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Selective Health Care Populism

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Anyone who participated in blog comments sections back in the previous decade knows that there was an inevitable response to criticisms of the Bush administration: “Republicans keep winning elections neener-neener.”  This was true until it wasn’t, as well as being irrelevant to the criticisms.  As Jon Chait argues, with virtually all of their empirical predictions about the ACA having proven to be spectacularly wrong, all that critics of the ACA have are public opinion surveys:

This is the reality that the entire Republican Party has failed to come to grips with. The American health-care system before Obamacare was an utter disaster — the most expensive in the world and also the only one that denied access to millions of its own citizens. Obamacare set out to change those things, and it has worked.

There is one remaining indictment of the law that Tanner makes, and it’s true. “The law remains extraordinarily unpopular, with opponents topping supporters by nearly 11 percentage points, according to the latest Real Clear Politics average,” he argues. It is notable that opponents of Obamacare have fixated on the law’s poor polling. In a recent column, Reason’s Peter Suderman quibbles halfheartedly with the law’s demonstrable success in carrying out its goals — suggesting that the astonishing drop in medical inflation may be owed to outside forces — before reveling for six paragraphs in his major point, which is continued lack of public approval. “Obamacare is simply not well liked,” he concludes, “This is the political reality — and President Obama still refuses to embrace it.”

It is telling that, having lost every substantive argument about the law’s operation, their sole remaining refuge is an argument about its perception. It’s true: Their lies got halfway around the world before the truth could get its pants on. Indeed, if you google most of the factual disputes I discuss above, you’ll get a lot more hits from conservatives making hysterical and false predictions than you will find from reports showing those predictions failed to come true. Those myths still hold enormous sway over public opinion. Far more Americans believe Obamacare has death panels, which is false, than believe its costs have come in under projections, which is true. Conservatives have won the propaganda war over Obamacare. The trouble is that they think this is an indictment of Obamacare, when in fact it’s an indictment of them.

As Chait says, it’s not an accident that much conservative criticism has focused on assertions that the ACA would fail on its own terms. The position of most American conservatives on health care — i.e. that in 2009 too many people had insurance and the insurance that many people did have was too good — is not only morally barbarous but would make the ACA look more popular than free beer in comparison. And in this sense, while the argument that the ACA is unpopular is unusually true for an anti-ACA talking point, it’s still very misleading. Preserving or expanding the ACA remains more popular than cutting it back or rescinding it. The ACA is the least popular health care proposal on offer except for all the others. Which is yet another reason for why Obama is not going to embrace Peter Suderman’s “reality.”

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