“The Moment Of Truth”: The GOP Must Admit It Was Wrong On Obamacare
Is there any accountability in American politics for being completely wrong? Is there any cost to those who say things that turn out not to be true and then, when their fabrications or false predictions are exposed, calmly move on to concocting new claims as if they had never made the old ones?
The fact that the Affordable Care Act (ACA) hit its original goal this week of signing up more than 7 million people through its insurance exchanges ought to be a moment of truth — literally as well as figuratively. It ought to give everyone, particularly members of the news media, pause over how reckless the opponents of change have been in making instant judgments and outlandish charges.
When the health-care Web site went haywire last fall, conservatives were absolutely certain this technological failure meant that the entire reform effort was doomed. If you doubt this, try a Google search keyed to that period relating the word “doomed” to the health-care law.
It should be said that the general public was much wiser. A CNN poll in November that Post blogger Greg Sargent highlighted at the time found a majority (54 percent to 45 percent) saying that the problems facing the law “will eventually be solved.” Political moderates took this view by 55 percent to 43 percent, independents by 50 percent to 48 percent. Only Republicans — by a whopping 72 percent to 27 percent — and conservatives (by 66 percent to 33 percent) thought the law could never be fixed.
Their representatives in Washington, moderate conservatives as well as the tea party’s loyalists, followed the base’s lead. In mid-November, for example, Sen. Rob Portman (R-Ohio) told Fox News flatly that the law is “destined to fail,” “fundamentally flawed” and “not ready for prime time.” House Speaker John Boehner predicted dire outcomes before the Web site fiasco. He repeatedly insisted, as he did in July, that “even the Obama administration knows the ‘train wreck’ will only get worse.”
This attitude affected more neutral observers. Forbes magazine posted a piece on Nov. 22 under the headline: “What to do if and when Obamacare collapses.” The op-ed modestly acknowledged that “it’s too soon to write an epitaph for Obamacare,” but then barged forward, since “its crises are piling up so fast that one has to begin looking ahead.”
At this point, the etiquette of commentary typically requires a “to be sure” paragraph, as in: To be sure, the law could still face other problems, blah, blah, blah. But such paragraphs are timid and often insincere hedges. After all, every successful program, even well-established ones such as Medicare, Social Security and food stamps, confronts ongoing challenges.
So let’s say it out loud: The ACA is doing exactly what its supporters said it would do. It is getting health insurance to millions who didn’t have it before. (The Los Angeles Times pegged the number at 9.5 million at the beginning of the week.) And it’s working especially well in places such as Kentucky, where state officials threw themselves fully and competently behind the cause of signing up the uninsured. Those who want to repeal the law will have to admit that they are willing to deprive these people, or some large percentage of them, of insurance.
Too many conservatives would prefer not to say upfront what they really believe: They don’t want the federal government to spend the significant sums of money needed to get everyone covered. Admitting this can sound cruel, so they insist that their objections are to the ACA’s alleged unworkability, or to “a Washington takeover of the health system” (which makes you wonder what they think of Medicare, a far more centralized program). Or they peddle isolated horror stories that the fact-checkers usually discover are untrue or misleading.
Thus the moment of truth, about the facts and about our purposes.
From now on, will there be more healthy skepticism about conservative claims against the ACA? Given how many times the law’s enemies have said the sky was falling when it wasn’t, will there be tougher interrogation of their next round of apocalyptic predictions? Will their so-called alternatives be analyzed closely to see how many now-insured people would actually lose coverage under the “replacement” plans?
Perhaps more importantly, will we finally be honest about the real argument here: Do we or do we not want to put in the effort and money it takes to guarantee all Americans health insurance? If we do — and we should — let’s get on with doing it the best way we can.
By: E. J. Dionne, Jr., Opinion Writer, The Washington Post, April 2, 2014
“Jobs And Skills And Zombies”: Skills Gap, An Idea That Should Have Been Killed By Evidence But Refuses To Die
A few months ago, Jamie Dimon, the chief executive of JPMorgan Chase, and Marlene Seltzer, the chief executive of Jobs for the Future, published an article in Politico titled “Closing the Skills Gap.” They began portentously: “Today, nearly 11 million Americans are unemployed. Yet, at the same time, 4 million jobs sit unfilled” — supposedly demonstrating “the gulf between the skills job seekers currently have and the skills employers need.”
Actually, in an ever-changing economy there are always some positions unfilled even while some workers are unemployed, and the current ratio of vacancies to unemployed workers is far below normal. Meanwhile, multiple careful studies have found no support for claims that inadequate worker skills explain high unemployment.
But the belief that America suffers from a severe “skills gap” is one of those things that everyone important knows must be true, because everyone they know says it’s true. It’s a prime example of a zombie idea — an idea that should have been killed by evidence, but refuses to die.
And it does a lot of harm. Before we get there, however, what do we actually know about skills and jobs?
Think about what we would expect to find if there really were a skills shortage. Above all, we should see workers with the right skills doing well, while only those without those skills are doing badly. We don’t.
Yes, workers with a lot of formal education have lower unemployment than those with less, but that’s always true, in good times and bad. The crucial point is that unemployment remains much higher among workers at all education levels than it was before the financial crisis. The same is true across occupations: workers in every major category are doing worse than they were in 2007.
Some employers do complain that they’re finding it hard to find workers with the skills they need. But show us the money: If employers are really crying out for certain skills, they should be willing to offer higher wages to attract workers with those skills. In reality, however, it’s very hard to find groups of workers getting big wage increases, and the cases you can find don’t fit the conventional wisdom at all. It’s good, for example, that workers who know how to operate a sewing machine are seeing significant raises in wages, but I very much doubt that these are the skills people who make a lot of noise about the alleged gap have in mind.
And it’s not just the evidence on unemployment and wages that refutes the skills-gap story. Careful surveys of employers — like those recently conducted by researchers at both M.I.T. and the Boston Consulting Group — similarly find, as the consulting group declared, that “worries of a skills gap crisis are overblown.”
The one piece of evidence you might cite in favor of the skills-gap story is the sharp rise in long-term unemployment, which could be evidence that many workers don’t have what employers want. But it isn’t. At this point, we know a lot about the long-term unemployed, and they’re pretty much indistinguishable in skills from laid-off workers who quickly find new jobs. So what’s their problem? It’s the very fact of being out of work, which makes employers unwilling even to look at their qualifications.
So how does the myth of a skills shortage not only persist, but remain part of what “everyone knows”? Well, there was a nice illustration of the process last fall, when some news media reported that 92 percent of top executives said that there was, indeed, a skills gap. The basis for this claim? A telephone survey in which executives were asked, “Which of the following do you feel best describes the ‘gap’ in the U.S. workforce skills gap?” followed by a list of alternatives. Given the loaded question, it’s actually amazing that 8 percent of the respondents were willing to declare that there was no gap.
The point is that influential people move in circles in which repeating the skills-gap story — or, better yet, writing about skill gaps in media outlets like Politico — is a badge of seriousness, an assertion of tribal identity. And the zombie shambles on.
Unfortunately, the skills myth — like the myth of a looming debt crisis — is having dire effects on real-world policy. Instead of focusing on the way disastrously wrongheaded fiscal policy and inadequate action by the Federal Reserve have crippled the economy and demanding action, important people piously wring their hands about the failings of American workers.
Moreover, by blaming workers for their own plight, the skills myth shifts attention away from the spectacle of soaring profits and bonuses even as employment and wages stagnate. Of course, that may be another reason corporate executives like the myth so much.
So we need to kill this zombie, if we can, and stop making excuses for an economy that punishes workers.
By: Paul Krugman, Op-Ed Columnist, The New York Times, March 30, 2014
“In Addition To Honesty, It Requires Accountability”: Ryan Unsuited To Lead ‘Adult Conversation’ About Poverty
These days, a favorite talking point of Republican Congressman Paul Ryan’s is calling for an “adult conversation” about poverty.
“It’s time for an adult conversation,” he told The Washington Post.
“If we actually have an adult conversation,” he said in remarks at the Brookings Institution, “I think we can make a difference.”
The problem is that a prerequisite for any adult conversation is telling the truth and it is there the congressman falls monumentally short.
In addition to Rep. Ryan’s recent, racially-coded comments about “our inner cities” where “generations of men [are] not even thinking about working,” his rhetoric around policy should raise red flags for anyone — including the media — assessing his credibility.
A report from Emily Oshima Lee, policy analyst at the Center for American Progress Action Fund, examines the hatchet job Rep. Ryan did on Medicaid in his 204-page account of antipoverty programs that The Washington Post generously described as a “critique.” Indeed, Ryan’s report — which would have been flagged by my excellent 10th grade English teacher for misrepresenting and cherry-picking data — is a dangerous disservice to a public which has neither the time nor the staff that Ryan has at his disposal to delve into literature assessing antipoverty programs.
Lee notes that Ryan misuses research to imply that Medicaid coverage leads to poorer health — that people enrolled in Medicaid will have worse health than those with private insurance and the uninsured.
“The privately insured comparison is patently unfair because these people tend to be higher income and that comes with a whole host of health privileges,” said Lee.
She notes that Medicaid enrollees tend to struggle a lot more with chronic conditions and illnesses than other populations.
“A large body of literature identifies various social determinants of health, including socioeconomic status and living and work environments, as risk factors for poor health outcomes,” writes Lee, in my opinion admirably resisting the temptation to add, “duh.”
As for the uninsured being healthier — it would be one thing if Ryan were making an “apples to apples” comparison, but he’s not.
“The uninsured is a diverse group and doesn’t only include low-income individuals. It may include people who are high-income and don’t really want insurance but can afford health services, and lower-income people who may not have previously enrolled in insurance for a number of reasons — including cost and not having any real health issues,” Lee says. “But again, to imply that Medicaid is somehow making people worse off is absurd.”
Ryan also argues that Medicaid coverage has little positive effect on enrollees’ health. But as Lee points out, Ryan conveniently overlooks studies showing an association between Medicaid and lower mortality rates; reduced low-weight births and infant and child mortality; and lower mortality for HIV-positive patients, among other heath benefits.
“In general, we need more data to accurately assess the effect of Medicaid coverage on people’s health,” Lee continues. “But several studies do indicate positive health and non-health effects of coverage — such as increased use of preventive care and greater financial security.”
Rep. Ryan also plays on fears of low-income people abusing the welfare system when he asserts that Medicaid coverage improperly increases enrollees’ use of health care services, including preventive care and emergency department services. Ryan makes this case too by comparing Medicaid enrollees to uninsured people, who, as Lee writes, “are less likely to use health care services due to significant financial barriers.”
“Presenting data that Medicaid enrollees use more health services than the uninsured affirms that insurance coverage allows people who need care to seek it out,” writes Lee, “and that being uninsured is a major barrier to receiving important medical care.”
Further, one of the two studies Ryan references explicitly states that “neither theory nor existing evidence provides a definitive answer to… whether we should expect increases or decreases in emergency-department use when Medicaid expands.”
Despite Ryan’s shabby work when it comes to antipoverty policy, the media repeatedly seems willing to overlook it. That’s another strike against the prospects of a truly adult conversation about poverty — in addition to honesty, it requires accountability.
By: Greg Kaufmann, Moyers and Company, Bill Moyers Blog, March 29, 2014
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