Politics & Policy

Real Simpletons

A popular magazine ignores the downside to Obamacare.

My wife subscribes to Real Simple, a women’s-interest magazine specializing in articles on how to make life more organized. I often joke that our lives would be more organized if we didn’t have eight copies of Real Simple floating around the apartment at any given time. But since they are around, I’ll flip through them occasionally to see if there’s anything worth reading. And today, in the latest issue, I saw a short feature titled “How Health-Care Reform Affects You.”

The article reads like an advertisement for Obamacare. One would be forgiven for thinking it a part of the administration’s campaign to improve the legislation’s popularity. Here is a complete list of the article’s subheads:

‐Insurers have to spend more money on care.

That’s it: All good, no bad, and the only two sources quoted in the article represent non-profits who supported the legislation. Don’t take my word for it: While the article isn’t available online, you can hear a podcast of the article (alas, the third of three recorded items) here.

Here are a few questions about how health-care reform affects you that the Real Simple piece didn’t answer:


The closest thing we have to an empirical experiment of how Obamacare might work is the Massachusetts health-care reform that passed in 2006. Health-care costs in Massachusetts went up. Premiums in Massachusetts went up. When the governor of Massachusetts tried to counteract these premium rises with price controls, his administration was plunged into an embarrassing lawsuit with the state’s non-profit insurers, who argued that the premium caps would put them out of business. Leaked e-mails from a top insurance official supported their argument and warned of a “train wreck” if the premium caps were allowed to go through. Real Simple notes that the new federal law requires insurance companies to spend at least 80 percent of their revenues on health care — gotta keep those greedy insurance companies from just using people’s premiums to pad their bottom lines. But insurance-company greed clearly isn’t the problem in Massachusetts, where most of the insurance market is not-for-profit. The problem is that somebody has to pay for what the government has decided everyone is entitled to get.


Premiums aren’t the only thing going up: The state has added $1 per pack to its cigarette tax and imposed $89 million in new fees and assessments on health-care providers and insurance companies, and it is still not enough to cover the cost. It turns out that disconnecting cost from treatment — or, as Real Simple puts it, “You won’t be charged co-pays or out of pocket costs” — drives up the cost of health care, and when the government is paying for it, that means higher taxes or fewer services as policymakers find ways to fill the fiscal holes such entitlements create.


Speaking of fiscal holes and entitlements, the Obamacare legislation makes cuts to Medicare, not to ensure the solvency of that program, but to pay for all the wonderful things Real Simple says you’re now entitled to. So, your kid can stay on your insurance until he or she is 26, but your mother stands to lose her coverage under Medicare Advantage, meaning she might need supplemental insurance that, depending on her means, you might have to pay for. Sooner or later, debt economics will require us to turn Medicare into a need-based program, and middle-class citizens will have to shoulder a larger share of the cost of caring for their elderly parents. Any Medicare “savings” should be used to smooth the transition into that ineluctable future, not dedicated to the further infantilization of 18-to-26-year-olds.


All major employers will be running cost-benefit analyses to determine whether it is cheaper to offer health coverage or to pay the tax penalty for not offering such coverage. Depending on how much premiums rise (see above), it could very well turn out to be cheaper for most employers to discontinue coverage and dump their employees onto the government exchanges, disrupting their employees’ existing health-care arrangements and forcing them to find new doctors. This is already happening in Massachusetts, and it is likely to happen on a national scale, Obama’s claims to the contrary notwithstanding.

Supporters of the Obamacare legislation have noted often in recent weeks that, while the legislation is still unpopular with a majority of Americans, the gap in the polls is narrowing — from 52 percent opposed, 42 in favor, in January, down to 47 opposed, 40 in favor, in July, according to a chart that has popped up on several blogs as evidence that the legislation is getting more popular with time:

[Click the image for a larger version of the graph.]

I think it’s pretty obvious why. The closer the legislation got to a vote, the more it was covered in the news. The more it was covered in the news, the harder it became for media gatekeepers to shut out conservative critiques of the legislation. Supporters of the bill called these critiques “misinformation” and blamed the bill’s unpopularity on the propagation of false ideas about what it would do. But the Real Simple article mentioned above doesn’t just exclude “misinformation,” real or imagined: It excludes any mention of the bill’s drawbacks at all. It portrays Obamacare as all benefits, no costs.

Now that the bill has passed and news coverage of it has plummeted, snippets that accentuate the positive like this Real Simple item might be the only thing many Americans read about health care this month. Most Americans are rationally ignorant about politics. If members of Congress aren’t reading the 2,000-page bills they keep churning out, can we really expect Americans with busy lives and children to keep up with the details? Lifestyle publications such as Real Simple can make a big difference in how such bills are perceived.

The unpopularity of the bill is dropping because reminders of its costs have been excised from the broader cultural conversation. But supporters of the bill shouldn’t take too much comfort in those poll numbers they’ve been talking about. You can’t hide the costs of a bill like this forever. Just ask the good people of Massachusetts. Better yet, ask their new senator, Republican Scott Brown.

– Stephen Spruiell is an NRO staff reporter.


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