An American Lion

FiveThirtyEight.com

Nate Silver draws us the picture you see above, and, quite frankly, it reminded me to stop thinking of myself and to start thinking with that little pragmatic bone I have in my body somewhere:

Nevertheless, it’s clear that this family would be receiving a verysubstantial subsidy, on the order of $10,000 in pretax income, under the Senate’s bill. The reason I picked this particular family is because it provides a reality check against the example selected by the great Darcy Burner, who argued in an article at Open Left:

Affordable coverage for everyone: FAIL.

The latest CBO estimates for the Senate bill say that a family of four with a household income of $54,000/year should expect to pay 17% of their gross income on healthcare - about $9,000/year. (And that was when there was a public option to hold down costs!) That’s more than they’ll spend on federal taxes. That’s more than they’ll spend on food. I’m guessing if you took a poll, very few Americans would consider that affordable. And because of the way they’ve approached this, there’s no effective cost cap on premiums and nothing providing downward pressure, so this is a problem that would get worse rather than better over time.

We can debate whether $9,000 for a family earning $54,000 is “affordable”; what we know is that it’s a hell of a lot more affordable than the status quo, under which the family might have to pay more than twice as much to receive equivalent coverage.

In fact, Burner’s example is unfortunately chosen; she picked one of the groups — a low-income family in the individual market — that would benefit the most under the Senate package. Other groups would not be so beneficially impacted. Premiums are projected to rise slightly, for instance, for high-income earners in the individual market, although this is a small fraction of people and they’d get better health coverage as a result. And people in the employer market would not be much affected, except those with generous benefits packages subject to the excise tax; these folks would have to pay more out of pocket, although probably in exchange for more cash income. On the other hand, there are those who have a pre-existing condition and who are not able to buy health coverage at all, and for whom the benefit is almost incalculably large.

I understand that most of the liberal skepticism over the Senate bill is well intentioned. But it has become way, way off the mark. Where do you think the $800 billion goes? It goes to low-income families just like these. Where do you think it comes from? We won’t know for sure until the Senate and House produce their conference bill, but it comes substantially from corporations and high-income earners, plus some efficiency gains.

Because this is primarily a political analysis blog, I think people tend to assume that I’m lost in the political forest and not seeing the policy trees. In fact, the opposite is true. For any “progressive” who is concerned about the inequality of wealth, income and opportunity in America, this bill would be an absolutely monumental achievement. The more compelling critique, rather, is that the bill would fail to significantly “bend the cost curve”. I don’t dismiss that criticism at all, and certainly the insertion of a public option would have helped at the margins. But fundamentally, that is a critique that would traditionally be associated with the conservative side of the debate, as it ultimately goes to mounting deficits in the wake of expanded government entitlements.

The sad thing is, no one thinks pragmatically. I feel genuinely upbraided for my own navel gazing stupidity, and I don’t say that very often. Much of my bullshit is refuted by this post.

Honestly, low income Americans are not skimming blogs and commenting at length unless they’re recently laid off wealthy Americans with too much education and not enough earning power. The guy who changed your oil last week and has two kids, one on the way, and his wife cuts hair at the Hair Cuttery and they own a Dodge Neon? Yeah, think about what this legislation means to them. They’re not ignorant, but they’re not spending every night cheering Rachel Maddow’s wry put-downs and they’re not drafting their eight hundredth Kos Diary about the dangers of overfarming in West Africa because NO ONE GETS HOW SMART THEY ARE ABOUT THIS STUFF YA KNOW!!!

People think about what this means to them, to their preconceived notions, and what they imagine they’ve been arguing about. They want to yell at Joe Lieberman because they’ve carried too much water for an indifferent President who gives great speeches and loves the fact that he can tell the plane where to go. If you simply said “this turd we’ve shined up for you actually helps people who need to be helped” and then waited for that to register with someone who has been over-thinking their own important ideas and their own overwrought beliefs on what it means to them, well, you’d be waiting a long time for an honest answer.