While healthcare is the titular issue of this post, and much of it will be spent discussing the newly unveiled American Health Care Act (a.k.a. Trumpcare) it’s also going to delve into some ideological views about law and legislation. Over the past couple of weeks the Trump Administration has been in the process of publicly unveiling and trying to rally support for its long awaited plan to replace Obamacare. Similarly to President Obama before him President Trump set some pretty high expectations for this plan saying that everyone should be covered and that he would unveil “something terrific“. As of now we can’t really say if the AHCA is going to be terrific, but we do know some of its major pros and cons.
The non-partisan Congressional Budget Office released its report on the AHCA earlier this week (the full text can be found here, and decent summary here). The basic gist of that report goes something like this: if implemented the new healthcare law would save $300 billion over the next ten years,a little less than 10% of the annual federal budget. However the CBO also estimated that about 14 million people (less than .5% of the population) would lose health insurance, with that number possibly rising to 24 million by 2026. While the CBO is not perfect, its far from being an overtly partisan organization, and its report on Obamacare from all the way back in 2008 turned out to be pretty acurate.
So Trumpcare might be terrific and it might be terrible, depending largely on your own political views and what you believe about access to healthcare. What worries me most about the AHCA though, and many of our conversations about law/legislation in general is just how lazy the public discourse surrounding it is. Especially on the issue of healthcare I feel that people simply lean on their ideology to provide a blanket solution to problems. For example a typical liberal might say that more government and/or regulation is the solution, while a typical conservative might follow the line that government is the problem and less of it is the solution. While I openly admit that I fall on the liberal side of a lot of issues, and especially healthcare, it bothers me that our conversations about highly complex problems devolve into vague platitudes about the value of government.
Perhaps nothing illustrated this better than when White House Press Secretary Sean Spicer insinuated that the AHCA was somehow better than Obamacare only because the text of the bill was literally smaller. Despite my political stances I understand that large government can sometimes be overreaching, interfering with markets, crowding out the public, and decreasing overall welfare. However smaller government should not be an ends unto itself. If less government is better for the public I’m all for it, but you need to prove it on a case-by-case basis with an argument more substantive than government=bad. While its very hard to predict the impact of substantive legislation like the AHCA I wish that public discussion would lean more on its effects, not generalities about government and if there should be a right to healthcare.
Fixing our national dialogue isn’t easy. Things like health care are pretty obviously complex, and people only have a finite amount of time and interest to dedicate to public policy. One of the things that’s helped me most in having productive dialogues with people of all views is knowing when to step back, listen, and admit that you don’t know enough about a problem to form an educated opinion. This isn’t a perfect solution, people dislike looking uninformed, and even if we listen to the best experts they can be wrong. But I think that more often knowing (and acknowledging) what we don’t know would be a step in the right direction.
Side Note: I mainly focused on a conservative instance of gross oversimplification, so I’d love to see some examples of liberal oversimplification in the comments.