What’s Really Behind Conservative Attacks on ObamaCare?

Republicans in Congress are planning a largely ceremonial attempt to kill Democratic health care reform.  Their recently unveiled legislation, entitled “Repealing the Job-Killing Health care Law Act,” will be voted on in the House, but is assured to fail in the Democratically controlled Senate.  In the meantime, Republicans are seeking an additional PR boost by promoting their recently released report: “Obamacare: A Budget-Busting, Job-Killing Health Care Law.”  Unsurprisingly for those who critically follow political debate in Washington is one fact: Republican opposition to health care reform has little to do with concern over the budget or jobs.

It is a sad state in American when journalists are utterly incapable of promoting an honest debate on public policy matters.  The reason is largely structural: “professional” journalistic norms of “objectivity” require reporters to grant serious attention to, and consideration of claims made by both parties, no matter how patently absurd the statement may be.  Mainstream academics in the communications field are fond of defending American journalists as non-partisan.  The problem with this approach, however, is that it completely misses the point.  American journalists are not partisan ? they’re bi-partisan.  The official source bias inherent in American journalism has been a main staple of reporting since the emergence of corporate dominated media a hundred years ago, and as I (and many others) have documented over the years.  This bias ensures that both Republican and Democratic views dominate the news, and that this narrow spectrum of opinion successfully prevents alternative points of view from being considered.  Those who deny this longstanding bi-partisan bias are either dishonest or ignorant in their political beliefs.

The thorough reliance of reporters on official spin manifests itself in toxic ways in the case of reporting on major policy issues.  The latest round of “debate” on health care reform is a classic example.  Those who wish to follow this “debate” will be left with a worse understanding of the issues at hand than when they started.  Such is the way of things in a system dominated by manipulation and indoctrination.  A January 8th article from the New York Times demonstrates this point quite clearly.  The story, titled “In the Battle over Health Care Reform, Math Cuts Both Ways,” leaves readers with the false impression that the evidence provided by both Democrats and Republicans regarding health care is equally legitimate.  This “postmodern” approach (manifested in the cynical assumption that every opinion is as good as another) may allow reporters to claim “objectivity” by reporting “both sides,” but it does a serious disservice to policy debates, since competing arguments seldom carry the same empirical rigor.  One can think back to the now notorious case of “weapons of mass destruction” and Iraq for an example.  Reporters were happy to parrot official Republican claims ? which were largely unchallenged by Democrats (who only mounted largely procedural challenges) ? that Iraq was an imminent threat to U.S. national security.  Those claims turned out to be blatantly false, but this inconvenient truth, although long known by inspectors who spent years in Iraq and disarmed the country during the 1990s.  This fact was deemed irrelevant, however, by reporters who construct readers’ reality within the narrow bi-partisan confines of the American political system.

A similar development is taking place with regard to health care.  Republicans now claim that the health care reforms passed in 2010 will “kill jobs” and increase deficit spending, while Democrats reject these claims.  More specifically, as the New York Times recently informed readers, a new report from the Republican Party warns that “The health care law will cost the nation $2.6 trillion when fully implemented, and add $701 billion to the deficit in the first 10 years.”  Notably absent from the New York Times’ reporting are multiple independent, non-partisan sources that directly refute Republican misinformation.  For example the non-partisan, not-for-profit FactCheck organization, based out of the University of Pennsylvania, roundly rejects Republican claims that the health care law will be a “job killer” (for more, see its report at: http://factcheck.org/2011/01/a-job-killing-law/).  FactCheck’s review of available evidence demonstrates how embarrassing mainstream reporting on this issue has become.  A few points worth considering from FactCheck’s reporting:

The GOP claims that 1.6 million jobs will be lost due to “Obamacare,” while ignoring the fact that the study they rely on (disseminated by the National Federation of Independent Business, or NFIB) to make this claim is based on a “hypothetical employer mandate” that was never included in the law passed by Democrats in Congress.  This finding has been predictably ignored by Republicans in Congress, and has been ignored by the New York Times in its reporting over the last week.

Also ignored by Republicans and the New York Times is a projection from the NFIB that health care reform would result in the creation of 890,000 jobs in the private health care industry (in light of projected hiring by hospitals, doctors, and insurance companies).  This second finding should hardly surprise anyone who closely followed the health care debate in 2010, as the reforms passed were described by reporters as comprised of ‘boons” for the private sector.  Such “boons” were seen most directly in the legal mandate that all Americans purchase health insurance from the private sector in lieu of the Democrats’ abandonment of a public option.  This revelation makes short shrift of the grotesque fiction that “Obamacare” represents a “socialist takeover” of health care.  Rather, Democratic reforms were an active expansion and embrace of the private health care industry, at the direct expense of the notion that health insurance should exist as a not-for-profit public good.

With regard to the Republican claim that the actual health care bill passed will cost jobs, FactCheck points to a number of important findings from the Congressional Budget Office that debunk such warnings.  Of particular importance is the claim that 150,000 to 350,000 jobs would be lost by firms that fire workers, seeking to avoid the penalty they would pay for not providing health insurance (as required by the new law).  As the CBO explains however, this job loss would be offset by job gains in the health care industry itself, as described above.  These basic points have also been ignored in reporting from the New York Times.

Republican claims that 650,000 jobs would be lost due to health care are also without merit.  To the extent that employment declines following the health care reforms, it will be largely due to a conscious choice on the part of Americans to work fewer hours as a result of their increased health care cost savings.  As FactCheck reports (and the New York Times again ignored), a major reason why “fewer people will choose to work is that many low-income people will have more money in their pockets as a result of the law expanding Medicaid and providing federal subsidies for many who buy insurance privately.”  Simply put, Americans will actually have more freedom in light of the reforms, as they will have to work fewer hours to pay for a basic necessity such as health care.  Another reason for decreased work, FactCheck and the CBO report, is due to the choice of older workers to retire early due to the savings they will accrue from the health care law, which restricts insurance companies from denying coverage based on preexisting conditions, and inhibits these companies from imposing higher rates on the elderly.

Republican warnings about runaway deficit spending from health care reform are also a systematic distortion of available evidence.  The CBO reported last year that the legislation passed by Democrats would not increase the federal deficit, but would actually decrease it by $143 billion due to increased savings from Medicare reforms, increased taxes on the well off, and from the establishment of regulated state insurance exchanges, among other changes.  The Center on Budget and Policy Priorities has recently reinforced CBO conclusions that health care reform will not increase the deficit, as the organization’s report refutes point-by-point claims from Republicans that the cost of the reforms will outpace taxes collected to pay for those reforms, claims that the Medicare savings and increased taxes collected to pay for reform are being “double counted,” and arguments that the CBO’s methodology is being manipulated by Democrats and liberals in government (for more, see: http://www.cbpp.org/cms/index.cfm?fa=view&id=3366).  On the final point, the CBPP points out that the “procedures that CBO uses to prepare cost estimates” are the product of “longstanding, bipartisan procedures ? not assumptions specified by the sponsor of the legislation.”  These procedures were developed by both parties through the Congressional House and Senate Budget Committees, alongside various presidential administrations from both parties over a period of several decades.  In short, the claim that the professionalized CBO is operating as a partisan agent is utterly false.

Even more problematic for Republicans is the CBO’s conclusion that repealing Democratic health care reform would increase the deficit by $230 billion, compared to the $143 billion the Democratic reforms are projected to contribute to reducing the deficit.  This increase in the deficit would materialize, the CBO predicts, first because of the repeal of planned Medicare cuts that were a part of the Democratic bill, which plans to cut spending for Medicare Advantage ? a more expensive alternative to traditional Medicare which relies on private insurers to function.  Second, the deficit would increase due to the rollback of the planned tax hikes that are a part of the Democratic bill, and are needed to pay for health care reform.  None of these contributions to the deficit that will result from Republican repeal of “Obamacare” have been acknowledged by Republicans.

Readers of the New York Times are unlikely to be aware of the perverted “debate” going on between Democrats and Republicans after reading the paper’s reports over the last week.  Times reporting in the first week of January uncritically repeated Republicans’ false claim that the CBO was “double counting” the Medicare savings and increased taxes that will help pay for health care reform.  The paper’s approach is thoroughly post-modern in its “all sides are equal,” “policy debates are too complex to accurately explain” approach.  Nowhere is this approach clearer than in a recent New York Times story, which misleadingly argued that “there are uncertainties around all of the projections and predictions” regarding health care reform’s costs and effects on the deficit and jobs.  Along these lines, the paper reported that “some questions, like whether the law will create or eliminate jobs, improve outcomes for patients or make medical care harder to obtain cannot be answered with any precision. Or at least no one on Capitol Hill seems to have the needed crystal ball.”

While it is certainly true that policy outcomes are always marked by uncertainty, the Times’ reporting neglects the basic reality that some policy analyses (namely those based on careful examination of empirical evidence) are superior to others (such as those driven by partisan motivations), and that there are always better and worse analyses of public policy initiatives.  The most professional, least partisan analysis in the case of health care reform comes from the CBO, which was created specifically to provide non-partisan assessments of the costs of public policy proposals.  Tellingly, the New York Times failed to mention the long non-partisan history of the CBO in any of its stories on attempts to repeal health care reform that appeared during the first week of January.  As a result, readers have been left with little ability to independently assess competing Democratic and Republican claims about the bills’ alleged costs.

Of course, the most grotesque fiction emanating from the entire “debate” in the corporate press over health care reform revolves around one basic fact: it is the private, for-profit health care system that is the most responsible for the terrible state of American health care.  The U.S. has the highest health care costs in the first world, and the worst quality of care outcomes, as measured in a variety of comparative studies done in recent years.  These outcomes are due to the fact that the U.S. is the only country that allows for a for-profit health insurance industry ? one with a vested incentive in denying coverage to the sick and consistently raising premiums for the healthy.  The real debate in Washington right now should not be over whether minimal restrictions imposed on the health care industry by Democrats will save Americans money.  Rather, we should be asking why Democrats didn’t go further in reducing health care costs by promoting either a public option or a full Medicare-for-all, single payer health care system.  Implementing such proposals, after all, would be far more effective in reducing long term health care costs and in reducing deficit spending (massive Medicare spending for skyrocketing pharmaceutical prices has long been a major problem, exacerbated by Congress’s refusal to negotiate down drug prices for those covered by the program).

Democratic health care reforms, while failing to seriously reign in costs and provide better health care, are still comparatively better than conservative efforts to repeal those reforms.  The CBO estimates that Republican efforts to destroy “Obamacare” would not only wipe away the modest progress expected for the 32 million additional Americans who are projected to have health insurance by 2019 as a result of the Democratic bill, but would actually increase the number of uninsured beyond current levels, with 54 million suffering without coverage by the end of the decade.  Sadly, the current propaganda that passes for political and media “debate” on health care reform has succeeding in obscuring this reality from most Americans.  Recent CNN polling from December 2010 finds that 54 percent of Americans oppose the “major changes to the country’s health care system [that] became law” in March of 2010.  A plurality of those who oppose the bill do so, not because it doesn’t go far enough in promoting universal health care, but because they erroneously perceive it as “too liberal” in its orientation.  Without an organized progressive counter-response, little is likely to change with regard to the problem of public ignorance on health care reform.

ANTHONY DiMAGGIO is the co-author (alongside Paul Street) of the forthcoming: Crashing the Tea Party, due out from Paradigm Publishers.  He has taught U.S. and Global Politics at Illinois State University, and is the author of a number of other books, including When Media Goes to War (2010) and Mass Media, Mass Propaganda (2008). He can be reached at: adimag2@uic.edu


Anthony DiMaggio is Associate Professor of Political Science at Lehigh University. He is the author of Rising Fascism in America: It Can Happen Here (Routledge, 2022), in addition to Rebellion in America (Routledge, 2020), and Unequal America (Routledge, 2021). He can be reached at: anthonydimaggio612@gmail.com. A digital copy of Rebellion in America can be read for free here.