I heard about Jonathan Gruber’s Health Care Reform comic book on the Internet, so when I saw it in my library’s New Item Shelf I checked it out. It almost looks like a parody, as some opening pages show a movie-theater marquee announcing with great fanfare: “Everyone will be able to afford insurance… And we will do all this while reducing the federal deficit!” (There is a crowd of people yelling “Yay! Hoo-raay!”) But it’s a very serious graphic novel by a very serious MIT economist who wants to explain to laypeople how the “Affordable Care Act” is supposed to work.
Gruber does an admirable job explaining both the problems of the current American health care system, and the ways Obamacare will try to fix that. It also provides helpful context for understanding news about health care reform (like the recent birth control hoopla). From a technocrat’s point of view, or if you’re optimistic about the things government can do, this book makes the ACA look like an intelligent and pragmatic attempt to fix a real problem. There are a few things I find reasonably hopeful, and a few things I find commendable (like experimenting with five different methods of cost control with the flexibility to adjust these methods as we figure out what works. Reminds me of the Little Bets book I’ve been reading, and it’s pleasantly surprising to see the government trying to be more flexible than usual.)
But from my bias, it also makes the bill look like an insanely complex technocratic mess. To cite just one example: it explains how employers with 50+ employees that do not provide insurance plans will face fines of $2,000 per employee, and how this is supposed to incentivize employers to provide plans. Will this encourage 49-person businesses to delay hiring another person? Who will be deciding whether or not that incentive is effective enough, and how much the fine needs to be changed as time goes by to keep the proper incentives aligned? But that’s just an example of arbitrary complexity, and not a “problem,” per se; it’s just how government regulation works. However, I do have ten real problems with the health care reform comic book based on information it provides that either lacks context or is wrong or outdated:
10. Death Panels. “What about death panels…?” “There are no ‘death panels.’ That’s a political contrivance. It was a myth designed by reform opponents to scare people away from the facts.” (136)
The “death panel” talk came from statements in the health care bill about “end-of-life” counseling. Many conservatives exaggerated such statements or took them out of context, but it’s a little disingenuous to completely write it off as a “political contrivance” and a “myth.” But, hey, maybe Gruber just didn’t have room to explain that…
Continue reading 10 Problems With the Health Care Reform Comic Book
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