Senate Majority Leader Harry Reid (D-Nev.) says he shares colleagues’ concerns that the Affordable Care Act could become a “train wreck” if it’s not implemented properly. Reid warned that people will not be able to choose health insurance plans on government health exchanges if federal authorities lack the resources to set them up and educate the public. “Max said unless we implement this properly it’s going to be a train wreck, and I agree with him,” Reid said, echoing a warning delivered last month by Senate Finance Committee Chairman Max Baucus (D-Mont.). Reid warned the federal government is not spending enough money to implement the law because of Republican opposition to ObamaCare. “Here’s what we have now, we have the menu but we don’t have any way to get to the menu,” Reid said. “The president is taking money — I wish we had the money just to do this on its own, but he’s agreed, he’s determined he’s going to take money from some of the other things that he feels are less important in the healthcare bill and put it on letting you and others know what’s in the bill,” Reid [said].
Where to begin? First, notice how these problems are never, ever the fault of the disastrous law itself. No, it's always the Republicans' fault -- or the public's, for not properly understanding how great the new program really is. President Obama effectively advanced the latter argument at his Tuesday press conference: Ninety percent of you rubes are already enjoying the wonders of my munificence, even if you're too dense to realize it. Thus, now we're back to Democrats lamenting their inability to "tell better stories" or whatever, even though they've had the presidential bully pulpit for five years, and a generally pliant media running interference for them. We're informed that a law whose price tag has already doubled -- and is likely to rise even further -- requires additional taxpayer dollars to finance yet another PR campaign for itself. But weren't Obamacare's provisions going to convince us all, just as soon as it was fully implemented? Lower premiums! Reduced deficits! Cost curve down! Keep your plan! Plenty of doctors! None of that is actually happening, though, so the only conceivable solution is to appropriate more money to temporarily prop up public perceptions for awhile. "Re-education" funds, as Kathleen Sebelius might call them. Nevertheless, no amount of slick advertising can erase what even elected Democrats and mainstream journalists can see with their own two eyes. (Part-time worker? Sorry, bud). Empirical results are almost irrelevant to the party of "science." Case in point: A hot-off-the-presses landmark study on Medicaid, the results of which are devastating to government healthcare cheerleaders:
In 2008, Oregon expanded its Medicaid program, but because the state could not cover everybody, lawmakers opened up a lottery that randomly drew 30,000 names from a waiting list of almost 90,000 and allowed them to apply for the program. This created a unique opportunity for health researchers, ultimately allowing them to compare the health outcomes of 6,387 low-income adults who were able to enroll in the program with 5,842 who were not selected. Contrary to liberal assumptions, researchers found that those who enrolled in Medicaid spent a lot more on medical care than those who weren’t able to enroll, but didn’t significantly improve their health outcomes.
Specifically, researchers found that those who received Medicaid increased their annual health care spending by $1,172, or 35 percent more than those who did not receive Medicaid. Those with Medicaid were more likely to be screened for diabetes and use diabetes medication and to make use of other preventive care measures. The study also examined health metrics including blood pressure and cholesterol. Ultimately, the authors concluded that, “This randomized, controlled study showed that Medicaid coverage generated no significant improvements in measured health outcomes in the first two years...
In a sane political world populated by quasi-rational actors, this research would be a true game-changer. Here we have solid, methodologically-sound evidence that an enormously expensive government program -- Medicaid -- is failing to improve health outcomes for low income Americans, compared to being uninsured. Which is the entire point of the program. It turns out that Medicaid recipients also aren't cutting down on hospital and emergency room visits, another favored talking point for universal coverage. The primary difference between beneficiaries and their uninsured counterparts is that the former group uses healthcare services more, thus raising expenditures. One of this study's co-authors just happens to be a key designer of Obamacare (MIT's Jon Gruber), so this can't be written off some right-wing hatchet job, either. The new program Gruber helped create calls for the massive expansion (by 11 million people) of an old program that Gruber has now determined doesn't work. Ta-da! Liberal activists and journalists, meanwhile, are feverishly churning out copy to distort the results and salvage what they can from this catastrophic blow. Be sure to check out Avik Roy's must-read piece that methodically rebuts apologists' straw-grasping. But will this data earthquake impact actual policy one wit? I'm afraid Allahpundit may be right:
Righty wonks are treating this like a bombshell insofar as it might halt Democratic efforts to expand Medicaid under ObamaCare, but I don’t know. It might give confidence to Republicans in purple states, but the blue states will plow ahead. If they did ten more studies confirming this result, those would all be spun away too. This is an “identity” issue for Democrats — they’ll fight to protect the welfare state, whether it works or not, whether we can afford it or not — and as with abortion (or guns on the right), they won’t cede an inch on “slippery slope” grounds. Even if they were convinced that Medicaid isn’t worth the expense, they won’t relinquish a key political bludgeon against the right. Celebrate the result as a win for truth, but not because policy’s likely to shift dramatically.
Ultimately, the "party of ideas" is about one idea: Statism. The inefficacy of government programs -- no matter how thoroughly demonstrated -- simply isn't enough to pull the plug (eg: Head Start, the unkillable federal Helium Project, etc). Which is why it'll be full speed ahead on Medicaid expansion in blue (and some red) states, amidst calls to spend millions more on applying lipstick to the Obamacare pig. It's for our own good, you see; we just don't understand well enough yet.