“Look at the rest of the developed world!” That’s perhaps the strongest argument in favor of adopting some form of universal health care system in the U.S. Compared to other developed countries, we spend the most per person on health care by far—and get nowhere near the best results. How does the right wing counter that powerful point? You likely already know the answer. Does the term “alternative facts” ring a bell?
The California State Senate just passed a plan to establish an expansive single-payer health care system. The plan would cover everyone in California, and would pay for essentially any legitimate medical expense, including dental, eye care, and mental health. There would be no premiums, no co-pays, and no deductibles. Other than the VA, all existing forms of insurance, including private insurance, Medicaid, and Medicare, would disappear. There would be no physician networks, so, according to Mother Jones, “you’d be able to see any licensed doctor.” A small percentage of doctors in areas with a lot of concentrated wealth might move to operating cash-only practices, but even so, patients would in most cases have more choice than they do now.
The budget details have yet to be worked out, but as a general cost framework, California would get more than halfway there by taking the $200 billion already being spent by the state and federal governments on health care. Most of the rest—and perhaps all, if expected savings from getting rid of for-profit health insurance and moving to single-payer come to pass—would come from the money individuals, families, and employers are already spending on health insurance. Instead of paying insurance companies, they’d pay the government and get better, more comprehensive coverage. A study of the California plan done at the University of Massachusetts and sponsored by the California Nurses Association and National Nurses United found that households and businesses would spend less overall on health care under the new plan than they do today.
And now we come to the aforementioned lie. If you think Republicans hate Obamacare, ask one of them about the California single-payer plan. They’ll respond that health care in Canada or the U.K. or France stinks, and ask you why would we want to do that here. And when you come back at them with data on, say, life expectancy, be prepared for this lie.
The day before the California Senate passed its plan, Jonah Goldberg wrote the following at the National Review:
Indeed, the chief reason American life expectancy lags — slightly — behind that of other developed countries has nothing to do with health care whatsoever. When the World Health Organization ranked America 19th out of 29 in life expectancy, Scott W. Atlas of the Hoover Institution pointed out that if you removed fatal car crashes and murders, the U.S. suddenly had the “world’s best life expectancy numbers.”
Really? Boy, if that were true it would be a pretty compelling point, although it would also provide a pretty compelling argument against our lax gun laws, but that’s another issue. Atlas relied on an analysis done by Robert L. Ohsfeldt and John E. Schneider, both of the University of Iowa. However, there are significant problems with their rejiggering of the numbers on life expectancy. Aaron Carroll, one of the editors-in-chief at the Incidental Economist, a well-respected health policy blog cited widely by journalists such as Ezra Klein and Kevin Drum, debunked Ohsfeldt and Schneider’s conclusions back in 2010.
Without getting too deep into the statistical weeds, Carroll explains the significant mathematical flaws in the their methodology. Additionally, he takes up Ohsfeldt and Schneider’s point that comparing life expectancy once people reach a more advanced age enables one to remove from the comparison the kind of violent deaths they say skew the data. Carroll looked at life expectancy for people once they reached 65, and found that we are far from the top among the wealthy G-7 countries. More recent comparisons yield similar results. Although Americans are eligible for Medicare at 65, years of many being uninsured or underinsured prior to 65 take a toll on our collective health. Obamacare should start to narrow the gap between us and our peer countries—if it survives the Trump presidency, that is—but even that law has left 10 percent of Americans uninsured.
Taking Carroll’s point further, the rate of infant and child mortality is also essentially unaffected by murders and traffic deaths. Our performance there leaves plenty to be desired as well. In 2015, there were 6.5 deaths out of every 1,000 children under 5 years old in the U.S. That puts us behind 35 European countries, including those with median incomes and overall standards of living far below our own, like Bosnia and Macedonia—two Balkan countries that are still recovering from long periods of political instability. Oh, and we’re behind Cuba too. We’re also behind Western European countries—and that pesky Cuba—on infant mortality, i.e., deaths of children under the age of 1. Go, American capitalism.
Overall, we have higher child and maternal mortality rates than any other developed country, according to a brand-new study published in the Lancet and based on research done by the World Health Organization and Imperial College London. The worst. While not all of the disparity can be blamed on our lack of universal health coverage, clearly it plays a much bigger role in the deaths of children and mothers in childbirth than do murders and car crashes. And remember, we spend much more per person on health care than our peers.
But none of these facts matter to Jonah Goldberg, a pundit whose analyses rely so profoundly on truth and accuracy that he wrote a book called Liberal Fascism. They don’t matter to the National Review either. The goal of right-wingers like them is not to actually improve our health care system, or to do right by the American people. Their goal is to win the political debate, and the only way they can do that is by lying, by keeping the people inside the right-wing media bubble misinformed.
What’s going on in California, and in Nevada—where a bill that would allow anyone to buy into Medicaid just passed both houses of the legislature and is on the desk of the Republican governor, Brian Sandoval—and elsewhere, are all signs that there is real support out there for universal and, yes, single-payer health care.
That scares the hell out of the right, and that’s the reason this zombie lie on health care came back to life this week. We have to be ready with the truth.
Ian Reifowitz is the author of Obama’s America: A Transformative Vision of Our National Identity (Potomac Books).
PS: As an example of how this lie spread throughout the right-wing media bubble, I first heard it last week when a conservative cable TV host threw it at me during a discussion of California’s single-payer proposal. I knew there had to be something wrong with her claim, as the comparative life expectancy data remains widely cited, but, unfortunately, I didn’t have the relevant information at my fingertips to counter her. After the interview, I started researching, and the result is this post. The video of our discussion is below.