Notes on a Theory…

Thoughts on politics, law, & social science

This One Chart Shows Everything That’s Wrong With Liberal Politics

with 5 comments

All right, not just a chart, but the chart and accompanying post. And not everything, but something important.

The other Jonathan Cohn had a post from shortly before the election at the New Republic that highlights a chart from the Georgia Budget and Policy Institute regarding the state’s decision not to expand Medicaid as part of the ACA.

It’s easy to recognize the human toll of refusing to expand Medicaid. It’s not so easy to recognize the economic toll. Maybe this chart will help:



But the state officials who have blocked expansion aren’t simply depriving some people of health insurance. They are depriving the entire state of federal funds. Under the Affordable Care Act, the federal government picks up 100 percent of the expansion cost for the first three years, then scales back its support to 90 percent. At that point, states will have to find the money to cover that remaining 10 percent. It’s real money. But it’s tiny compared to what they get in return. The federal money is a huge influx of cash, which goes first to providers and suppliers of health care. That money, in turn, generates additional economic activity.

Where to begin? First, it may be easy to recognize the human toll, but there’s been precious little effort by the Democratic Party or the liberal media to put that front and center. Sure, there’s been plenty of attacking Republicans for it, but that’s not the same. And the reality is that if you are trying to mobilizing people, letting them hear the stories of real people who are affected by a policy is far more effective than cost arguments.

Second, do you really think that Georgia legislators don’t know this? Cohn seems to take conservative arguments a bit too seriously, as if their whining about costs were sincere.

Conservatives like to point out that the federal dollars don’t materialize out of thin air—they come from the federal treasury. That’s true. But there’s a net transfer of money here, from the very rich (who pay higher taxes under the health care law) to the poor and middle class (who get either Medicaid or tax credits for buying private insurance). That’s perfectly consistent with a program that fosters growth, particularly at a time of low demand, since it’s taking money from rich people (who might otherwise save it) and puts it right back into the economy.

Let’s leave aside the fact that federal dollars do materialize out of thin air. Transferring money from the rich to the poor is precisely what conservatives don’t want to do. Normally this complaint is about “redistribution” but the reality is that conservatives (especially elite conservatives) are opposed to any distributions that don’t transfer money upward. They support policies that make the poor more insecure, more miserable, and they oppose those that prevent the rich from having more wealth and power. They will pay the costs when it comes to these goals. As I’ve said before, ‘big government’ is any action that enforces the law against the rich or provides protections to the poor while ‘small government’ is any and all protections and benefits for the rich or punishments for the poor. This is the conservative project, not spending less federal dollars as a matter of principle.

Every once and a while there’s a renewed effort among liberals to insist that the GOP is the party of death because they oppose universal health care (or more to the point, somewhat more universal). People die without health care, people don’t get health care without health insurance, so those who oppose expansion of health insurance are ensuring people die. But if we admit that people die without health care than what do we say about not fighting to change that? The Democratic Party has still not engaged in a serious effort to fight for Medicaid expansion. The original bill was designed to coerce states into accepting it, and when the Supreme Court took that mechanism away, Democrats mostly threw up their hands. (I mean officials and candidates. Even then there are exceptions. There are people out there fighting for this, and they are to be commended and supported). The party put most of its resources and attention on the Senate, never really made a case for why people should vote for them, never tried to move passive supporters of Medicare expansion or various other policies into active supporters, and the GOP ended up racking up large victories in state houses around the country in addition to taking the Senate.

The thing is that Medicaid expansion is popular. It’s popular in red states. It gives Democrats a wedge to use in less hospitable places.  But to translate that position into political support takes work. And charts won’t do that. Facts won’t do that. ‘Cost’ arguments won’t do it. Only contestation will.

[Update] For what it’s worth, I was objecting to liberal claims that the Medicaid expansion would happen without a fight back in June 2012. One could argue that it will happen eventually so there is no need to worry about it, but that still leaves many people without access to health care that might have it if we fought for it.

Also, to be clear: I’m not against charts. I like charts. I like facts. My point is that they won’t do our political work for us.

[Update 2] Like I said, I’m not against all charts.


Written by David Kaib

November 10, 2014 at 10:58 pm

5 Responses

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  1. Transferring money from the rich to the poor is precisely what conservatives don’t want to do. Normally this complaint is about “redistribution” but the reality is that conservatives (especially elite conservatives) are opposed to any distributions that don’t transfer money upward.

    The Medicaid expansion still does that. It just gives less fortunate better health. And the GOP won’t allow the less fortunate to be helped.

    Phil Perspective

    November 16, 2014 at 8:56 pm

  2. Point 1.

    Here’s a comment (i even give money to panhandlers, though I don’t put this in that class; i also speak out of turn and have laughed in the face of police and petty criminals when they go after me—in one case you might get tased—i just said ‘do it’ but they locked me for an ‘open container’ etc—in the other case you might get shot—in which case, though i’ve never done it, i say ‘well i just found a gun, in your hand, so its mine’ (and my plan is to throw it into the sewage system—i forget what those are called where the water goes down under the street).

    Point 2.

    I’m actually on dc health alliance—essentially free. I am sortuh the problem people talk about—who end up in the ICU since they dont maintain themselves. I already have missed 3 appointments, and i actually caught pneumonia when i was hanging out at Occupy DC and had to spend a month and a half in the hospital. I mentioned to my local family on the phone i could no longer walk and was hallucinating tho i wasnt asking for help—but they came and made me go to the hospital. I was actually hoping to get some morphine and they gave the guy in the next bed dilaudid (synthetic heroin) but they said you just get tylenol. They said i’d be out in 5 days, but it stretched out into 6 weeks—-i got out the day after april fool’s day. (but i was on an oxygen tanks, which i carried around).

    (I ran up supposedly over 200,000$ in bills (about 3500$ a day—-i call this affordable housing, and it comes with room service—i would order like 8 coffees at a time— and some sort of cable TV (i liked watching the ‘prosperity bible’ shows, and documentaries on the amish, and herman melville.

    Interestingly, the book ‘moby dick’ by melville which i read in DCPS and is considered a classic, was also his downfall in terms of a career as a writer. It got bad reviews but he didnt commit suicide and just got a regular job—sort of a reverse einstein (who started in a patent office). Of course, now the ‘creative class’ can make a good living off of Melville.
    A whole lot of musicians, etc. almost never made a dime, but the record companies and such did.
    Van gogh i guess also had a prosperous life).

    That is what is called by Mosca and Pareto—ancient italians— ‘the iron law of oligarchy’).

    They even had a show with obama being entertained by mick jagger and keith richards, and i think muddy waters was there too.
    I only had to pay about 15G. (Keith Richards may be an example of why on occassion one person’s poison is another’s medicine, since he is known to be a dope addict).

    Point 3.

    I listen to CSPAM, so you hear all kinds of things about ‘Obamacare’ (and my mom actually goes to the same unitarian church in hawaii obama went to) . I also saw some blog post that says there is going to be ‘sticker shock’ when rates go up, if people don’t do their homework and change plans. Obviously some states accepted Medicaid expansion (I’m not sure that includes Kentucky, where McConnel (sic) won—who i happen to dislike; he’s up there with Tim Crews (Texas, foreigner from Canada though maybe he could get a job up in the tar sands and have fun sniffing glue with the local athemascan people), and that womyn from Iowa.

    One thing is, in my view, nobody is going to read all these blogs, articles, studies, etc. The current Jacobin has an article on free education in germany—its basically a tracked system, just like the USA. In the USA, ‘behavioral genetics’ is quite big (eg James Fowler on genetic predispositions for poltical orientation, often published in PNAS (Proc Nat Academy Scis.)—–and in my view, and some others (tho no one will say it—since if you ‘whistleblow’ you will be terminated like snowden or jjulian asange, and this also happened to a whole lot of the russian mathematical community under stalin—-people just stole their stuff and put them in jail ) , its really going downhill (opinion pieces backed by nepotism and big data passed off as ‘science’).
    and of course then you have a whole community of grad students, data processors/IT people, service jobs, grant administrators, restaurants, bars, etc dependent on this.

    I wonder if Braverman goes through the whole ‘supply chain’ in the division of labor.

    (For example, on this blog there is a link to some Canadian site on ‘progressive economics’, randall wray, b black, etc See what they say about the current noble economics laureate tirole—i personally have studied a fair amount of game theory, but to a large degree its really irrelevant—-but maybe like say ‘special relativity’ or quantum mechanics eventually it will turn into something (though those also turned into atomic bombs. Its usually not really applied because it can be somewhat complex, though i guess they tried variants like a few alternative voting systems in communities such as Takoma Park, and auctioning off things like FCC liscenses (eg Tyler Cowan of GMU—markets in everything (except, of course, himself and his crew—like Mercatus Center).).

    Point 4.

    I guess I’ll have to see the post on ‘only contestation will’ (change things). I also have to pack for thanks(for indian) giving— i’m hoping the weather wont be too bad; and maybe i have time for a bit of music . peace out (i wonder if this comment will be deleted). ‘i wonder why i wonder why i wonder why…’ (feynman)


    November 25, 2014 at 5:08 am

  3. […] 4. This One Chart Shows Everything That’s Wrong With Liberal Politics […]

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  5. […] stated, is that we all agree on the ends but just disagree on the means. This is the notion that arguing solely via stats and charts appear to make sense, even though generally speaking this convinces very few people. But politics is […]

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