For years, I’ve wrestled with the ultimate political question, “Are conservative wonks really that ignorant or are they simply forced to pretend to be because of their ideological necessities?” I think I’ve come down on the side of, “They’re really that ignorant.” In modern America, just following the facts makes one a liberal. Conservatism is an ideology; liberalism no longer is. Thus, the only people left to do the conservative wonkery are ideologues who are not interested in the facts except in as far as they substantiate their ideology.
Consider healthcare reform. The solution that we finally got with only Democratic votes is a conservative one that depends upon the existing insurance market system. Liberals looked at the available proposals and went with the one they thought they could get passed. Conservatives, on the other hand, start with the idea of everything that healthcare reform cannot be. For example, it could not be a single payer system. And in the end, it could not even be their own conservative plan. We see this over and over again in other areas: first comes ideology and any solutions to problems must pass that hurdle first.
Friday night, Holman Jenkins wrote, The Medicare-for-All Diversion. In it, he boldly takes on the oft repeated (true) claim by liberals that Medicare is better than private insurance because it has far lower administrative overhead. Medicare has 2% overhead costs while private insurance has 20%. Aha, Jenkins notes, “Much of Medicare’s overhead is hidden on the books of other agencies.” Q-E-fucking-D! Except… Not so much.
Austin Frakt at The Incidental Economist provides, Facts on Medicare Administrative Costs. It turns out that, contrary to what every conservative just knows, the government is pretty good at just about everything it does. And that is especially true of accounting. The Treasury Department applies the work that the IRS and HHS does for Medicare to Medicare. In other words, and not to put too fine a point on it: Holman Jenkins is just wrong.
But this isn’t even Jenkins’ main point. He must know deep down that he doesn’t know what he’s talking about. (That would require research!) So he argues that the reason Medicare is so efficient is because its members are so unhealthy. Really! Get this:
Ask yourself: If the overhead ratio is the right measure of insurer efficiency, which is the least efficient insurer? Answer: The one with the healthiest customers, who consume little or nothing in the way of medical services. An insurer with perfectly healthy customers would spend 100% of revenues on overhead.
So private insurer administration costs are higher because they are keeping their members so healthy. Or something. That might make some sense if he were talking about profits. But he isn’t and health insurance profits are really quite low. It is all that money they spend trying not to pay for care that eats up the money. If insurance companies paid out no money to members because they were all so healthy, administration costs wouldn’t go up, profits would. And, of course, then insurance costs would go down. Blah blah blah. Leave it to a conservative to understand absolutely nothing about how business works.
He ends by making another totally bogus claim that his own column contradicts, “Look, if Medicare had cracked the secret of administering large sectors of the economy more efficiently than the private sector can, we’d be wise to hand the entire economy over to Medicare. We don’t hear too many making this argument.” We actually do have data that shows just that. And the fact that healthcare in the US costs about double what it does in other advanced economies also shows that. But the facts never get in the way of a conservative making an argument against what they see as socialism. It is disingenuous in the extreme for a Wall Street Journal columnist to say that he would follow the facts to the best policy. That just isn’t true. Even if you could convince him of the facts, he would still be against the policy because, “Freedom!”
Holman Jenkins is a real charmer. Here, via Gawker, is what he wrote about Stop & Frisk:
Liberals criticize stop-and-frisk because those stopped and frisked and sent to jail under New York’s draconian gun enforcement are disproportionately black and Hispanic. Never mind that those who commit murders and those who are victims of murders are disproportionately black and Hispanic. The thing to notice here is that stop-and-frisk can liberate us from the prevailing political unrealism of the gun-control debate.