?

. . .

Obviously, since I'm pro-choice, I think you can argue against abortion control in many effective ways. But this is not one of them--at least not if you hew to the feminist notion that women are entitled to their own choices and preferences as individuals, not lumped in with some vast undifferentiated mass of women who all want the same thing.

A Politically Serious Nation?

David Brooks at his best:

When Maj. Nidal Malik Hasan [murdered 13 people] in Fort Hood, Tex., last week, many Americans had an understandable and, in some ways, admirable reaction. They didn’t want the horror to become a pretext for anti-Muslim bigotry.

So immediately the coverage took on a certain cast. The possibility of Islamic extremism was immediately played down. This was an isolated personal breakdown, not an ideological assault, many people emphasized.

Major Hasan was portrayed as a disturbed individual who was under a lot of stress. We learned about pre-traumatic stress syndrome, and secondary stress disorder, which one gets from hearing about other people’s stress. We heard the theory (unlikely in retrospect) that Hasan was so traumatized by the thought of going into a combat zone that he decided to take a gun and create one of his own.

A shroud of political correctness settled over the conversation. Hasan was portrayed as a victim of society, a poor soul who was pushed over the edge by prejudice and unhappiness.

There was a national rush to therapy. Hasan was a loner who had trouble finding a wife and socializing with his neighbors.

This response was understandable. It’s important to tamp down vengeful hatreds in moments of passion. But it was also patronizing. Public commentators assumed the air of kindergarten teachers who had to protect their children from thinking certain impermissible and intolerant thoughts. If public commentary wasn’t carefully policed, the assumption seemed to be, then the great mass of unwashed yahoos in Middle America would go off on a racist rampage.

Worse, it absolved Hasan — before the real evidence was in — of his responsibility. He didn’t have the choice to be lonely or unhappy. But he did have a choice over what story to build out of those circumstances. And evidence is now mounting to suggest he chose the extremist War on Islam narrative that so often leads to murderous results.

The conversation in the first few days after the massacre was well intentioned, but it suggested a willful flight from reality. It ignored the fact that the war narrative of the struggle against Islam is the central feature of American foreign policy. It ignored the fact that this narrative can be embraced by a self-radicalizing individual in the U.S. as much as by groups in Tehran, Gaza or Kandahar.

It denied, before the evidence was in, the possibility of evil. It sought to reduce a heinous act to social maladjustment. It wasn’t the reaction of a morally or politically serious nation.

Abortion Amendment

A few thoughts on the recently-passed Stupak Amendment, which limits federally-subsidized abortion coverage . . . .

First, President Obama feverishly (and, at the time, disingenuously) denied allegations that the health care reform bills before Congress would allow for any federal funding of abortions. This was essentially the status quo under the Hyde Amendment and subsequent legislation. No one should be surprised that this amendment passed, since the president had promised as much.

Second, the amendment does not prohibit federal funding for all abortions. There are exceptions for rape, incest and the health of the mother. These exceptions fit with the mainstream view on abortion rights.

Third, a strong plurality of Americans believe that abortion should be "legal only in a few circumstances." This is reflected in the composition of the House of Representatives, where a majority of legislators supported the amendment. Those who are broadly in favor of abortion rights (myself included) must acknowledge that we live in a democracy where relatively few Americans support a universal right to abortion. Most people have complex views on the subject.

Fourth, a person's stance on abortion is not strongly associated with gender. In fact, most studies I've seen show no statistically significant difference between men and women on this issue. Today, women are more likely to call themselves "pro-life" than "pro-choice."

Update: Ezra Klein makes an interesting point:

[T]he biggest federal subsidy for private insurance coverage is untouched by Stupak's amendment. It's the $250 billion the government spends each year making employer-sponsored health-care insurance tax-free.

That money, however, subsidizes the insurance of 157 million Americans, many of them quite affluent. Imagine if Stupak had attempted to expand his amendment to their coverage. It would, after all, have been the same principle: Federal policy should not subsidize insurance that offers abortion coverage.

This is certainly how economists and policy analysts would view the situation. Although, I suspect most ordinary Americans would recognize a slight difference between providing a direct federal subsidy for health insurance and merely lifting the tax on employer-provided insurance.

I wonder if Ezra shares Greg Mankiw's fears about marginal tax rates . . . .

Gay Marriage Bigotry

Rod Dreher over at Beliefnet writes:

Unless I'm missing something, in the 31 states in which voters had a say on whether or not gay marriage was going to be the law of the land, they all rejected it. Every single state.

. . .

[U]nless you're prepared to call more than half the country bigots -- and I have no doubt that many, perhaps most, gay marriage supporters are, and let that self-serving explanation suffice -- maybe, just maybe, you ought to ask yourself if there's something else going on here. And that maybe, just maybe, serious attention should be paid, instead of paying attention long enough to insult people who disagree with you as evil people who deserved to be excoriated and harassed.

Ta-Nehisi Coates responds:

I probably wouldn't use the word "bigot." I don't think, for instance, that half this country thinks hate crimes against gays is a good thing. But I have no problem believing that half the country--maybe more--is deeply prejudiced against gays. This generally fits into my view of all -isms. I think prejudice is part of who we are as humans, and thus as Americans. Following from that, I think prejudice is one of the many forces that influence how we vote. Hence the notion that half this country is deeply prejudiced against gays really doesn't shock me.

I'm sympathetic to Coates's argument. In my experience, people who strongly oppose gay marriage do tend to be animated by some form of prejudice. However, I think this debate is extremely counterproductive. Charging your opponents with bigotry -- or even the lesser offense of "prejudice" -- is a surefire way to lose the argument.

Even some social conservatives would admit that the secular case against gay marriage isn't very strong. Those of us who support marriage equality should be engaging with that argument and trying to expose its tortured logic, not hurling ad hominem attacks at our opponents.

We can accept prejudice as a given, but it doesn't serve our purpose to use it as a trump card when we're in the minority. Instead, why don't we just call on our opponents to defend their position?

It shouldn't be hard to point out the illegitimacy of that position.

(Hat tip: Andrew Sullivan)

Pulling for Daggett

I realize that, barring an act of divine intervention, Chis Daggett is not going to win the New Jersey gubernatorial race. But I really do hope that he garners a reasonably large share of the vote.

Daggett is clearly the best candidate. He's also the only one who could introduce any real reform. I agree with this Star-Ledger endorsement of Daggett (follow-up here):

The lamentable fact is that the two parties are, themselves, little more than narrow special interests. Their competition for short-term political and/or monetary gain has jeopardized the state’s long-term economic health and left it with a tarnished national reputation. Where the major parties have differed, their differences have been inconsequential. Where they’ve been the same, their similarities have been destructive.

They have contributed equally to gross overspending in Trenton by consistently pandering to the pay, pension and retirement policies demanded by powerful public employee unions. Democrats have financed the spree with tax hikes, Republicans with borrowed money, and both with pension-fund raids.

How do we now signal them that this has got to stop if not by rejecting their anointed candidates? How if not by electing Chris Daggett?

I would also second David Frum's comments:

I interviewed Daggett this past weekend, and I can attest – this independent too is a much more attractive candidate than his official Republican rival.

His proposals for balancing the state’s books are detailed and workable. He’d extend the state’s 7% sales to cover services as well as goods. He’d end the hodge-podge of property tax rebates. He’d then use the money gained to finance an across-the-board property tax cut and also reductions in corporate income taxes. (A fuller statement of the plan can be read here.)

Daggett emphasizes New Jersey’s most important environmental issue: the preservation of open spaces from urban sprawl. He’d use state funds to buy and preserve open land. He favors major ethics reform to try to clean up New Jersey’s notoriously corrupt political culture.

Like most New Jersey Republicans, he is unexcited by social issues, accepting the status quo on abortion, guns, and gay rights. (On that last, he says he’ll leave the issue to the legislature. If they pass same-sex marriage, he’ll sign it.) And make no mistake: Daggett has been a Republican almost all his life. A protégé of former Governor Thomas Kean, he was appointed as state Environmental Protection Agency administrator by Ronald Reagan.

Daggett would make a very good governor.

Sometimes the two-party system can be so frustrating . . . .

Update: Chris Christie is the projected winner. It doesn't look like Daggett made much of a dent in the end.

Kind of depressing.

Update II: In hindsight, maybe I should've voted for Gary Stein for governor. Check out his awesome ballot statement (pdf).

How Do We Gauge the Stimulus?

Greg Mankiw responds to Paul Krugman's self-righteous assault on "conservative economists" who question the veracity of the administration's stimulus numbers.

Mankiw writes:

I do not object to claims such as,

A: "Based on our models of the economy, we believe there would be X million fewer jobs today without the stimulus."

But it is absurd to suggest that you can say,

B: "We have measured how many jobs the stimulus has saved or created, and the number is X."

Economists are capable of making statements such as A, but it is beyond our ken to make statements such as B. Statement B is, of course, much stronger than statement A, as it purports to be based on data rather than on models. Unfortunately, we are hearing statements like B much too often from administration officials. A good example is here, where can you "learn" that 110,185.36 jobs have been created or saved in California alone.

Marginal Tax Rates and Health Care Reform

In his latest NYT op-ed, Greg Mankiw argues that the current health care proposals will substantially raise marginal tax rates on middle-income earners. This has a lot to do with how economists (and policy analysts) view taxes, which isn't necessarily the way everyone else views taxes.

For example, Mankiw explains:

A family of four with an income, say, of $54,000 would pay $9,900 for health care. That covers only about half the actual cost. Uncle Sam would pick up the rest.

Now suppose that the same family earns an additional $12,000 by, for example, having the primary earner work overtime or sending a secondary worker into the labor force. In that case, the federal subsidy shrinks, so the family’s cost of health care rises to $12,700.

In other words, $2,800 of the $12,000 of extra income, or 23 percent, would be effectively taxed away by the government’s new health care system.

Will this dramatically damaged economic productivity? I'm not sure, but Mankiw's point should be taken seriously.