BOOKS FEBRUARY 20, 2013
Put aside the woes of the Republican Party: Not all opportunity is lost under the conservative umbrella. What appear to be the two most crushing recent moments for the American right—the Supreme Court's upholding of most of the Patient Protection and Affordable Care Act and the reelection of President Barack Obama—were in fact gifts from God to his favorite industry: the fundraising, merchandising, and publishing apparatus of the conservative movement.
Survival tips: These are now what's for sale, at your conservative movement vendor of choice. I've spent a week holed up reading three guides to all things ObamaCare: ObamaCare Survival Guide: The Affordable Care Act and What It Means for You and Your Healthcare by journalist Nick J. Tate, Beating Obamacare: Your Handbook for Surviving the New Health Care Law by infamous "Constitutional Scholar and Patient Advocate" Dr. Betsy McCaughey, and ObamaCare Survival Guide: The Affordable Care Act and What It Means for You and Your Healthcare by Bartholomew Okonkwo.
Perhaps you noticed something similar about the first and last titles—specifically, how they're the same. That's because the Okonkwo book is a hilarious self-published hustle that doesn't even try to disguise itself as such. The cover features blurry, pixellated plain text of its stolen name; inside, we learn that the book was merely "Complied [sic] by Bartholomew Okonkwo." ("Complied" from what, it's hard to tell.) At the end, the reader is informed that "if you enjoyed this book, then you'll love" Okonkwo's No Easy Hunt: The First Definitive Account of the Rise and Fall of Osama bin Laden. Bartholomew Okonkwo is basically a book-length spambot.
The actual ObamaCare Survival Guide, penned by Nick Tate, bears a cover design similar to the For Dummies series, but in this case is a product of Humanix Books, a publisher "affiliated with" the conservative Newsmax Media. Tate's book is safely ensconced in the Amazon.com top 20 and #2 on the New York Times bestseller list for the paperback advice and miscellaneous category. This is at least partly because Newsmax is running one of those buy-billions-of-copies-and-resell plots the conservative media is constantly offering its subscribers. On its website, Newsmax is selling the book for $4.95—fifteen dollars below list price—as part of a package that includes several trial subscriptions to other Newsmax Media pamphlets. Donald Trump is blurbed in the promotion, too: "The ObamaCare Survival Guide is terrific. It lays out the truth about ObamaCare. A must read for anyone who is worried about getting good healthcare for themselves—or their employees."
And yet one must feel for Tate. Because beyond the sketchy marketing ploys, questionable recommendations, and frightening cover language about "Medicare shockers," "Hidden taxes, levies, and fines," and the "Survivor" title itself, there's a text here that does a lot of things well and even-handedly. Tate neatly outlines how the basic mechanics of the bill work in the first chapters and has a few nice words for provisions like the small business tax credits and medical-loss ratio requirements. He swats down some of the more paranoid rumors about the Affordable Care Act, too, including the idea that the IRS is going to send everyone who doesn't get health insurance to jail, that illegal immigrants will be covered (assuming you'd consider that a bad thing), and, of course, the establishment of "death panels." Tate also acknowledges reasonable fears about the law's rollout, like its effects on state budgets, overwhelmed doctors, and possible lack of effective cost-control measures. Upward and downward pressures on costs are weighed against each other, concluding that no one really knows for sure which pressures will outmuscle the other. "ObamaCare lives in a fluid state," he writes. "It's likely that new developments will cause the law to mutate into something different from what it is today." Indeed!
Which isn't to say that Tate doesn't generously cherry-pick questionable numbers from partisan outlets like Rasmussen Reports or the Heritage Foundation, or toss in plenty of doom-and-gloom prophecy about how all of these well-meaning provisions could collapse entire healthcare markets before you have the opportunity to flee the country. Too often there's a tone of, "this could all go to hell and you and me are going to have to pay for everyone's free health care," channeling the Makers vs. Takers worldview that's come to dominate much of the conservative movement's rhetoric in recent years. But alas, such are the compromises one makes by signing a book deal with a Newsmax Media affiliate.
But if there isn't enough red meat in Tate's guide for the reactionary survivalist's appetite, well, that's why the conservative Regnery imprint keeps Betsy McCaughey around. McCaughey is the lady who shows up whenever there's a healthcare reform bill in the offing to lie about how it will kill off most of the population. And while she publicly and repeatedly admonishes the density of the law, it's fairly clear that that's her favorite part; it gives her 2,752 pages of new legislative language to twist into a marketable and comprehensive horror story that's comfortably maintaining its spot near the middle of Amazon's Top 100.
The central paradox at work in McCaughey's "handbook for surviving the new health care law" is that she seems to believe not one person will survive this new healthcare law, which she admits is "here to stay." Each chapter begins with bullet-pointed "Did you know?" "facts" to entice the poor reader into continuing to the next page. For example: Did you know that "The Obama health law awards bonus points to hospitals that spend the least on seniors?" The doublespeak here is the work of a pro. What she seems to be referring to is a pilot program that rewards groups of doctors who are able to work together, rather than just follow their own individual incentives, to provide the most efficient and waste-free treatment programs for patients. Her take implies that the government will give money to doctors who go out of their way to shaft their patients. This is the sort of manipulation that guides the entire, terrible book, which concludes, hilariously, by stating that "the law's consequences… will… bring down the curtain on the golden age of medicine." (Needless to say, she doesn't think healthcare spending was a problem before ObamaCare, citing recent year statistics of flat health care spending growth that are largely due to the bad economy and efficiency measures taken by medical professionals in advance of the law's full implementation.)
It's only the beginning of 2013, so expect the conservative movement to publish a raft of additional "survival" guides their fraudulent reprint hustle schemes for at least the next year, until the main provisions of the Affordable Care Act set in, and we begin to see actual empirical data on its success or failure. Right now, marketing them as necessary to every human being's survival may help them sell. But it still comes from a place of paranoia, marketed to paranoiacs, where the ObamaCare is something that requires the installation of backyard bunkers. But beyond forcing some folks to set up an appointment with a financial adviser, the bill won't kill you. It's going to help some people and hurt others at first, like any reform law, and why we have the processes of legislative oversight and maintenance to mitigate those trends. You'll survive. Really.