MIT professor Jonathan Gruber has produced a firestorm of controversy over remarks made in various settings about the Affordable Care Act (“Obamacare”) and how drafters like himself relied on the “stupidity” of voters in passing the legislation. It appears that the Gruber hits keep coming, even as he prepares for another round of questioning in Congress. The latest comments from 2009 reveal Gruber saying that Obamacare would not produce affordable health care for many citizens since its focus is coverage not costs. This statement made five months before the passage of the Act from a key architect is in stark contrast to President Obama’s repeated assertions that premiums would go down dramatically. The latest statement will fuel questioning before Congress on whether the White House knew that premiums were unlikely to do down and that people would not be able to keep their current policies as promised by President Obama in selling the program.
Gruber stated in 2009 that Obamacare lacked cost controls in it and would not be affordable for many:
“The problem is it starts to go hand in hand with the mandate; you can’t mandate insurance that’s not affordable. This is going to be a major issue . . . So what’s different this time? Why are we closer than we’ve ever been before? Because there are no cost controls in these proposals. Because this bill’s about coverage. Which is good! Why should we hold 48 million uninsured people hostage to the fact that we don’t yet know how to control costs in a politically acceptable way? Let’s get the people covered and then let’s do cost control.”
That view of the likely impact of the ACA was not only never shared by the Administration, it is in direct contradiction with the statements made by the White House on how costs would decline and people would be able to keep their policies if they liked them.
The latest comments are unlikely to gain Gruber any more allies. Once given millions to advise the federal and state governments on their health care system, he is now persona non grata. Indeed, Democratic minority leader Nancy Pelosi expressed a complete lack of knowledge of who Gruber is, was, or will be — even though she previously cited his work and he was paid $400,000 as one of the architects of Obamacare and has made over $2 million from HHS.
Gruber had already previously attracted controversy with statements where he endorsed the theory at the heart of the recent decisions in Halbig and King by challengers to the ACA: to wit, that the federal funding provision was a quid pro quo device to reward states with their own exchanges and to punish those that force the creation of federal exchanges. That issue will now be decided by the United States Supreme Court. Gruber caused uproar when, after he had denounced the theory as “nutty” during the arguments in Halbig and King, he was shown later to have embraced that same interpretation. Gruber has become a major liability in the litigation. Gruber then was back in the news with an equally startling admission that the Obama Administration (and Gruber) succeeded in passing the ACA only by engineering a “lack of transparency” on the details and relying on “the stupidity of the American voter.” Now a new videotape has surfaced from Gruber speaking at the University of Rhode Island in 2012 and expressing the same contempt for the intelligence of citizens — suggesting again that they were hoodwinked to “the lack of economic understanding of the American voter.” In another view taken from at an October 2013 event at Washington University in St. Louis, Gruber also refers to the “Cadillac tax,” and says “They proposed it and that passed, because the American people are too stupid to understand the difference.” His comments of working in Massachusetts (with Mitt Romney) are no less insulting to an array of people.
The latest statement is also likely to serve to increase calls for Gruber and the Administration to produce withheld documents previously demanded by the House Oversight and Government Reform Committee. This statement is far more important than past comments calling voters or politicians stupid. In 2009, Gruber was saying that the ACA was not about reducing costs but guaranteeing coverage. That seems manifestly true but it was not what the White House was saying at the time or even now. The statements are likely to draw more fire with fines set to increase under Obamacare in 2015.
The statement was again in a lecture by Gruber. Once again, Gruber was displaying the type of honesty and openness that students expect in classroom discussions. That is not the expectation however in political discussions, particularly in Washington. Gruber’s admissions have embarrassed the White House and Democratic leaders who pushed through the ACA on a razor thin vote. This is why academics often find work in politics to be particularly precarious. The nature of our work demands intellectual honestly and transparency that can be a liability in the political world. Indeed, conservative editorial are already proclaiming that “Grubergate” just got “better” .
The cancellation of state contracts is likely to be the least of Gruber’s problems in 2015 as he appears again before Congress.
Prior to Dems trying to take over 1/7 of the economy 95% of the people who had health insurance were happy. This isn’t about medicine, this is about wealth redistribution. Americans aren’t Canucks or Europeans. We demand the best and we WILL NOT WAIT YEARS for surgeries. Why is it the people I know who have lived in Canada and UK hate it. I guess I know smart people and you know lemmings. 2 tiers. You want socialized medicine, build you underachievers a dole system. We achievers will stick w/ our system. Maybe we can fold you lovers of govt. into the VA system. Why do people who are happy need to go w/ something THEY DON’T WANT. Have a friend who worked for a large MN. hospital chain. They had Canucks coming down for treatment all the time. We’re different than hosers. We’re wealthier, smarter and a lot less compliant.
Nick
If you read a reasonable spread of newspapers you will find that Americans, who didn’t have because they couldn’t afford, health insurance, have been going to Canada for medical procedures that cost far less than in the US irrespective of insurance. Like mentioned in the previous comment, Americans have been going to other countries for cost reasons for some time.
As a citizen and resident of both countries I could fill pages with stories of satisfied Canadians, British, French, and other nationalities that have single payer basic health insurance. The US is the only country that is obsessed with defending the right to get reamed by the private sector. It is as if vacuous words such as choice and freedom could be filled by any con artist with some snake oil to sell.
The strength of the American medical system lies in the over all level of ability to pay on average as well as through government subsidies and a population large enough to support it. The cost of about twice what comparable systems are in other countries is found in the oligarchical system of government control by private industries, in this case the insurance industry.
In the early 60’s when Canadian provinces went from private insurance to public insurance those in favor were labelled ‘Communists’. The accusations were overflowing with vitriol, just like today, here in the US. The majority of Canadians, when asked, would rather stay with the present system. For a while they objected to the only government option dictates and because of democracy and irrespective of lobbyists, they elected to add a private level of insurance if desired, the best of both worlds.
Obama slammed through a dog’s breakfast of a system at a time when unemployment was ten percent. To have done the most cost effective thing and push through a medicare/medicaid administered system of insurance would have place three to four hundred thousand people out of work. We pay for these unnecessary workers through our premiums, along with corporate salaries, and shareholders’ dividends.
We are in reality dictated to by the private sector as to paying twice as much, getting far less, and when it comes up in our democratic process, the system morphs into an oligarchy and the individual citizen, what all this is about, loses to the special interest.
Your description of the ‘two tier’ system needs to be refined. Everyone pays into a basic system, comparable to the average coverage today. In return, the costs are cut in half. Then if the ‘average’ level of coverage is not good enough, as it is in Canada for some, one has the option to augment or supplement the basic coverage with extra stuff. The bottom line is that nobody dies because they can’t afford insurance. People stop leaving easily treated ailments until they end up in the emergency ward where we all pay. The people are healthier in Canada and that is one of the reasons.
There isn’t one founding father that stated that Americans had to get screwed by private sector monopolies. Everything that was written and recorded speaks to evolving as a nation in the best interests of the individual, not the oligarchs.
Something written 238 years ago in a different context is easily interpreted one way or another. I tend to lean towards common sense and the best interests of the individual, not mumbo jumbo and some global corporation.
issac – if everyone in Canada is so healthy and the system is so great you all can stop clogging up the system in Arizona during the winter. Canadian snowbirds come down here and tie up our doctors getting procedures done on Canadian insurance. They spend the fall making appts. We residents have trouble getting an appt. until after Easter.
Aridog,
I do not think Lerner’s appointment was any more coincidental than the rounds in your FNX-45. I’ve read in these threads where people believe in the goodness of others. That’s a quaint notion and respectable in the proper context, but when it comes to an institution with the power to destroy your life; it’s a verify before trust policy for me and she has been verified as…CORRUPT!
People w/ money and BRAINS come to the US. To argue we don’t have the best medicine in the US is a lie. We do! Maybe poor people go to socialized medicine countries. But the wealthy and smart come here. And if you’re dying of cancer, you don’t go to the country w/ the best “prevention” for chrissake. And, if you do, well Darwin explains that pathology. If you want to nit pick DCN’T WASTE MY TIME. You are free to go to any other country. I’ll get my healthcare here, where the smart and wealthy do. And, it comes down to that, it’s about hating the rich. It ain’t about medicine. It’s about resenting the wealthy. I don’t waste my time w/ your ilk. You will not here from me again.
Nick-
“Why do people, who are dying, come to the US. They sure as hell don’t go to Canada or the UK.”
That actually isn’t true at all. Plenty of people travel to nations with public health care that they can’t afford in their own Nation.
“If you want the most cutting edge, best medicine, the US is the gold standard.”
Nonsense. As an example, do you have a limbal stem cell deficiency? Well then, you’d be far better off going to India or Italy, etc. where they allow stem cell research rather than the USA, which lacks the technology to clone and graft stem cells because of the loony religious right making policy. The USA has historically been better at high tech intervention, the reason being that it’s far more profitable than prevention. Nations with socialized health care excel at prevention, and I’d much rather not need high tech intervention in the first place.
“Then, the majority of people, who are VERY HAPPY w/ our insurance”
More fiction. Before the ACA, we still had, by far, the most expensive system of healthcare with the lowest approval ratings, lowest rate of coverage, highest infant mortality rate, shortest life span. . .
You entire post is nonsense based upon your erroneous perception that doesn’t even have a fleeting acquaintance with reality. Quit embarrassing yourself. At least make the attempt to become informed before you jump on your soapbox and start preaching,
Olly…do you think it was a simple coincidence that Lois Lerner, previously with the Federal Election Commission (FEC) before her appointment (totally unqualified) to her position in the IRS. I ask given she had election experience, and once in the IRS could act to impact those things and make trouble for those she disliked. How could that have been anything but political? Given all SES are appointees, Ms Lerner’s transfer to IRS was as coincidental as sunrise in the east. That “institution” you’ve cited at work.
Olly said …
Unfortunately, by the time the failures becomes recognizable they are also institutionalized. The scandal goes away but the institution does not.
You are virtually quoting me, if not literally. Dead on the money. The “institution” remains. And repeats its manipulations in time. And, yes, it is very much a bipartisan problem.
Sad to say, I don’t know if we can elect a Congress and President who (with the courage required) will act to really change it. A very serious major RIF at the senior most levels, above GS civil service (where RIF’s occur regularly…makes more space for SES, etc.) would have to be the first whack at the “institution.” YMMV.
Why do people, who are dying, come to the US. They sure as hell don’t go to Canada or the UK. If you want the most cutting edge, best medicine, the US is the gold standard. That’s because we don’t have DMV union govt. union workers handling how we get our medicine. Single payer is NEVER going to happen here. We like to live, not die waiting. VA is all people need to look @ for the reason we don’t want govt. healthcare.
A 2 tiered system is what I see. Govt. medicine for those who can’t pay, or are too lazy to work for it. Then, the majority of people, who are VERY HAPPY w/ our insurance, can remain in the private sector. We earners will have to pay for the govt. medicine. Many I am more than happy to pay for, people truly needy. The folks who fake disabilities and get on the dole, well that’s how our culture has devolved in my lifetime. C’est la vie. I’ll still keep catching some of the malingerers.
Karen,
Your cardiologist example reminded me of a recent experience. I have Tricare and predominantly use private sector care. Recently, I was referred to a doctor at the Naval Hospital on Camp Pendleton. When I arrived at the front desk, the E-5 corpsman sitting in front of me that was supposed to check me in was busy on the phone with his automobile insurance company discussing a recent claim. As the check-in line began to grow behind me I had to get the attention of the HMC to get this guy to actually do his job. By the way, I didn’t have to wait long to get an appointment because I wasn’t limited in my choice of doctor availability. Once I did get my treatment, the care was excellent.
This is not ‘why’ government run healthcare doesn’t work; it is a symptom of the lack of profit motive for efficiency AND effectiveness. To believe government run anything can be better than the private sector is to ignore human nature. The perfect example of this principle is our military; what are they good at and what are they not good at? They can accomplish any mission imaginable. The ‘tip of the spear’ is very efficient and effective but the further removed one gets from the risk found at the business end of the spear the less efficiency and effectiveness will be measured and accountable. If you don’t believe this then scour the ocean floor west of Hawaii and you’ll find a graveyard of taxpayer money dumped over the side from ships returning from deployment. Same can be found in the Atlantic east of Norfolk.
I taught TQM in the Navy in 1990’s. I had learned from W. Edwards Deming that “You can expect what you inspect.” That simple philosophy is all we need to know when accounting for human nature; whether in government, business or our personal lives. The trick for government is to convince the citizens to inspect only what they expect. These are the very people Jonathan Gruber and the government sausage makers rely upon. Unfortunately, by the time the failures becomes recognizable they are also institutionalized. The scandal goes away but the institution does not. It simply remains as a human nature ticking time bomb; nothing to see here, move along. This is how the ACA is sold and when it doesn’t deliver… This is the VA…. This is the IRS… This is the War on Poverty… This is NCLB… This is Green Energy… This is the Stimulus Bill… This is TARP… Pick an agency and the story will be the same. This will be Common Core… and this is a bipartisan problem.
Yep, Pete sounds good.
Inga,
I’m just enjoying the show.
popcorn?
Karen-
“What does it mean when one doctor does the work of 8? ”
It could mean several things. That statistic means nothing in itself.
“It means longer wait times at the VA. ”
Possibility, but not necessarily. That would depend upon scheduling, size of population served, etc.
“Does that sound like a model on which to build our healthcare to you?”
That just sounds like speculation on your part. Some government agencies function well, others don’t.
“Another aspect that people may not be aware of . . .”
Because it only exists in your mind? I personally think that mass immigration is caused by economic catastrophe in the countries from which those immigrants derive. Mexico, for example, isn’t a poor Nation, but the people are. The way to curb that immigration is to address the economy in that country which produces such large numbers of refugees fleeing across State lines, not further criminalize and marginalize workers from other countries fleeing abject poverty.
However, mass immigration is a by-product of American foreign policy, and intentionally so because it drives down wages. In the San Francisco Bay area, for example, in the 1990’s most skilled construction workers were middle class, and the majority were American citizens. By 2010, most construction workers in the area lived below the poverty line, wages had fallen by more than 50%, and 80-90% of the workers were Hispanic immigrants.
Immigration increases profitability in industries that are labor intensive because it provides a powerless labor force, so those industries will always lobby for increased immigration. However, you could care less when that middle class sector disappeared, it was only when you personally experienced some economic discomfort that you started whining about the war on the middle class. Your problem is that, on the one hand, you’re upset about the war on the middle class, but on the other you are so politically naive and entirely reactionary that you support the policies that create the war on the middle class.
I’m happy that the uninsured and those with prior medical conditions can now have insurance.
I’m disappointed that medical insurance has become more expensive and increasingly unaffordable for many.
My personal opinion is that yes, single payer would have been a better solution, but I’m not married to the idea. On the other hand, I would not have voted for the ACA (there’s nothing affordable about it, contrary to its title) and as it stands now, I’m hoping it’ll be terminated.
Chip – great post on the Netherlands and Switzerland.
Another aspect that people may not be aware of is that our policy of accepting large numbers of immigrants is an additional drain on our system that no other country experiences.
To immigrate to Holland, for example, you must prove that you will be a contributing member of society, among other things. Here in the US, we take the position that anyone of the most humble origins is welcome. I agree with this. My great-grandfather was a poor printer, I believe.
But some people fail to take into account those numbers of indigent immigrants are an additional cost that must be taken into consideration when designing any plan.
Aridog – I couldn’t agree more with your remark about too many “flag rank” civilians in government office, of which Lois Lerner is a prime example.
Anarchist:
“Oh I see, you’ve confused productivity with quality.”
What does it mean when one doctor does the work of 8? It means longer wait times at the VA.
Either the one doctor is using a factory output model, spending seconds with each patient, or the 8 VA government employees are working very slowly.
Government employee models do not reward hard work. You have job security if you sit in a chair and twiddle your fingers in front of your face. You can even kill people, by throwing away their information and making them wait for 9 months to see a doctor until they die without help, and you won’t get fired.
Does that sound like a model on which to build our healthcare to you?
your mistake is that you are willing to assume private healthcare is automatically better than government subsidized healthcare, even though all the statistics from the western world involving figures like infant mortality, lifespan,cost, etc. suggest otherwise.
Trying to back away from your single-payer love, I see.
Regarding the stats, I’ve described, and posted links to, the relevant data here several times. I would again, but I don’t think you’re open-minded enough for that to be worthwhile.
So I’ll simply say, your argument utterly fails b/c it misses the difference b/w unconditional and conditional probabilities. Show me any evidence that you know what that diff is, and we can talk.
But I have other things to do right now.
Anarchist 2.0 said …
…because it at least provides one improvement- those with pre-existing conditions can now find health care. I wouldn’t support scrapping the ACA however, because we have no reasonable alternative.
1.) There was an “improvement, of long standing, that does provide that there can be no exclusions for pre-existing conditions. It even had bipartisan folks propose it for adaptation nation wide. I’ve cited here multiple times on other threads. I won’t bother again.
2.) Re: “no reasonable alternative” … Same answer as #1 above …there is an alternative. Posed in 2004 and in 2013 and at others times as well by less well known proponents. Again, I’ve mentioned it previously and won’t bother again. No one is paying attention to it. Must not line enough pockets. Must not provide sufficient bureaucratic control. Or something.
Chip-
“Karen’s only mistake was assuming that you could figure out the relative quality of VA and private-practice cardiologists all by yourself.”
No, her whole argument was a mistake. However, your mistake is that you are willing to assume private healthcare is automatically better than government subsidized healthcare, even though all the statistics from the western world involving figures like infant mortality, lifespan,cost, etc. suggest otherwise. America, with it’s completely private system had a much higher cost, lower rate of coverage, lower life span, higher infant mortality. . .
God forbid you take any of that into account though. It might inject some rationality into the discussion.
Karen-
” resort to ad hominem attacks”
Why do modern “Conservatives” love to play the victim so much? Poor widdle baby is being subjected to vicious ad hominem attacks by a “liberal”! Karen, when you begin a conversation with insults, as you did, you can at least display enough maturity to forgo whining when your opponent responds in kind. Maybe you’ll earn a little respect if you can quit whining like a child and take responsibility for your own actions.
“I have a sincere concern, and people like you wrecked my family’s finances.”
More playing the victim. Americans are your enemy. Yep, you’re a Republican alright.
” You caused great financial hardship on millions of people.”
Waaah!!! Waaaah!!!!! Big bad liberal!!!! Waaaaah!!!!!!
“Fiscal conservatives seek for . . .”
Whatever their radio tells them to seek for. You people lack rationality, personal responsibility, and willingness to learn.