Assessing Failure: The Death Spiral Revisited

Let us take an analytical look at the death of Obamacare, from the point of view of an expert on failure. Mrs. Megan McArdle, author or The Up Side Of Down: Why Looking Down On The Poor Cheers Me Up, has written approximately 95 posts since September of last year on why Obamacare would be a complete and utter falure. She has written 0 posts on Obamacare recently, which is odd since McArdle surely wants to compare her predictions to tentative results. Some of those predictions, carefully hedged, were:


1. Obamacare will limit your choices when it forces insurers to leave the market.
2. The poor website rollout "could destroy Obamacare -- and possibly, the rest of the private insurance market."
3. Obamacare was in a "death spiral."
4. Obamacare was like Three Mile Island because it was doomed to fail from the start.
5. Obamacare was "dying of old age"; young people would not sign up.
6. Obamacare will "pull the plug" on medical innovation. Yes, she is still making this claim.
7. Obama destroyed Obamacare.
8. Obamacare won't lower costs.
9. Young people aren't signing up and won't sign up later.
10. A slowdown in health spending is due to the recession, not Obamacare.
11. "Watch Obamacare make Health Care Costs Soar"


McArdle did say that we would have to wait until the Census to determine if Obamacare was working but one would think that she would be interested in the latest report of its progress.


Paul Krugman notes this phenomenon in the media in general:

How many Americans know how health reform is going? For that matter, how many people in the news media are following the positive developments?  

I suspect that the answer to the first question is “Not many,” while the answer to the second is “Possibly even fewer,” for reasons I’ll get to later. And if I’m right, it’s a remarkable thing — an immense policy success is improving the lives of millions of Americans, but it’s largely slipping under the radar. How is that possible?  

Think relentless negativity without accountability. The Affordable Care Act has faced nonstop attacks from partisans and right-wing media, with mainstream news also tending to harp on the act’s troubles. Many of the attacks have involved predictions of disaster, none of which have come true. But absence of disaster doesn’t make a compelling headline, and the people who falsely predicted doom just keep coming back with dire new warnings.

 That's because billionaires keep hiring and paying them. The fun part of Mr. Krugman's article is the way in which McArdle fits his exemplary conservative hack examples.

Consider, in particular, the impact of Obamacare on the number of Americans without health insurance. The initial debacle of the federal website produced much glee on the right and many negative reports from the mainstream press as well; at the beginning of 2014, many reports confidently asserted that first-year enrollments would fall far short of White House projections.

Yes, McArdle said that there was no way Obamacare would enroll enough people to meet its goals.

Then came the remarkable late surge in enrollment. Did the pessimists face tough questions about why they got it so wrong? Of course not. Instead, the same people just came out with a mix of conspiracy theories and new predictions of doom. The administration was “cooking the books,” said Senator John Barrasso of Wyoming; people who signed up wouldn’t actually pay their premiums, declared an array of “experts”; more people were losing insurance than gaining it, declared Senator Ted Cruz of Texas.

McArdle made the first two claims as well. In fact, she made them in the same words.

Is Obama Cooking the Census Books for Obamacare?  

By Megan McArdle  

For several months now, whenever the topic of enrollment in the Affordable Care Act came up, I’ve been saying that it was too soon to tell its ultimate effects. We don’t know how many people have paid for their new insurance policies, or how many of those who bought policies were previously uninsured. For that, I said, we will have to wait for Census Bureau data, which offer the best assessment of the insurance status of the whole population.

McArdle has a lot of influence and did her very best to kill Obamacare. Fortunately she is an expert on failure and did not succeed, but not for lack of trying.

... I’ve been seeing some claims on the right that the dramatic reduction in the number of uninsured was caused by economic recovery, not health reform (so now conservatives are praising the Obama economy?). But that’s pretty lame, and also demonstrably wrong.  

For one thing, the decline is too sharp to be explained by what is at best a modest improvement in the employment picture. For another, that Urban Institute survey shows a striking difference between the experience in states that expanded Medicaid — which are also, in general, states that have done their best to make health care reform work — and those that refused to let the federal government cover their poor. Sure enough, the decline in uninsured residents has been three times as large in Medicaid-expansion states as in Medicaid-expansion rejecters. It’s not the economy; it’s the policy, stupid.

Lame, stupid, demonstrably wrong. That about sums it up. As linked above, McArdle did this as well.

What about the cost? Last year there were many claims about “rate shock” from soaring insurance premiums. But last month the Department of Health and Human Services reported that among those receiving federal subsidies — the great majority of those signing up — the average net premium was only $82 a month.

Yes, McArdle predicted that as well. Krugman also says:

And as I suggested earlier, people in the media — especially elite pundits — may be the last to hear the good news, simply because they’re in a socioeconomic bracket in which people generally have good coverage.

That, and all the anti-government regulation money sloshing around.