The Coalition of the Conspiracy-Minded

I am somewhat surprised to see Megan McArdle entering the lists of the conspiracy-minded. Here’s her reaction to the announcement that the Census Bureau is changing the questions it will ask in its regular survey so that we will never know confidently how many more people have received healthcare insurance as a consequence of the PPACA:

I’m speechless. Shocked. Stunned. Horrified. Befuddled. Aghast, appalled, thunderstruck, perplexed, baffled, bewildered and dumbfounded. It’s not that I am opposed to the changes: Everyone understands that the census reports probably overstate the true number of the uninsured, because the number they report is supposed to be “people who lacked insurance for the entire previous year,” but people tend to answer with their insurance status right now.

But why, dear God, oh, why, would you change it in the one year in the entire history of the republic that it is most important for policy makers, researchers and voters to be able to compare the number of uninsured to those in prior years? The answers would seem to range from “total incompetence on the part of every level of this administration” to something worse.

I think as good an explanation as any is that the good folks at the Census Bureau are merely justifying their jobs. If you never change anything in the surveys, why would you retain people who write surveys or figure out how to improve them? That the timing of the change is good for the administration is just a lagniappe.

Besides, as supporters of the PPACA have demonstrated time and again, they don’t really care about the practical impact of the legislation. It’s the idea of it they like.

27 comments… add one

  • Guarneri

    If I was an engineer working in, oh, I don’t know, a steel mill or something and we were trying a practice change this is the way I’d do it:

    http://gregmankiw.blogspot.com/

    Or even a board member. Not perfect. But sensible and the best way we have.

  • Jimbino

    Couldn’t somebody run a smaller census using the old rules and correlate the outcome with that of the new census, so that the new census could be used to assess Obamacare?

  • ...

    Given that the people in charge are running the country counter to the wishes of the people on a large number of issues, it would seem that us conspiracy minded folks have a good case. Especially those of us aware of the concept of implicit collision, and even the concept of unconscious collusion seems like an idea worth considering.

    The best conspiracies are out in the open. It’s just that their stated goals and actual goals aren’t completely the same thing. One can determine actual goals by looking at actions. This helps explain everything from union negotiations to political parties being in stated opposition to each other while basically supporting the same policies.

    High-trust societies with lots of social cohesion should be dismissive of conspiracy theories. Low-trust societies with little or no social cohesion have the problem of figuring out which conspiracies are in effect and which aren’t. The USA not being Denmark….

  • michael reynolds

    http://www.politico.com/story/2014/04/health-insurers-obamacare-105676.html

    Health insurers got their first taste of Obamacare this year. And they want seconds.

    Insurers saw disaster in the fall when Obamacare’s rollout flopped and HealthCare.gov was a mess. But a strong March enrollment surge, along with indications that younger and healthier people had begun signing up, has changed their attitude. Around the country, insurers are considering expanding their stake in the Obamacare exchanges next year, bringing their business to more states and counties. Some health plans that skipped the new marketplaces altogether this year are ready to dive in next year.

    At least two major national insurers intend to expand their offerings, although a handful of big players like Aetna, Humana and Cigna, are keeping their cards close for now. None of the big-name insurers have signaled plans to shrink their presence or bail altogether after the first rocky year. And a slew of smaller health plans are already making moves to join more states or get into the Obamacare business for the first time.

    (My bold.)

    So, more insurers getting into the game with more plans. Those plans will then compete on price, meaning that in order to turn a profit they’ll have to drive down costs.

    All together now: Thank you, Obamacare!

  • jan

    Conspiracy has gotten to be one of those words automatically implying a groundlessness of thought. Consequently, any idea that goes against the grain of a sensibly etched plot, is thrown into the bin of “conspiracy-minded,” and instantly dismissed as crazy-making.

    I’m with ice, though, in his more open-minded considerations of “unconscious collusion” happening. In fact, I would go even further to speculate that many unfathomable events, sudden turn of statistics, well-timed evolutions of opinions on social issues are deceptively constructed on a conscious level, and then carefully maneuvered into the public mindset to foster the desired effect wanted.

  • jan

    When I read that article earlier, Michael, you and a predictable posting of it came instantly to mind.

  • michael reynolds

    Jan:

    Oh, you can count on me rubbing all your little noses in your years worth of bogus claims about O-Care. It’s quite fun!

  • steve

    All the left of center health policy people are upset by this also. No one seemed to know it was coming. I predict that they will run side by side data for a while.

    “Besides, as supporters of the PPACA have demonstrated time and again, they don’t really care about the practical impact of the legislation.”

    You keep saying this, and it makes no sense. It seems to be based upon the fact that you decided it was a failure before the sign up period was done. Or is there something else? There is tons of stuff written by supporters worrying about the impacts , what they think they will be, hope they will be and where they think it is going. As far as I can tell the big difference is that most of us expect it to take years to see full effects. (Have you been reading John Goodman? He likes to cite studies showing positive effects in the first year. Of course on follow up, those are often gone. Why arent people interested in long term effects?)

    Steve

  • ...

    Well, your claim was that it would insure 45 million people over night. Seven million people doesn’t quite seem like a success metric to me. Nor does the fact that Obama sold the thing on the premise that it would drive down premiums by $2500 per family. Or that people would get to keep their plans, or their doctors. Or that Obama would keep re-writing the law (in effect) in order to exempt people and corporations from the law because the government didn’t want to look to bad in front of an election.

    As for this:

    So, more insurers getting into the game with more plans. Those plans will then compete on price, meaning that in order to turn a profit they’ll have to drive down costs.

    Why is this magic of competition only happening now? Is it because Black Jesus willed it so, and people like you clapped your hands because you believed in fairies?

    I also don’t see how that is going to impact self-insured employer plans in a meaningful way. I can guaran-damned-tee you that Disney et al have been working their asses off to lower costs since back before Obama was just another young author from Kenya. It didn’t seem to have much impact on costs, or at least not enough.

    I really don’t know why idiots like you think market competition only happens after the government socializes something. Oh, wait, that ‘idiot’ part probably gave it away.

  • It seems to be based upon the fact that you decided it was a failure before the sign up period was done.

    No. It’s because a) its fans have said as much and b) neither the administration nor, apparently, anyone else will settle on a metric for success.

  • ...

    It seems to be based upon the fact that you decided it was a failure before the sign up period was done.

    Well, Obama sold it on the ideas that it would (a) insure 45,000,000 uninsured people, (b) would drive down premiums for those already insured by $2500 annually per family, and (c) that if you liked your plan/doctor you could keep them.

    (a) isn’t happening, (b) isn’t happening, and (c) isn’t happening. Given how your personal Black Jesus sold it, it is a failure. The fact that you all want to change the metrics NOW is more an indication of the fact that Obama supporters are just as dishonest as Obama is himself. Which is really quite a high bar to get over.

  • ...

    It’s because [snip] neither the administration nor, apparently, anyone else will settle on a metric for success.

    That’s not true at all. The metric is that initial supporters of ObamaCare agree now that it is a success. Based on that criterion it is an overwhelmingly successful program.

  • The metric is that initial supporters of ObamaCare agree now that it is a success.

    An a priori success then. That’s another way of saying the same thing that I did initially.

  • michael reynolds

    Squirm and rail and denounce all you like.

    You all said they couldn’t fix the website. Fixed.

    You all said they wouldn’t hit 7 million. Done.

    You all said health insurers would flee. Wrong.

    You all said premiums would skyrocket. Nope.

    You all said the healthy would not sign up. Appears that isn’t true. In fact, that’s one of the reasons cited for more insurers rushing in to join the O-Care system.

    You’ve gotten nothing right so far. But hey, I’m sure the death panels and the doctors refusing to practice and the rest of the bullshit scare stories will occur at any moment.

  • michael reynolds

    Oh, look, more bad news: http://www.nytimes.com/2014/04/14/nyregion/in-new-york-hard-choices-on-health-exchange-spell-success.html?_r=1

    New York has signed up more than 900,000 people for commercial or government plans, lured 16 insurance companies onto its exchange, provided subsidies for most customers and reduced premiums across the board.

    Individual premiums for Manhattan residents, for instance, dropped from $1,534 for a standard health maintenance organization, or H.M.O., in 2013 to $621 for a comparable exchange plan now. “I think it has in part ensured that customers have affordable options,” Ms. Frescatore said.

    So, premiums cut in half. Wow. It’s the apocalypse you all warned us of. Time to escape to freedom! Somalia beckons!

  • ...

    You all said premiums would skyrocket. Nope.

    Ours sure as Hell have.

    Also, still haven’t come close to meeting (a), (b) and (c) as it was sold. Not ever going to meet (b) or (c). Given enough time (a) may even be doable. Let’s see, 45,000,000 divided by 7,000,000 … Should hit your target some time in sometime around 2020.

    I’ll also note that my primary complaint was that ObamaCare doubled down on a bad system. That is still true. Healthcare costs are still rising at unsustainable rates, and the price of insurance is going up faster than pay (which is falling for a great many people).

    But again, what was promised is not the measure that any Obama supporter wants to use. Never is. Just like Obama’s claims on how quickly he’d get the country back to work have all proven to be wrong, and yet Obama and his supporters still claim this is a wonderful economy. Fucking useless goddamned liars, the whole lot of you.

  • ...

    An a priori success then.

    The cluelessness of it matches that now expected of the Administration and its supporters.

  • michael reynolds

    I’m glad to see that we are beginning the transition from “It’s the end of human life on earth!” to “It hasn’t yet met all of its goals completely!”

    Previewing the next phases:

    – It’s only met 80% of its goals!”

    – “It’s only succeeded because we attacked it!”

    – “We were for it all along!”

    – “As your Republican Senator, I vow that I will never cut your Obamacare benefits!”

  • jan

    “Oh, you can count on me rubbing all your little noses in your years worth of bogus claims about O-Care. It’s quite fun!”

    Michael,

    You also must know that a game is never over until it’s over, which means those who laugh first are not always the ones laughing last.

    I’ve been up front about my dislike for the PPACA. It’s based on it’s flawed construction, and how I think it will ultimately harm medical care, not help it. So far, with some 30 plus revisions, delays, tons of controversy, dishonest claims, useless complexity, obfuscated numbers one can’t say this legislation was either thought out nor implemented well. If the kinks can be worked out — fine. If not, I’ll continue to disparage it. But, IMO, the jury is still out as to it’s overall success.

  • jan

    This is how the WH manages it message to smooth over the rough edges of the PPACA. A new CBO report now estimates HC costs to be lower. The WH, hand-in-hand with the media who partners with all good tidings emanating from them, can now gush about this new news — kind of like Michael has been doing in linking to ‘good’ PPACA articles. However, the devil is in the details (again). And, these new lower figures are due to insurers modifying policies to lower costs — specifically:

    A crucial factor in the current revision was an analysis of the characteristics of plans offered through the exchanges in 2014. Previously, CBO and JTC had expected that those plans’ characteristics would closely resemble the characteristics of employment-based plans throughout the projection period. However, the plans being offered through the exchanges this year appear to have, in general, lower payment rates for providers, narrower networks of providers, and tighter management of their subscribers’ use of health care than employment-based plans do.

    The assumptions drawn in this piece are:

    The narrowed networks that insurers are using to keep costs down and the lower reimbursement rates for doctors and hospitals are things that neither consumers nor providers tend to like in the long run — which will likely mean more strain on the system and higher costs further down the road.

    Is seems like the bottom line to what the insurance companies are doing is to reconfigure plans to make costs more palatable, which ultimately creates “sub-par” bare-bones insurance plans, similar to the ones originally denounced, laying the preemptive groundwork calling for Obamacare.

  • michael reynolds

    Well, Jan, if I can’t believe Hot Air which has been right about . . . well, nothing, ever . . who can I believe?

    I am happy to see this: But, IMO, the jury is still out as to it’s overall success.

    That’s it, ease into the transition slowly. We will get you to the point where you deny ever having opposed O-Care, but we’ll do it slowly. No one will even notice.

  • ...

    “It hasn’t yet met all of its goals completely!”

    It hasn’t come close to meeting any of the stated goals at the start, which were not, contra your stupid lying ass, “It’ll be much better than the absolute worst possible predictions!”

    According to you, ObamaCare is a flaming success because is didn’t cause the end of the universe.

    So there’s your metric for success, Schuler: It did better than the worst possible predictions! That still allows for failure, as the Universe COULD have ended because of this. I mean, just maybe.

  • ...

    More seriously: Under no circumstances would steve or Reynolds or any other Obama toady ever admit that it hadn’t succeeded. There’s no metric for FAILURE, either.

  • steve

    “Well, your claim was that it would insure 45 million people over night.”

    No. Please provide a cite if you really think this is true. What was predicted is that about 7 million would sign up in the exchanges, and about 14 million people would have insurance by the end of 2014 who would not have had it w/o the ACA. (I can provide citations on this if you want, but these are pretty easy to find.) As the RAND study suggests, we are probably on track, though we wont know for sure for a while. The early predictions were that about 25 million would sign up via the exchanges by 2017 (maybe 2018, need to double check).

    Yes, Obama was wrong about not keeping your insurance. We knew that 4 years ago. Cant say I am that torn up about it since turnover is so fast in health care insurance in the individual and small group market. Save $2500? Up to 90% off? Sound familiar? Many families in the individual market will save much more than that. Some will end up paying more. For equivalent levels of insurance, ie making an apples to apples comparison, the individual market (what he was actually talking about) will most likely see decreases.

    jan- No. First, narrow networks and high deductibles are the market based approach to keeping costs down. It is central to every GOP “plan”. Remember that term “skin in the game”? (Catastrophic insurance with HSA sound familiar? Consumer directed health insurance? All high deductible plans.) Anyway, this is not at all like the sub-par, bare bones plans that laid the groundwork for Obamacare. These are all plans that have all of the mandates required by the ACA. If anything, they are loaded with too many mandates. They are not bare-bones, but rather obese. I think there is room to remove some of the mandates. When the GOP regains power I hope the actually decide to govern (one can hope) and get rid of a few.

    Bottom line- I said this before and say it again. It is incomplete. If I were the prof grading this it gets an I. If we hit 2017 and have 25 million new people signed up, and if costs dont go out of control, then I will consider it a success. If it does so and costs slow or decrease, it will be a major success. My interim assessment is that I am surprised at how well it has gone given the disastrous rollout. Given the active levels of sabotage, I expected worse.

    Steve

  • Guarneri

    Sigh. The very sponsor has delayed implementation of provisions some 35-40 times, and exempted his political friends.

    Politicians, whose very lifeblood depends on campaigning on winning issues and legislation……..refuse to be seen near ObamaCare.

    Sure fire evidence of boffo legislation.

    And yet we all, just babbling fools on some internet site, can viddy all.

  • steve

    Fact free assertions. Convincing.

    Steve

  • jan

    I am happy to see this: But, IMO, the jury is still out as to it’s overall success.

    That’s it, ease into the transition slowly. We will get you to the point where you deny ever having opposed O-Care, but we’ll do it slowly. No one will even notice.

    Michael,

    I’m predisposed to seeing too much wrong with the PPACA to like and consequently support it, now. I’m not predisposed, though, to denying real evidence — well-proportioned demographics, fair premiums, good health care and choices for all (not just a winners/losers kind of HC system), etc — that Obamacare is working more for people than hurting them. You see, I find honest skepticism to be healthy.

    How about you, Michael? Are you able to process evidence that the PPACA is not working, and be able to change your mind, accordingly, in the future?

    Steve,

    Having “skin in the game,” to me, means a consumer involved HC system. It doesn’t mean, though, being forced to accept fewer options, having mandated coverage that you either don’t want or isn’t even applicable to you or your family. Under Obamacare HSAs have been weakened. I think they should be strengthened, with thresholds changed encouraging their usage. Options continue to be limited in the Obamacare exchanges — recent talk of ‘copper’ plans has been more of a Hail Mary attempt to mitigate this problem, rather than something that was originally incorporated into this legislation. And, when a plan is defined as “sub-par,” it’s a definition based upon the judgment call of outsiders, rather than considering what the recipient of such a plan thinks of it — how well a coverage fits into their lives. I think this is intrusive, and arrogant.

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