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Pyle: In Obamacare battle, it's dogma vs data

Published November 1, 2013 5:21 pm
This is an archived article that was published on sltrib.com in 2013, and information in the article may be outdated. It is provided only for personal research purposes and may not be reprinted.

"To retain respect for sausages and laws, one must not watch them in the making."

The quote is widely attributed to Otto von Bismarck, the first chancellor of a united Germany. (The first time it was united.)

It may well have described Otto von's feelings. A bit of googling, though, suggests the thought really sprang from the wit of an American poet, John Godfrey Saxe.

Saxe, in turn, was the guy who had taken an old story and set it into a poem called "The Blind Men and the Elephant," the tale of a handful of blind men who each tried to describe what an elephant was like by touching a different part — legs like a tree trunk, a snout like a snake, sides like a giant boulder.

So, of course, all of them were wrong. Not only wrong, but firmly, even belligerently, wrong.

Which implies that people should be able to see the whole picture of things that are important to them. Sausages and laws.

Or, in the Age of Big Data, as the wonkery of Ezra Klein and Nate Silver replaces the punditry of George Will and Rich Lowry, we abandon the advice of the Iron Chancellor, or the Michigan poet, and adopt the direction of your middle school math teacher.

Show your work.

Case in point: The horrible roll-out of the really-buying-insurance part of the Affordable Care Act, aka Obamacare. As my old friend Kathleen Sebelius told a House committee last week — seldom dropping that withering Mom-can-see-right-through-you stare of hers — it was, indeed, a major foul-up, for which she, as boss of the Department of Health and Humans Services, was responsible.

What doesn't get a lot of attention — certainly from the side of the argument that is absolutely petrified at the thought of the working poor having the same access to health care that every civilized nation on the planet has long taken for granted — is why the horrid complexity of the health insurance exchanges exists.

It is because neither Sebelius, nor President Obama, nor then-House Speaker Nancy Pelosi, who is probably the person most responsible for what's actually in the law, had the power to do the right thing.

The right thing would have been to kill off the whole awful, money-sucking insurance system and replace it with single-payer Medicare for all and funded with a progressive payroll tax. And, while we are dreaming, a carbon tax.

There are two reasons why that didn't happen. One was the power of the health insurance industry, an interest group that Democrats had to buy off this time rather than risk another round of the Harry and Louise commercials that torpedoed Hillarycare 20 (!) years ago.

The other is the widespread belief, the founding cry of the whole tea party movement, that civilization is a bad idea. By civilization, of course, we mean government action to prevent bad things. Big bad things like the collapse of the global financial system. Little bad things like the high percentage of personal bankruptcies — and very personal illness and death — that happen when people can't afford health care. (Did I mention that the grand and glorious United States of America is the only nation on earth, of the countries that any of us would consider living in, where that happens? I did? Sorry.)

Another flaw in the implementation of the ACA is the fact that the expansion of Medicaid to the not-so-poor was integral to making it work. But the Supreme Court — in an action that was first reported to have killed Obamacare, then reported to have saved it — pulled that plug by saying that states had the option to bail out of that part.

Enough of them — including, perhaps, Utah — may take that brutal exit that the bottom line of Obamacare may not be success, but just more poverty, suffering, premature death and economic wreckage.

Such wreckage would be the final victory of dogma, which is all Obamacare opponents have going for them, over data.

George Pyle, a Tribune editorial writer, has never labored under the illusion that everything he has does not come from a web of civilization, public and private. Challenge him at gpyle@sltrib.com. Twitter: @debatestate. Facebook: facebook.com/stateofthedebate




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