Is it possible that the reason all the Republican horror stories about the Affordable Care Act haven’t panned out is because there aren’t any (real) horror stories? People worse off, yes, but not stories that would make for great TV ads? That’s speculation that I’m starting to see from liberals, beginning (as far as I know) with Michael Hiltzik at the Los Angeles Times, following up on Kevin Drum’s post in Mother Jones I wrote about last week. Paul Krugman is on it to. Is it plausible? I’m not sure. There’s another one today; perhaps this one will pan out.
In any case, let’s put a major warning label on this fight. A law can be pretty bad without producing TV-ready bad-news stories. Or it can be pretty good without producing TV-ready good-news stories. More to the point: The ACA is a huge law, and the U.S. is a nation of more than 300 million people. A few entirely accurate horror stories or a few entirely accurate great stories wouldn’t actually tell us anything about whether it’s a good law or a bad law.
What matters are aggregate numbers, not anecdotes. And while true horror stories (if there are any) matter, so do small improvements. And it also matters if people are a little bit worse off, at least if there are millions of them. Even if the effects are indirect, and the people involved don’t even realize how the law changed their situation.
Which, after all, is going to be the case for the overwhelming majority of Americans. Policy evaluation is hard! Arguing it out by anecdotes is never going to be very informative, even when the stories are accurate.
Not that there’s anything wrong with ad campaigns that feature dueling personal stories, though it would be nice if they were, you know, true. That’s what happens in campaigns, and there’s nothing anyone can do about it. And, yes, that includes the part where the phony stories get debunked. But no one should confuse any of that for real policy analysis of how well or how badly health care and health insurance are working under the new law.
To contact the writer of this article: Jonathan Bernstein at Jbernstein62@bloomberg.net.
To contact the editor responsible for this article: Max Berley at firstname.lastname@example.org.