The news media has been reporting on polls showing diminished public support for Barack Obama following the squandering of $5 billion on a bunch of semi-functional health insurance web sites (see this analysis of $4.5 billion in federal spending on state-operated exchanges, plus another $500+ million on the federal one).
At Thanksgiving gatherings with friends and family, however, I found that people who had previously supported Obama were no less enthusiastic about him than in previous years.
None of the Obama enthusiasts had any idea what web development typically cost or any knowledge about what healthcare.gov cost or what it was supposed to do. Therefore they didn’t have a strong opinion about the reported problems with the site.
To the extent that there were any problems with America’s healthcare system, Obama supporters blamed insurance companies and their inefficiency and greed. They didn’t see any contradiction between this opinion and the idea that the federal government should force people to do business with these inefficient and greedy companies.
Generally Obama supporters accepted that “health insurance” and “health care” were equivalent and therefore a person without health insurance would not be able to get health care. The Obama supporters believed that health care was a universal right and that, without insurance an American would not be able to obtain any care, so they were very happy that Obamacare was going to result in universal coverage [i.e., none were aware that Obamacare will leave approximately 30 million Americans uninsured (see this Washington Post article)].
The minority of Obama supporters who were were aware that the U.S. currently spends a much higher percentage of GDP on health care than other countries believed that with appropriate direction from Washington, D.C., our costs could be brought in line with the rest of the world’s, if only the central planners were given more power. [Health care spending in the U.S. was 4 percent of GDP in 1950 and is 18 percent today; Singapore spends about 4.6 percent of its GDP on health care, according to the World Bank, while most European countries are in the 9 percent range.]
Obama supporters believed that the only possible way for poor people to get health care was if the federal government paid for it through Medicaid. They believed that between 1776 and 1965, Americans who were poor and sick could not get any treatment at all. Obama voters who lived within walking distance of Boston City Hospital (founded 1864) were unaware that local or state governments had ever played any role in delivering health care to the poor. Obama supporters who lived within a short drive of one of America’s hundreds of Catholic hospitals were unaware that health care for the poor had ever been delivered through private/religious charity. If the federal government had not started paying in 1965, Americans who lacked funds would simply drop dead in the streets for want of a straightforward procedure (hence Obama supporters were very grateful for the continued existence of Medicaid).
Obama supporters felt much better about our continued wars in Iraq and Afghanistan than they had during the George W. Bush years. While Bush was president the same folks had argued for withdrawing our troops but since Obama was elected they no longer actively opposed foreign military intervention (they could have starred in this video). I asked if they wouldn’t have been happier if Obama had withdrawn our troops from Iraq and Afghanistan on January 20, 2009, using his authority as Commander in Chief. The answer was two-fold: (1) it might have made sense for Obama, in 2009, to continue the wars, even at the cost of thousands of American lives and tens of thousands of civilians’ lives, through his 2012 election campaign in order to improve his chances of being elected, (2) “Obama couldn’t do anything about the wars because of the military-industrial complex.” [i.e., Point 2 boiled down to them being passionate about Obama’s election and the election of similarly-minded successors, but at the same time believing that the president for whom they were actively campaigning didn’t have any power when it came to starting or stopping wars.]
Generally Obama supporters among my friends and family were happy with the way things were going, except that they wished that taxes were higher (ideally collected from people who earned more than they did). To the extent that they wished the U.S. economy would grow faster, they blamed Republicans in Congress for obstructing Obama’s proposed spending, regulations, and taxes. Generally there was no erosion in support for a centrally planned economy (see this poster that I made just before the 2012 election, after listening to the various promises made by Obama and Romney).
My poll was admittedly unscientific, but I did not find any erosion of support for Obama, centrally planned health care, shifting responsibilities from local/state to the federal government, or a larger percentage of the economy being given over to government. What are the readers seeing? Are friends and family who’d voted for Obama in 2012 now disillusioned because they read that healthcare.gov doesn’t work? If so, would they be motivated to vote differently in the future?
[Related: My 2009 health care reform article]
Big-state leftists (but I repeat myself) have no problem living with cognitive dissonance. It’s their default state of mind. Once you understand that, you understand their way of thinking. Intentions trump everything else. If the outcome isn’t so good, but if you had good intentions at the outset, then all is forgiven.
Re your guests:
Sounds like a case of “confirmation bias” (http://en.wikipedia.org/wiki/Confirmation_bias) – a well-known mental bias which leads people to very efficiently filter out data that doesn’t confirm a favourite hypothesis – or even to take confounding evidence as supporting their position.
Re government/charity:
The hardest place to diagnose “Confirmation bias” is in one’s own thinking however. Consider the basic thrust of your piece – which I understand to be, that centralised government control and taxation isn’t a necessary feature of delivering healthcare good-value good-quality accessible healthcare, and that previously the US managed to deliver high-quality healthcare via charitable institutions. Check out the graph I built at GapMinder:
http://www.bit.ly/19dh4ET
…which plots young-child mortality against per-capita healthcare spending. You will notice that the US is a real outlier on cost (incredibly high) while ALSO having worse outcomes. Not good! You will notice that the top-performers on our chosen metric are not relying on private charity as a means of funding and organising healthcare – quite the reverse. This is not to say that it can’t be done – just that countries that do that are currently way in the top left of the chart – low spending, bad outcomes.
To see where the old US system you describe fits on the chart, you just need to pick your year, then get check the outcomes for the metric and get your per capita figure. There certainly are countries today with such systems, but, so far as I known, they are poor countries with bad outcomes.
Well, the story of the state exchanges proves that it is possible to do a lot better than the Federal government has. In New York State, the exchange had some problems in the first week, but it has been very possible to complete registration since then.
The real issue in politics is that there isn’t much support for either the democrats or republicans, but rather the two parties are like two punch drunk boxers who are holding each other up by leaning into each other. It’s not a matter of “left” or “right” but really “them” vs “us”.
There is a large segment of people who think of voting Republican as like putting their hand in a toilet and another large segment that feels that same way about voting Republican. Try to run a third party candidate and you will get the most vicious attacks from the people closest to you on the spectrum who tell you “If you run for X, the Y will win”
Following from a real progressive website firedoglake, unlike your friends.
“In a desperate attempt to get what the administration considers to be the most important elements just barely working in time, huge sections of the law have been delayed for at least a year. Almost all the focus has been put on getting the individual market exchanges working at the expensive of almost every other part of the law.
I would go so far as to say roughly half the law will not be in place next year like it was supposed to be. Two of the biggest elements of the Affordable Care Act, the employer mandate and the SHOP exchanges, will not be in place next year.
The employer mandate was one leg of a three legged stool. This huge delay will cost taxpayers around $12 billion and increase the number of uninsured by half a million.
The small business exchange was one of the Democrats’ biggest selling points for the law. It was meant to significantly change how small businesses and millions of their employees selected insurance to help them better compete with large companies. This now won’t be ready in any form until 2015.
Several other less fundamental but still significant sections also won’t be in place in time. The Federal Basic Health Plan Option, which would have given states another option for covering people making slightly too much to qualify for Medicaid, was crippled by a one year delay. The move could’ve impact millions and probably increased the number that will be uninsured.”
It’s obvious that the federal heath care exchange was bungled. I’m not surprised why this comes as a surprise once we look at the number of very large contractors involved. It’s my impression that many of them have been over charging the country for years. They seem to have been allowed to do this by lobbying members of congress of both parties. I’m not sure we can really blame Obama for this, but maybe he had more authority to choose the implementation details than I am aware of.
Since many of the major changes mandated by the law are not in effect yet it’s too early to gauge the effectiveness of the law. My guess is it will have some areas that help lots of people (removing preexisting condition exclusions). I don’t expect it to actually cut costs, but it’s possible we will improve outcomes for the same cost. We will need to wait and see. I think it will be 10 to 20 years before we can really gauge whether the ACA was a good deal or not. Knowing this I’m withholding judgement of Obama based on the ACA. If I had to guess I think we would be a lot better off in the long term if we adopted a universal health care system that pulled the best ideas from the rest of the world. But there was no way for Obama to push that through, so he went with the compromise that is the ACA (remember it was born in a conservative think tank – most leftists think it’s too conservative).
As for your contention that religious charities used to provide health care, that wasn’t working in the current system. As soon as all hospitals were required to treat anyone walking through the doors the rest of us started paying for the uninsured (after the few with money bankrupted themselves) by way of higher costs and then higher premiums. The system was obviously broken. I don’t know how mandating charity care is a viable alternative to the ACA. Across the country I don’t remember a rush for the state governments to pick up responsibility for the problems. So I’m glad Obama tried to fix the problem. I suspect it will require many tweaks and maybe an overhaul to actually accomplish the fix. It’s also looking like congress is so broken that it could completely fail to be fixed as well.
As someone who voted for Obama both times I am disappointed in his willingness to perpetuate the war in Afghanistan and operations in Pakistan. I am also appalled by his escalation of the drone war. While possibly effective militarily, it’s a diplomatic disaster (and it seems illegal based on my understanding of international law). I however do not think things would have been better under McCain or Romney. Lesser of two evils if you ask me.
Folks: My point was not that I agree or disagree with Obamacare. It was that the news media are incorrectly reporting that the failure of healthcare.gov is having a major effect on popular support for Obama and the expansion of government.
Phil,
I think they should make a movie of you at these get togethers. From the sounds of it, the only way to make it work would be to hire Terry Gilliam to write it. I can only add that I quit talking politics because all people came in two varieties, over involved and boring, or ignorant and without much to say.
It is sad to me that this small subset of the population spends all of their time following politics, getting one sided information and essentially suckling the media. The other group has gotten so fed up that they just quit participating. I’m not sure any of this is new in American History.
http://xkcd.com/1127/
According to the Centers for Disease Control Hispanics have the longest life expectancy in the US. That paradox merits discussion.
http://www.cdc.gov/nchs/data/databriefs/db115.pdf