The main schism over health-care can be reduced to a philosophical difference over how to approach a problem. The President’s supporters swat away criticisms by explicitly referencing what the House bill says and what Obama says. Arguments not grounded in legislation or Obama’s words, they say, are unfounded speculation. Critics of the President instead point to the inevitable outcome of any bill that becomes law. If A happens, then B will happen, eventually leading to C. In a sense, they detect a nefariously causal and linear sequence ultimately leading to the rationing of health-care except for the uber-elite. Although many neatly formed causal puzzles that are predicated upon one fact tend to be spurious, in this case it is better to air on the side of logic than to rely on factual chicanery.
To help explain what I am saying, it is useful to revisit the fractious debate over the stimulus package in February. Proponents of the $787 billion bill said that lower and middle class citizens would particularly benefit because it included a tax cut of $25 per week, prolonged Medicaid benefits, and employment-heavy projects. These facts, treated in isolation, are inarguably true. When critics of the bill would riposte that this empowers government, takes away individual liberty, etc., advocates would always return to those previously stated benefits. The true logic of the bill is that those lower and middle class citizens will in the future pay for that $787 billion in the form of higher taxation, interest rates, inflation, and/or a weaker dollar. In response, someone on the left could argue that those things will be more burdensome to the wealthy than the poor, but the evidence points to the contrary. The point is that folks on the left exclusively focused on the present facts and benefits while the right would speak of economic laws that they believed will surely come to fruition. Debates over whether more public spending comes at the expense of private spending and whether inflation will always come as a direct consequence of an increase in the quantity of money are perhaps debatable, but they cannot be dismissed in an argument that wants to only stick to the “facts.”
So we once again have the same thing for health-care. The President promises that if someone likes their healthcare, they can keep it. Detractors say the government can lull companies into opting for a public option by the government option promising the same benefits for less as a result of having no cost of capital and being able to run in the red. The logic follows that eventually the government will need to cut costs, meaning fewer benefits and worse care than current insurers offer. The President says that there will be no pressure on cutting costs for old people. Critics say that if he promises to cover a lot more people at a lower cost, that will inevitably result in older people getting worse care. There is no mention of this in any speech or bill. Nonetheless critics say this is what will logically follow.
The espoused logic that refutes Obama’s plan is certainly not airtight. But all of these arguments should be concerned with the logic, not muddled empiricism. In many ways the financial crisis can be tied back to muddled empiricism that paid no attention to the logical outcomes of what it was proposing. Fannie Mae and Freddie Mac had to inevitably fail; a corporation gets to borrow money at artificially low rates because the government guarantees its debt. In return, the companies buy up half of all existing mortgages to promote middle and lower class housing. The outcome: a housing bubble bound to severely crash. Instead of citing graphs and esoteric models, it would have been helpful if a rational and thoughtful debate centered around economic assumptions and outcomes governed our government’s federal housing policies.
The same is true for health-care. Instead of writing off people who come to conclusions that aren’t stated by any public figure, let them articulate their premises and causal links. We’ll make much better policy that way.
