Why Progressives Would Be "Batshit Crazy" To Listen to Nate Silver on Health Reform
Nate Silver has written a piece called "Why Progressives Are Batshit Crazy To Oppose the Senate Bill." He says we need to stop being "polite" (who's polite these days?) and start being "real." In the spirit of impoliteness and reality (realness?), he offers some numbers in order to argue that the Left is nuts not to embrace the Senate health reform bill.
In that same "no-politeness" spirit, here's my response: Garbage in, garbage out. Is that "real" enough for ya? Progressives - and everyone else, for that matter - should keep fighting.
Silver's heart may be in the right place, and his math is right, but many of his assumptions are flat-out wrong. More importantly, he fails to place his work in the proper human and political context. It's like this: You can build the best model in the world for predicting the outcome of hockey games. But if you knew that sometime during the third period Rahm Emanuel was going to drive out on the ice in a Zamboni and flatten your team's entire defense, wouldn't that change your model a little? And if you knew half the hockey players would wind up bleeding and broken ... (Oh, wait - they do. Bad example.)
Progressives would be insane to do as Silver suggests. He tells us that "a picture's worth a thousand words" (and then gives us 1,795 words - but who's counting). Let's review both his analysis and his conclusions.
A number of Silver's assumptions are questionable. First, I think his assumed inflation is understated. (I've got a lengthier version of this post up which deconstructs his numbers in greater detail; that part starts here.)And he says that money to pay for helping lower-income people comes "substantially from corporations and high-income earners, plus some efficiency gains." The first part of the statement is essentially true for the House bill, but not the Senate's - and it's the Senate bill Silver's defending. As we've shown, the Senate bill's excise tax will pretty much indiscriminately affect working people, and not because they have rich benefits. (See conflict-of-interest statement below.)
What's more, all Americans are being mandated to buy into private insurance in order to make it actuarially easier to cover everyone, without a public option. That really a kind of invisible tax that's being charged to everyone in the form of premiums - premiums which are made higher by the absence of a public option. On top of that, the Senate's weak employer mandate will force more people into the costlier individual market. And "efficiency gains"? What efficiency gains? Every difficult cost containment decision has been kicked down the road in this bill.
Darcy Burner is absolutely right when she writes "affordable coverage for everyone: FAIL." Silver is absolutely wrong when he says that "we can debate whether $9,000 is 'affordable' for a family of four earning $54,000" - we can? Really? - or when he says the individual mandate penalty is "not very harsh." I'm astonished that anyone grounded in the real world could believe that these numbers (and those for higher middle-class earners) are not "harsh," unaffordable, and even potentially devastating for middle-class people trying to get by in this economy. That's craziness of the flying-rodent-feces variety.
It's all about context
Silver is most off-base in the area that arguably matter most in the long run: political context, strategy and tactic. He falls right into the trap that the Democratic leadership has set for progressives - the belief that, even with weeks to go in the process, it's either this bill or nothing. That's simply not the case. Yes, I saw a previous post where he argued that this outcome was inevitable given Senate math. But it's only inevitable if you assume a) no targeted use of reconciliation, and b) that the "centrist" Senators were inevitably going to be opposed to a bill with better provisions. To believe that, you also have to assume continued lack of strong leadership from Reid and the White House, together with continued lack of progressive pressure on them to step up.
Sounds like a self-fulfilling prophecy to me.
The Senate bill Silver so admires places enormous burdens on middle-class families, while going easy on high-earners and employers. The overall combination of mandates and weak cost controls shapes up to be political suicide for Democrats. It will hurt Democratic candidates in precisely those parts of the country where they can least afford the damage, like the Midwest. (This survey offers a preview.) And it's not too late to fix it.
That gets us to strategy. The day may come when the Silver argument needs to be deployed - namely, when a decision must be made on whether the final bill being voted onbetter than nothing. But that day isn't here yet. There's still time to change it, either in the Senate or House. Instead of accepting this bill as the best they can get, progressives should keep the heat on the Democratic leadership to fix it. That means eliminating the excise tax in favor of the House high-earner proposal, pressing for a robust public option, and pushing for stronger subsidies.
Doing anything else would be crazy.
(Disclaimer: I'm currently campaigning to ensure that the excise tax does not become law, which could fairly be considered a conflict of interest. I would point out, however, that I'm campaigning because I think the tax a bad idea;I don't think it's a bad idea because I'm campaigning.)