The noise around Obamacare

By E.J. Dionne Jr., Published: November 3 

The ace political and baseball prognosticator Nate Silver titled his book about prediction and statistical mastery “The Signal and the Noise.” Rarely has it been more important to distinguish between the two than in the uproar over the launch of the Affordable Care Act.
As Silver put it, “The signal is the truth. The noise is what distracts us from the truth.”

E.J. Dionne Jr.

The truth about this controversy is that there is a broad debate in our country over how much government should do to correct for market outcomes that leave so many Americans without enough income, opportunity or access to the essentials of modern life, notably health insurance.
Supporters of Obamacare, including those who wish it had gone even further, believe that social justice requires government to give significant assistance to those who find themselves on the wrong end of an economic system that is producing an increasingly unequal society.
Opponents of Obamacare want government to let the market do what the market does. That’s why the program’s critics have not come up with a plausible alternative to covering the uninsured — and why many in their ranks have been trying to hack away at Medicare and Medicaid. Their overarching purpose is to get government out of the way. If the market generates vast inequalities, this must be because such inequalities maximize efficiency.
Thus, foes of the new health-care law aren’t against it because its Web site worked badly or because the president once said that everybody could keep their current policies when it turned out that some in the small individual insurance market got cancellation notices. For those trying to kill the law, such noise is designed to distract attention from what they really think, which is that we should let non-elderly Americans sink or swim in the insurance arrangements that existed before Obamacare.
This market logic also underlies the GOP’s unconscionable attack on food stamps, known now as the Supplemental Nutrition Assistance Program (SNAP). By helping some 47 million Americans buy food, SNAP does, indeed, intervene in the private marketplace, albeit to the benefit of farmers and grocery stores as well as the poor and near-poor.
Such “meddling” violates market dogma, as Rep. Michele Bachmann (R-Minn.) suggested during a 2011 Republican presidential debate. She is retiring from Congress, which is too bad in a way because she often provides subtitles for conservative arguments by putting into candid words what many on her side say in more guarded language. “If you look at China,” Bachmann said, “they don’t have food stamps. If you look at China, they’re in a very different situation. . . . They don’t have the modern welfare state. And China’s growing.”
We’ll leave for another day the matter of why Bachmann might want us to model our social policies after those of a one-party communist dictatorship.
None of this absolves President Obama or his staff of responsibility for handing some useful tools to those who would build a noise machine around the Affordable Care Act (ACA). No one is more upset about the tech fiasco than those who want the ACA to work. There’s a lesson here that liberals apparently need to learn over and over: Good intentions without proper administration can undermine even the most noble of goals. And a White House that has sometimes played fast and loose with the loyalties of its congressional supporters can ill-afford to put the more politically vulnerable among them in an exposed position.
But panic-induced changes would be the very worst response to the challenges the law faces now. Rather than offer politically convenient delays that could undercut the entire structure of the ACA’s insurance system, those who want more Americans to have health coverage (including Obama himself) need to keep steering the discussion away from the clamor and toward the mission — starting by simplifying and fixing the Web site.
It was a Republican senator from Indiana, Homer Capehart, who applied an old saw to the art of salesmanship. “If handed a lemon,” he said in 1944, “make lemonade out of it.” The administration has never adequately defended the law or explained why government will inevitably have to play a larger role in guaranteeing health insurance to all our citizens — as the public sector does in every other wealthy democracy.
Now, everyone is paying attention. The way to still the noise is to challenge opponents of Obamacare. Can they really make the case that the country would be better off without it? And what would they do instead?