Obamacare Fiction

Search Feb 26, 4:28 pm 27A General Theory of Obamacare Fiction
by Paul Krugman
Conservatives appear to be really upset that liberals are actually taking on the facts in the anti-Obamacare ads they’ve been running. How dare you question whether the people in these ads are giving an accurate picture — they’re suffering!

OK, we’ve seen this kind of play before. Remember how anyone suggesting that Dick Cheney and whatshisname misled us into invading Iraq was attacking American’s brave fighting men and women?

But there’s a different kind of struggle anyone trying to point out the facts encounters — a barrage of anecdotes. You say that the Obamacare horror stories are fake, but I kind of know this man who is being told that he has to buy a policy he can’t possibly afford / I read this sad story in the Wall Street Journal / I heard this tale on the radio / etc..How do you answer that?

Well, it can’t be done retail. If the Koch brothers are pouring money into ads featuring a person, or the GOP response to the SOTU tells a story, then it’s worth trying to track down the particulars of this case. But to deal with the broader problem of anecdotes, what you need is a framework that tells you which anecdotes are almost surely wrong.

So here’s what you need to understand. The Affordable Care Act isn’t magic — it produces losers as well as winners. But it’s not black magic either, turning everyone into a loser. What the Act does is in effect to increase the burden on fortunate people — the healthy and wealthy — to lift some burdens on the less fortunate: people with chronic illnesses or other preexisting conditions, low-income workers.

Suppose, then, that someone comes to you with an anecdote about a cancer patient, or just an older person in poor health, and tells you that this person is about to lose the care she needs, or face a huge increase in expenses, under Obamacare. Well, it’s almost certainly not true — people like that are overwhelmingly beneficiaries of health reform, thanks to community rating, which means that they can’t be discriminated against because of their condition.

Or suppose that someone tells you about a struggling worker who had adequate coverage but is now being confronted with unaffordable premiums. You should immediately ask, what about the subsidies? Because the Affordable Care Act has subsidies that are there specifically to keep premiums affordable for lower earners.

If someone insists that he knows about someone in these categories who really is being grievously hurt, well, the burden of proof rests with the claimant. Basically, stories like that are going to be very rare.

Obamacare opponents could, of course, go with the real losers — people in the one percent paying higher taxes, healthy young men who are getting by with cheap, minimalist policies. But they want sob stories — the sick middle-aged woman facing tragedy. And so far, every single one of those sob stories has turned out to be false — because the very nature of the reform is such that such things hardly ever happen.