JONATHAN COHN SEPTEMBER 20, 2010
-
Read Later
READ LATERAvailable only to subscribers. SUBSCRIBE TODAY
-
Listen
ARTICLE AUDIO
- Font Size
The latest official statistics on income and poverty, which the government released last week, included some particularly alarming news about health insurance. From 2008 to 2009, the number of people with health insurance actually fell, for the first time since the Census began collecting such information, from 255.1 million to 253. 6 million. Meanwhile, the proportion of Americans without coverage reached 16.7 percent. That's a new high, up from 15.4 percent in the previous year.
Of course, you expect to see this sort of change in an economic downturn. When people lose their jobs, they typically lose their health insurance, too. But guess which state actually managed to reduce the number of people without health insurance, even as its unemployment rate was rising? Sure enough, it was Massachusetts, whose state-level expansions of health insurance are a model for what the Affordable Care Act will eventually do nationally.
From 2008 to 2009, the uninsurance rate in Massachusetts fell from 5.5 to 4.4 percent. As the graph here suggests, it was one of only a handful of states in which the uninsurance rate declined. And the other states with falling uninsurance rates have small populations, which means their statistics are subject to high sampling errors. (The exception is Louisiana and I have no idea what's going on there, although I suspect it has something to do either with the influx of post-Katrina health care funding or the ongoing out-migration of very poor people as the New Orleans area rebuilds.)
I can't prove that the Massachusetts numbers reflect the impact of health care reform there. (I'd have to sort through a ton of other variables.) But, at the very least, the statistics are consistent with what we already know about Massachusetts: The number of people without health insurance has fallen and, at the same time, people are getting better access to medical care.
More important, though, the latest numbers from Massachusetts seem to illustrate an under-appreciated point that Robert Greenstein, of the Center on Budget and Policy Priorities, made in a conference call last week: Health care reform is an automatic anti-recession measure, because, during downturns, government ends up enrolling more people in Medicaid and providing more people with subsidies to pay for private insurance. Those are two effective forms of stimulus.
You hear a lot about how President Obama and the Democrats focused on health care, at the expense of the economy. This would seem to be a reminder that, to some extent, they were doing both at the same time.
1 comments
I am curious to read the comments of those who believe that the President failed to 'set expectations': (1) He has made it clear, on innumerable occasions from the inauguration on, that 'change is hard' and will take time. (2) Apropos the recovery act, he again was clear that the aim was to create *or* save up to 3 million jobs, and has been specific about the kinds of jobs that were saved: police, fireman, teachers, construction workers employed by investments in green technology. He also made it clear that part of the act was to invest in a 'new foundation' for the economy, and that it would take *time* to build that foundation. The investments ranged from unprecedented sums devoted to science and health infrastructure to green jobs. Again, investments take *time* to pay off. (3) Apropos the auto 'bailout': he was straightforward with the country and said from the start that it was a decision he knew to be unpopular, but was one that had the potential to save millions of jobs associated with the auto industry. It has: both saved jobs and been unpopular, largely, I would argue, because Americans are at heart not very generous (it was *their* money being invested in *others*). What could the President have said to 'sell' people on the idea? Visit auto factories (did that)? Visit parts suppliers (did that)? (4) Apropos health care: he again was clear that most of the returns on investment would come over time: 'bending the cost curve'; greater efficiency from electronic record keeping; great efficiency based on evaluation and implementation of 'best practices'. Did he give a prime time speech 'fighting' for health care: yes. Did he debate Republicans face-to-face on their turf? Yes. Did he 'set expectations' carefully: yes, he didn't promise immediate change, he promised gradual improvement. The real problem is the obsession of the populace and the media with instant 'success' and gratification. How well did the President do in 'winning' today's news cycle, rather than 'how will this work in the long run'? I guess when CEO's worry more about next quarter's bottom line rather than next decade's performance (or even existence), it sets the tone for what the country has become: impatient, greedy, narcissistic, lazy and frankly unworthy of a man of reason who has worked diligently to make America a better place, now and in the future. God only knows what FDR might have faced if he had a 24 hour news cycle relentlessly attacking him for waiting until the collective weight of US production was fully ready to crush the Axis.
- sstrom
September 20, 2010 at 7:07pm