|"I cannot tell a lie"|
Friday, November 21, 2014
Another video has surfaced of Jonathan Gruber saying cringe-worthy things about Obamacare. Gruber is an MIT economist and health care expert who worked as a number cruncher for the White House during the push to enact Obamacare. Here’s what he said last year regarding the way political pressures distorted the legislative process:
This bill was written in a tortured way to make sure CBO [Congressional Budget Office] did not score the mandate as taxes. If CBO scored the mandate as taxes, the bill dies. So it’s written to do that.
In terms of risk-rated subsidies, in a law that said health people are gonna pay in — if it made explicit that healthy people are gonna pay in, sick people get money, it would not have passed. Okay, lack of transparency is a huge political advantage. And basically, call it the stupidity of the American voter or whatever, but basically that was really, really critical to get anything to pass.
Conservatives are up in arms, particularly over the “stupidity” part, convinced that Gruber’s comments expose the dirty truth of modern liberalism: It’s a conspiracy of snooty technocrats confident their superior brains and sociological analyses authorize them to control the everyday lives of the smelly masses, the rednecks and rubes too foolish to make the right choices, too stupid to know what’s good for them.
But let’s ignore that ridiculous argument and consider what Gruber was actually saying: that for any legislation to pass it must be politically presentable, it must not afford its opponents an easy target. And that applies to Obamacare in two ways. First, Democrats could not allow the individual mandate to be seen – by the CBO or the public – as a tax. Second, the essence of Obamacare is a transfer of health insurance dollars from the young, rich and healthy to the old, poor and sick; the public would never have allowed such governmental redistribution, so it had to be disguised. And Gruber was also saying that it was easy to slip those two deceptions past an American public that doesn’t closely follow healthcare policy debates. Charles Krauthammer charges that, “in order to get it passed, the law was made deliberately obscure and deceptive.” Is he wrong?
It’s true, as Brian Beutler protests, that Obamacare’s legislative process was more transparent than most (compared to say Bush’s 2003 Medicare expansion or the run up to the Iraq War). And it’s true, as Neil Irwin concedes, that certain aspects of the law itself (not the process) were deliberately obscured; and that is a “commonplace” tactic that's been employed by both parties on many occasions. So who’s responsible for the fact that the American public does not really understand Obamacare? Andrew Sullivan blames liberals and the administration for not making a better and clearer case for the law. But many pundits, such as Paul Krugman, Jonathan Cohn, Ezra Klein and Jonathan Chait, have been explaining it clearly for years. Gruber himself even wrote a comic book to make it easily understandable! And conservatives, of course, have invested an enormous about of time and energy lying about the very law they now accuse of deceit and deception. The national press did a bad job of covering all this, as they always do, by focusing on optics and neglecting substance. But if any individual wanted to know more about the law, they could have quickly and easily done so – as long as they turned off Fox News. The one actual, explicit lie used to sell Obamacare was the president’s promise that, “If you like your health plan, you can keep it.” He knew it was a lie when he said it, but he also knew that admitting that 7 or 8 million people would have their policies regulated away – even though they’d be replaced with better ones – might have put the whole law in jeopardy. The entire structure of American political discourse worked against an honest assessment of the law.
But let’s make the real confession. There is one fundamental lie liberals have made and continue to make about Obamacare, and it’s a lie of omission. The components, the details, the numbers have been endlessly examined, analyzed and debated. But the real meaning of the law has, for the most part, not been adequately addressed. What is its deeper significance? What is it really about? Redistribution. Both Gruber’s confession and conservative complaints really boil down to this one point: Obamacare severs the connection between income and healthcare coverage; it indirectly redistributes money from the rich, young and healthy to the poor, old and sick. The “indirectly” in that last sentence is what the current controversy is really about. Gruber both regrets the necessity of that indirection and gloats over its devious utility. And that gloating gives conservatives cover to deplore its dishonesty, though in reality they only lament its effectiveness.
But should we deplore its dishonesty? Only if we care about American democracy. Only if we wish it to be more rational and effective. Sullivan puts it nicely:
If someone were willing to explain the ACA in simple, clear and honest terms, I think most Americans would back it . . . I refuse to believe that a democracy has to operate this way for change to occur. Gruber’s arrogance and condescension are just meta-phenomena of this deeper dysfunction. Someone needs to treat Americans as adults again before this democracy can regain the credibility it so desperately needs to endure.
But is Sullivan right that Obamacare could have withstood a thoroughly candid presentation? Would a majority of Americans have supported it, even knowing the governmental redistribution that lay at its heart? The answer is not clear, but I think probably not. The idea of redistribution, explicitly promoted, would probably have been too unnerving.
We see that the distrust of Obamacare is primarily ideological. American instincts are generally conservative: they fear centralized authority, they mistrust regulation, they insist that each person is the master of his own fate. But American instincts constantly conflict with American interests. Modern society would not be livable without the welfare and regulatory state that liberals have created and conservatives threaten, and Americans affirm that every time they deposit their social security checks and present their Medicare cards. American conservatism evaporates at the door of the unemployment office. Put more prosaically, the American people are ideologically conservative but operationally liberal, as has been noted many times.
That’s the real reason public policy is often deceptive. Social Security pretends to give you back the money you paid in, but it actually pays more, relative to income, to those who made less. So liberal laws must be dressed up in conservative clothing. Many liberals, possibly including Obama himself, would have preferred single payer healthcare but considered it politically unpalatable, so they offered a market-friendly program cooked up in a right-wing think tank and instituted by a Republican governor. Many Americans dislike Obamacare (some hate it for the evil Satanic, Islamic, Communist conspiracy it is!) while they like most Obamacare provisions. Kentuckians, for example, hate Obamacare but love Kynect, their state’s implementation of the Obamacare exchange; but they returned to the Senate Republican Mitch McConnell, who has explicitly vowed to repeal Obamacare yet who refused to condemn Kynect when cornered in front of a Kentucky audience! In the last election people all over the country voted for liberal policies like marijuana liberalization and minimum wage increases while voting into office conservatives staunchly opposed to those very policies. Huh?
In effect, Americans want to be lied to. They want it both ways: to enjoy their liberal dessert while believing it’s sturdy conservative fare. This is the real deception at the core of this debate: the American people are kidding themselves. They’re not stupid, as Gruber and some liberals believe, nor are they solid conservatives. They’re inconsistent, and unaware of it. And that encourages politicians and pundits to see what they want to see. Conservative operatives dream of an America utterly given over to its deepest conservative instincts, but they’re woken from the dream by picketers angrily cursing any cuts to Medicare. And liberals can never understand why Americans don’t follow them out of the laissez-faire wilderness into the social democratic Promised Land. A consummate seduction of the American public eludes them both, though conservatives whisper sweet poetry and liberals offer alluring gifts.
But you don’t practice politics with the public you wish you had. Ultimately, Americans want to be told the truth. And they deserve the truth. Liberals need to come clean. The Democratic Party is the party of redistribution, and it should damn well act like it! That’s not socialism or authoritarianism – conservative paranoia to the contrary – it’s the pragmatic amelioration of the worst inequities of modern society. An economy that provides more and more to those at the top but demands more and more from everyone else does not satisfy the demands of democracy and justice. Unfair economics is as destructive to democracy as dishonest politics. If liberalism is not about justice for working people then it becomes little more than a loose confederation of identity groups, fighting over the scraps of a long gone shared prosperity. It abdicates its claim to universalism, it loses its fire and its soul. And so it has.
Gruber thought he bravely spoke the truth of American politics, that the people are so stupid that good policy must be deceitful policy. But Gruber’s story is really one of liberal cowardice. And there’s so much of our current misfortune that would be greatly improved with just a little more liberal courage. Human nature being what it is, game-playing cannot be removed from politics. But why can’t liberals successfully balance cunning and conviction? And can they do the ceaseless, thankless work of educating the public about what they stand for and why? And most importantly, can they learn to trust the people again? The people are not stupid, they have as many practical instincts as conservative ones; they are amenable to prudential, fair, liberal policy that would benefit them and strengthen the country. They’re merely waiting for leadership that both works for them and respects them. Conservatism, in its modern incarnation as plutocratic propaganda factory, does neither. Timid liberalism can only do the former. Only confident and candid liberalism can do both.