Phony numbers, flawed studies, and partisan denial rule the debate in Washington DC – and again, the american people stand to lose.
It is a common and well respected reality that nobody likes to be proven wrong. It is human nature to reach for straws, rationalize, or just plain deny any clear reality that does not affirm our convictions, positions, or in particular, the policies of our Team in DC, writ large R or large D. And no policy debate engenders more passion than health care, a most critical issue for every American and their families.
Each day companies throughout the country adopt policies after much thought, diligence and preparation. And just as often, after some period of time, it becomes clear that either the specific program needs to be scrapped, or it can only continue with significant modification. Continuous improvement and innovation is critical for every company to be successful, and the most important ingredient to such improvement and innovation is honest, factual assessment of each and every program. The only place where this does not seem to be recognized is in Washington DC, and by Washington DC I mean the whole “complex” – elected officials, bureaucrats and the national media.
A common Democrat narrative in vogue is that the ACA is and was just fine, and that the only reason it has any issues is due to undermining actions of the Trump administration, that is the only reason one third of US counties have only one plan available for 2017 is due to that dastardly Donald Trump. You may be thinking that it has to be a small number of people that would reach that illogical conclusion, but this single bit of nonsense is actually shouted from the rooftops by elected Democrats, Democratic strategists and various aligned individuals. (For the record, dishonesty is not one-sided, but I simply provide the forgoing as one clear example of the suspension of reality common in the debate). This article could proceed to provide dozens of similar, glaring examples of dishonesty, promulgated by both political factions, but this is not an exhaustive graduate thesis.
Further fueling the intractable nature of the debate are the continuous disingenuous recitations of flawed studies and demonstrably unreliable sources. “28,000 people will die per year if the ACA is repealed” – political figures keep quoting this with such language as “consensus” or “the most reliable studies”. The figure is based on one study that has been dismissed by peers as completely flawed. “22 million people will ‘lose’ coverage,” which is based on the CBO study. First, 16 million of the estimated 22 million people “losing” or getting “kicked off” of coverage are attributed to repeal of the Individual Mandate. If somebody is capable of enrolling in coverage, but is no longer mandated, and that person elects not to obtain coverage, then that person has not “lost” coverage or been “kicked off” coverage. Second, the CBO first scored the ACA in 2010 to indicate that 23 Million people would be enrolled in the individual Marketplace (exchanges, not Medicaid) by 2016. The actual number ended up being less than 11 million in 2017. (According to a Kaiser study, total enrollment in the individual market for 2016 was 18.8 million people, with approximately 35% of that group enrolled in individual coverage purchased outside of the Marketplace/Exchange. In 2017, according to Kaiser, 12.2 million people initially enrolled in the Marketplace, but after accounting for failures to submit premium and other causes for attrition, as of April, 2017 the official government announced Marketplace enrollment was less than 11 million people, 12 million less than the original CBO score). If that was the success rate of your surgeon, you would be looking for a more reliable surgeon. And one could go on with dozens of more examples of inaccurate studies, flawed positions, or just plain dishonesty.
The above few examples suggest a one way dishonesty or flawed logic. But we all know better. Several members of the party currently in control of the legislature propose one pandering, ill-conceived concept after another, such as the so called “Liberty” provision that would provide all sorts of skinny plans suited for the young and healthy, for example. Of course, in the absence of a massive high risk funding mechanism, such plans would gut the necessary expansion of risk pools to offset claim costs. Policies appropriate for the chronically ill would become completely unaffordable.
And yet, this is the health care debate in Washington. The rest of us simply become more and more cynical, and under the weight of what any honest assessment confirms is a flawed law and regulatory scheme, poorer.