19 August 2009

Why Don't People Disbelieve Obama Now?

One thing that's always struck me as strange about President Obama's supporters is the extent to which they support him because they think that he's lying about key policy positions. The best example of this is gay marriage: Obama announced that, as a Christian, he believes that G-d has mandated that marriage be the union of one man and one woman. The people who vociferously support gay marriage (Andrew Sullivan leaps to mind) shrug and tell each other, "he has to say that, but we know that he's lying." Robert Wright has said much the same thing about Obama's professed belief in Jesus. Wright can just tell that, in private, Obama is an atheist. I don't remember a candidate for whom perceived lying has been such an important selling point.

So why, I wonder, are people starting to believe him now. His real problem with the public on this lunatic idea of nationalizing health care (or the 2/3's of health care not already nationalized) is not that it's lunatic, but that he promises to cut spending. Since seniors have realized that cutting spending translates to not giving them hip replacements on demand -- the single most common surgery under Medicare -- they're up in arms. But isn't this just a completely transparent lie?

I don't know if Obama is really a Christian. I don't know if his religion forces him to oppose same-sex marriage. Pretty much, I'm with the courts. All we can know is what people say and do, so I have to give Obama the benefit of the doubt here. But one thing I'm sure of is that there is no way nationalized medicine is going to cut costs. The evidence from every other government welfare program, as well as common sense, is clear: the government is going to spend, spend, spend. Obama knows this perfectly well. He's clearly lying when he says that we're going to drive down the cost curve. No matter where the line is drawn on spending, some cute little kid or gray-haired Nana is going to fall just outside. The papers will have a field day, politicians will pontificate and bureaucrats will soon learn that the only downside is denying care. Pretty soon, we'll be looking back wondering how the 10-year cost appraisal could have been so wrong.

But I'm still puzzled: why do so many people suddenly believe the President the one time he is clearly lying?

11 comments:

pj said...

Well, if it's politically disastrous for him to be in favor of cutting costs, and he's very publicly in favor of it, doesn't that argue that he really wants it? How can you be sure he's lying?

Democrats were eager to cut Terry Schiavo's health care, I don't know why you think they'd oppose it in the future. Maybe that's one of the selling points for single-payer health care for them. If there's many payers, it's hard to assure that payment will be denied.

pj said...

Let me add that I agree that costs will not be cut. However, care will be. And the excuse for cutting care will be the need to cut costs.

David said...

The real loss, just as with OJ's nonsensical broken windows theory, is the innovations left undiscovered and the advances that won't be made.

Bret said...

Yes, that's the real loss.

What is almost always left out of discussions like these is what happens over time. When Medicare was enacted, if you just took a snapshot in time, there were winners and losers, and it was possible to make the argument that overall, it increased overall utility (and if you're a utilitarian, that would be a good thing).

However, things aren't static. The innovations and advances left undiscovered because of Medicare and health insurance tax policy coupled with moral hazard is what got us in the current crisis now that 50 years have passed.

In another 50 years, our descendants are going to curse us for nationalizing health care.

David said...

Another part of the static analysis that led to Medicare was the assumption that the elderly as a class would always be poorer than the young. The old are now rich, but the young are still paying for their health care.

Peter Burnet said...

David/Bret

A question from one struggling to make some sense of this issue without being condemned to read 1000 page bills winding their way through Congress:

Americans spend far more on health care than anyone else in the world--almost twice what we do. The order of magnitutde is really quite daunting and I can't believe it can be explained by shorter wait times for non-emergency care. I'm not aware of any statistical advantage in terms of life expectancy or other indices. What are you spending all that money on?

erp said...

A giant bureacrazy. Every Medicare transaction generates multiple pieces of paper and an army to process them all.

Bret said...

Peter,

Lot's of factors including the bureaucratic overhead and shorter wait times. Other factors include a less healthy population and more of a keep someone alive at all costs mentality than many of the other OECD countries. How many Terry Schiavo's do you have up there in the great white north, eh?

David said...

Peter:

It's a good question, and I don't have a great answers. We spend about twice as much per capita as Canada and about 1.5 times as much as a percentage of GDP. Some of the answers are:

1. Pharmaceuticals. We seem to spend about $500 per person more per year, partly because we take more drugs and partly because our drugs cost more.

2. Higher compensation. Doctors and hospitals get paid more per procedure/patient interaction.

3. High tech. We have more scanners, innovation, new surgical techniques, new drugs, etc., than you guys do.

4. Getting shot or crushed. We have a lot more violence and those gunshots need to be treated. We also get in more traffic accidents. This also explains, to some extent, the difference in life expectancy.

5. More poor immigrants. We get more immigrants from South America and the third world, who have received little or no health care growing up and are in worse shape, and in more dangerous/labor intensive jobs.

6. We're richer than you. As the spending per capita v. percent of GDP differences show (2X v. 1.5X), we just have more money and we choose to spend some of it on health care.

Hey Skipper said...

Democrats were eager to cut Terry Schiavo's health care ...

Ummm. No. The Republicans were eager to change the law and make it apply retroactively.

... health insurance tax policy coupled with moral hazard is what got us in the current crisis now that 50 years have passed.

Amazingly concise description. Anyone who doesn't focus on those two things is either stupid or lying.

Americans spend far more on health care than anyone else in the world ...

Most of the numbers in the cite look reasonable, but the US number ($6100 per capita) doesn't. I'm not certain what the cost to the company of my health care plan is, but $24,000 (family of four) seems way out of line on the high side.

Also, I wonder how much of that US amount, whatever it is, is spent on extremely expensive neonatal care for critically ill babies.

Whether that is a "wise" expenditure is off-topic. However, it should hardly count against the US for making that expense when other countries decline to.

4. ... This also explains, to some extent, the difference in life expectancy.

If you remove African Americans from life expectancy numbers, the US life expectancy goes up by (IIRC) nearly five years.

Compare like against like -- life expectancy for Japanese v. Japanese Americans, or Northern Europeans against NE Americans.

I'll bet the difference vanishes.

jim hamlen said...

There are several conundrums with the Democrats and health care. Lying about lowering costs is just one of them.

For one, I can't figure out why the trial lawyers are so supportive of single-payer, because there is no way they will be suing doctors or the government under such a system. John Edwards (as an example) would be working as a shampoo model if single-payer were the law of the land.

I suspect Obama and the Democrats lie so fluently because they have been conditioned to believe that whatever they propose is automatically 'better' than whatever the market has now. The market is the enemy. And cost itself is irrelevant, because the money comes from the rich and the corporations. So they simply say their plan will "cut costs", without even really knowing what that means. After all, Henry Waxman doesn't care about insuring more people, he doesn't care about crafting a system that provides better care, and he doesn't care about saving money. He cares about power - about beating his puny chest against what he sees as the enemy. But this "enemy" is just ordinary America - seniors, workers in corporate life, small business owners, etc.

For Obama and the Left, lying about their intentions and policies is a trifle, just a tactic in battling the "enemy". That's why they don't hesitate to call them un-American as well.