Thursday, May 02, 2013


A new study published in the New England Journal of Medicine looks at Oregon's Medicaid expansion and finds that there's clear improvement in recipients' lives in only some areas. Now, how did the first opinion-shapers who read this study react to it?

Well, right-wing opinion-shapers got to the study first, and they did what they usually do: they went nuclear. The Cato Institute essentially declared Medicaid expansion, and thus Obamacare, utterly and incontrovertibly worthless:
Today, the nation's top health economists released a study that throws a huge "STOP" sign in front of ObamaCare's Medicaid expansion.

The Oregon Health Insurance Experiment, or OHIE, may be the most important study ever conducted on health insurance.

... the OHIE's second-year results found no evidence that Medicaid improves the physical health of enrollees. There were some modest improvements in depression and financial strain -- but it is likely those gains could be achieved at a much lower cost than through an extremely expensive program like Medicaid....
Others on the right were equally unnuanced in their response to this study:

* Jennifer Rubin at The Washington Post: "Spending on Medicaid Doesn't Actually Help the Poor."
*James Pethokoukis of the American Enterprise Institute, at Business Insider: "Bombshell New Study Shows That Expanding Medicaid Does Nothing To Improve People's Health"
*Philip Klein at The Washington Examiner: "Landmark Study Shatters Liberal Health Care Claims"

Now, right-wingers say that the right-wing information machine -- Fox, talk radio, right-wing think tanks, right-wing blogs -- is a necessary corrective to the "liberal media," i.e., what most people think of as the mainstream media. So that means the mainstream media was just as unnuanced in its trumpeting of the successes shown in this study as the right-wing opinion machine was in trumpeting the failures ... right?

Er, no. Megan McArdle rounds up the initial mainstream responses:
"Study: Medicaid reduces financial hardship, doesn’t quickly improve physical health" says the Washington Post.

The Associated Press headline reads "Study: Depression rates for uninsured dropped with Medicaid coverage"

At the New York Times, it's "Study Finds Expanded Medicaid Increases Health Care Use"

I think Slate is closer to the mark, though a bit, well, Slate-ish: "Bad News for Obamacare: A new study suggests universal health care makes people happier but not healthier."
It's only now, after right-wing propagandists have set the terms of the debate, that there's some pushback from liberals. And even some of that is nuanced. At The New Republic, Jonathan Cohn touts the positive results shown in the study, and says of conservative critics, "Did they read read the same study that I did?" -- but the title-bar headline for his piece is "Medicaid Expansion: Oregon Study Shows Benefits, Mostly." Kevin Drum writes a gosh-I'm-not-sure-what-to-think post titled "So Is Healthcare Worthwhile or Not?," then gets around to reading the study and boldly proclaims, "Followup: Medicaid Probably Does Improve Health Outcomes After All." Mostly! Probably!

Look, I think the liberals in this debate are being more honest. But that's the problem. Our side is dominated by honest brokers -- people who'd read this and lean toward the argument that the government-intervention glass is half full, or maybe a fair amount more than half full, but never that it's completely full.

The problem is, they're up against a right-wing information machine that's ready to shout to the world that not only is the glass half empty, but it's shattered, and pieces of broken glass are being nibbled on by your babies, while other shards are cutting a hole in your wallet pocket.

The right wins all the time because the right thinks the whole point of political debate is winning. Right-wingers instantly pounce on everything that might give them a win. They exploit everything that might give them a win in a way that maximizes the chance of a win. And they all instinctively know how to flood the zone whenever one of them finds anything exploitable.

Intellectual honesty and nuance can't compete with that.


Victor said...


Republicans are masters of this. Today's take by them on this study is just the latest example.
They take some issue, or question, and blow it up out of all proportion, like the wonderful analogy you made with the glass.

My favorite ones, though, are when they ignore bad news for them, to try to twist it into success. Or, like when they try to take some catostrophic disaster that they caused, and minimize it.

That led to last weeks classic, "After 9/11, there were no significant terrorist attack on America.
Ignoring 9/11, the anthrax attacks, and numerous other examples of terrorist activity in the US.

Republicans always, ALWAYS, try to exploit any, and every, thing to their benefit.
Liberals and Democrats aren't wired that way - and hence, pass up too many opportunities.

They're too busy trying to show a reasonable approach, because their base appreciates reason.

Republicans never care about being reasonable. Their base isn't reasonable, and doesn't appreciate people being reasonable.

They want blood. The more, the better.

Unknown said...

It depends on what your definition of "winning" is.
I don't think they win just because they are first, or the loudest. If anything, by their drawing more attention to the study, it encourages more in-depth analysis of it.
And when one does that, it is clear that Medicaid expansion will help people primarily financially, which is one of the main goals of Obamacare. Preventive health treatment is not designed to cure people; it is designed to prevent people from developing life-threatening conditions before they get out of hand. Hence the conclusion of "not significantly improving the health".
It may not have improved, but it didn't get worse.

Ten Bears said...

My experience Scott, as a participant in both the lottery and the survey, is it made things better. This is just the Nazi propagandists pitching raw red meat to their constituency.

Bad news Tea Baggers... I'm gonna' outlive you.


No fear.

Examinator said...

Meanwhile in a country… not America.

A piss ant country at ass end of the world …Australia
Has enacted nearly all the US ‘conservatives’ (sic) hyperventilating fears of the precursors to freedom Armageddon… and yet…


Mandatory firearm checks, no 5yo shooting 2yo sister with birthday rifle (WaPo) etc.
Firearm misadventures are WAY lower than in US (including suicides); Oh yes suicides as a percentage are lower too … arguably partially because of Govt funded emergency counseling;
Did I mention terrorism is at background levels?
Tougher Vilification and libel laws; yet their non News Ltd press is more informative than US MSM.

Universal basic health care, private insurance for extras and preferences;

And free house hold ambulance attendance for emergencies;

Pharmaceutical subsidies with a maximum per year out of pocket safety net and it’s lower for the poor and pensioners; Would you believe that the conservative opposition has just agreed to an increase in the universal tax levy from 1.5% to 2% to help pay for
Universal disabled support… go figure?

OK they know if they opposed it in the up coming election they’d get electorially thrashed. As they did when they tried to monkey with the Industrial Relations law by forcing contracts rather than awards. Their unemployment level is about 6%.

Tighter control over Bank reserves etc…Aust was the only western country to avoid GFC recession and first to recover; they are in the top of the most profitable banks in the world;

Growth is higher than US; the A$ is higher than the US$!

They have a Carbon tax and a resource tax yet the industry is monumentally profitable;

You want more? Well insider trading applies to politicians too. As does the pecuniary interests register;
They have automatic voting registration and an independent electoral commission; one method of voting. Exclusions for citizens are, under 18; mentally incompetent; or IN jail (period).

The list goes on.

The point of this isn’t to sell Australia as anything other than a practical proof that limited Federal control over the supply of social services and man made tools (corporations) all in the greater community good DOES’T lead to communism (or the death of capitalism), extinguishing or freedom or a reasonable facsimile
Of democracy.In reality such obstructionist arguments are exactly what they appear manipulation self serving (selfish) rhetoric. (unsubstantiatible BULL SHIT if you prefer the term.
Ask your self is America better off because of its ingrained 'culture of Me first'? only potentially if you're in the 1%.
And not always then.

Rugosa said...

Examinator, all that sounds lovely but the 1% in America doesn't care. They want a society in which 99% are immiserated in order to keep the 1% as rich as possible. That they would still be rich in a society that functioned for the benefit of the 99% is beside the point - they wouldn't be quite as rich, and they can't enjoy their riches if they have to share any of the goodies at all. Yes, it's psychopathological, or as it says in the bible they like to thump but not read, love of money is the root of all evil.