Yes, the American health-care system isn’t that great. Conservatives shouldn’t have a problem admitting this.
Greg Scandlen argues in the Federalist that there are clear methodological problems with the recent Commonwealth Fund study that ranked the U.S. health-care system the worst among its peers. But that isn’t to say we should be happy with American health care: For one, it’s definitely incredibly expensive, regardless of outcomes.
One tendency on the right when talking about health care is to assume that before Obamacare wrecked everything, our system was fine. In reality, the system, as the Commonwealth Fund study or virtually any other metric shows, was excessively costly and locked out far too many individuals from insurance because our pre-Obamacare system lacked almost any market mechanisms.
One approach, in fact, to thinking about Obamacare is not that it’s so bad because it introduced “socialism” to American health care, but because it tried too hard to keep much of the old structure. Obamacare reinforced the inefficient and regressive employer-sponsored-insurance tax exclusion, expanded rather than reformed a Medicaid program that’s a clear failure, and continued the practice of offering consumers little in the way of choice. The job-killing employer mandate is a product of wanting to minimize disruption to those who already had employer-provided care.
This is a critical distinction going forward: Repealing Obamacare should not be the end goal of conservative health policy; the end goal should be a system much more market-oriented and equitable than either Obamacare or what preceded it, whether that comes by repealing and replacing Obamacare or by reforming it.
Unemployment in one’s teenage years can be a problem later in life.
Alina Tugend writes in the New York Times about teenage unemployment, how it leads to future employment and better wages, and some policy ideas to encourage it. Tugend:
Failing to find work doesn’t just mean a shortage of cash in the near term. A study released in March by the Brookings Institution’s Metropolitan Policy Program said finding a job when you’re older is harder if you haven’t worked during your teenage years. . . . Low-income and minority teenagers are particularly hard hit; only about 17 percent of African-American 16- to 19-year-olds were employed in 2013. . .
While job seekers can try innovative ways to attack the job shortage problem, the Brookings Institution study said high teenage unemployment also needed to be addressed through public policy. More programs in high schools and community colleges, for example, like work-based learning, where students learn technical, academic and employability skills in a real work environment, could help. More subsidized job programs are also needed, as well as classes that teach teenagers skills like interviewing and résumé writing, the report said.
The value of being exposed to the world of work early in life is obvious to many conservatives, and it informs many of their policy preferences. While it’s always encouraging to see left-of-center folks in the Times and at Brookings acknowledge this issue, the policy proposals mentioned are, even if interesting ideas, probably insufficient. A reduced or eliminated minimum wage for teenage workers, a broader payroll-tax cut, and wage subsidies seems like a framework that would do more to address the two obstacles to more teenage employment: teens’ costing too much to employ and the pay’s not being good enough to entice possible workers. It’s also worth noting that a hike in the federal minimum wage is perhaps the worst thing that could happen to teenage employment, as low-skilled teenagers are unlikely to be productive enough to warrant $10.10 an hour.
More evidence marriage should be part of our poverty discussions: No-fault divorce hurt lower-income men and women.
In a study that would seem to validate many of the arguments Ross Douthat has been advancing for a while, Raquel Fernandez and Joyce Cheng Wang have a new working paper out analyzing the way changed divorced laws impacted individuals across the income distribution. From the abstract:
During the 1970s the US underwent an important change in its divorce laws, switching from mutual consent to a unilateral divorce regime. Who benefitted and who lost from this change? . . . @e find that men in the top three quintiles of the initial productivity distribution are made better off by a unilateral system as are the top two quintiles of women; the rest prefer mutual consent.
Like the body of evidence that two-parent families are instrumental to children rising out of poverty, this study suggests that post-sexual-revolution lifestyles can be successfully adopted by upper-class individuals who have the resources and social networks to handle them, but that in poorer communities, the changing mores have wreaked havoc. It’s not clear to me that something like no-fault divorce can be put back into the toothpaste tube — or even that we would want to if we could — but the first step, one that the Left seems to have little interest in taking, is acknowledging the ways the changes to the institution of marriage have hurt much of America.