Tuesday, December 16, 2014

Comments on "Gruber-gate"

Professor Jonathon Gruber of M.I.T. has been at the center of a firestorm. Gruber is a highly respected health care economist who was instrumental in developing the Massachusetts (aka Romneycare) health care system and the Affordable Care Act (aka Obamacare).

What Gruber has in intellectual skills he lacks in political savvy. Gruber is seen on several videos ruminating about the passage of the Affordable Care Act, about how the inside politics worked, a lack of transparency and how the Act was massaged through the system to take advantage of “stupid” voters. Some comments:

Did ACA pass due to a lack of transparency?

Not in the sense described by Gruber. ACA passed because Democrats had control.

What sense then?

 ACA was so complicated and confusing no amount of transparency would have mattered.

Was ACA pitched to the voters?

Only to elected representatives. Or at least the elected Democrats. Or their staffs anyway.

Did the elected representatives read and understand the legislation?

According to former Speaker Nancy Pelosi, no. This seems credible. Not enough time.

Why is ACA so complicated?

A simple approach would have allowed direct targeted opposition. ACA is a cauldron of incentives, disincentives, and various sorts of social engineering. The bill is a giant lab experiment with many, many pieces and parts, a sort of Rube Goldberg health care machine.

Will the ACA work as intended?

Too early to tell, especially for medical providers and employers. The phase-in was designed to take many years, has been rocky and is now behind schedule.


Do the Republicans have a better plan?

No, the GOP has no policies that could be called a “plan.”