Tag Archives: health

My distortions are your fault

There was a time when a young Robert Samuelson insisted that cost should not count if something like an invasion of Iraq was necessary. He wrote:

A possible war with Iraq raises many unknowns, but “can we afford it?” is not one of them. People inevitably ask that question, forgetting that the United States has become so wealthy it can wage war almost with pocket change. A war with Iraq would probably cost less than 1 percent of national income (gross domestic product). Americans have grown accustomed to fighting with little economic upset and sacrifice.

He regretted writing that. Having spent something like a lot of money now on Iraq, one might reasonably ask whether Samuelson should be listened to on matters of cost. I would say not. In any case, so Samuelson makes his argument against health care reform by the well-known device of attacking someone’s motives:

The campaign to pass Obama’s health-care plan has assumed a false, though understandable, cloak of moral superiority. It’s understandable because almost everyone thinks that people in need of essential medical care should get it; ideally, everyone would have health insurance. The pursuit of these worthy goals can easily be projected as a high-minded exercise for the public good.

It’s false for two reasons. First, the country has other goals — including preventing financial crises and minimizing the crushing effects of high deficits or taxes on the economy and younger Americans — that “health-care reform” would jeopardize. And second, the benefits of “reform” are exaggerated. Sure, many Americans would feel less fearful about losing insurance; but there are cheaper ways to limit insecurity. Meanwhile, improvements in health for today’s uninsured would be modest. They already receive substantial medical care. Insurance would help some individuals enormously, but studies find that, on average, gains are moderate. Despite using more health services, people don’t automatically become healthier.

Let me state first that Samuelson isn’t talking here about the specific plan (he does later, but he relies on the Lewin group, an insurance company funded “research” group–so, really, please), he’s talking about the general concept of reform. For anyone with a minimal knowledge of other industrialized nations, who spend at most about half of what he do and get a lot more, this is just an insult. For more on that, see here.

But more basically, Samuelson is doing a bit of straw man–weak man actually–and a bit of ad hominem circumstantial. It’s a weak man because he picks on the weakest of the pro-health reform moral arguments. There are other good moral reasons to support health care reform, and they involve arguments against the very real threat of medical bankruptcy, recision, denial of coverage of pre-existing conditions, and so forth.

The ad hominem accompanies the weak man–so weak are these arguments (which Samuelson has imputed to pro-reform people), that they must rather be dishonest attempts to score political points. Now that’s just a double-wammy. It’s a bit like saying this: “the weak argument I have dishonestly imputed to you is so bad that I question your honesty in making it.”

On the arguments against the specific plan, I’d say Samuelson needs to look beyond anti-reform sources of analysis and information. It’s a fair question whether the current plans being discussed will help, so we ought to have an honest discussion of that. But that perhaps is just hoping for too much.

But let me close by going back to something Samuelson said in defense of his poorly thought-out defense of the Iraq invasion:

But I am certain — now as then — that budget consequences should occupy a minor spot in our debates. It’s not that the costs are unimportant; it’s simply that they’re overshadowed by other considerations that are so much more important. We can pay for whatever’s necessary. If we decide to do less because that’s the most sensible policy, we shouldn’t delude ourselves that any “savings” will rescue us from our long-term budget predicament, which involves the huge costs of federal retirement programs. Just because the war is unpopular doesn’t mean it’s the source of all our problems.

Other considerations that are much more important. Indeed.