Sins of Omission: What's Wrong With Gruber's Health Care Reform
By Bryan Caplan
Given my interest in health economics and graphic novels, I was initially hopeful about Jonathan Gruber's graphic novel, entitled Health Care Reform: What It Is, Why It's Necessary, How It Works. But in all honesty, the book is awful. Gruber crafts his argument like a salesman, not an economic educator. He's careful to avoid outright mistakes, and makes a couple of awkward disclosures. Yet he omits a long list of crucial, damaging points.
1. Gruber explains the basic facts about health care costs: they're rising, and government picks up much of the tab. But he almost totally neglects the connection between the two. Medicare and Medicaid vastly increase demand for health care. There's no denying it. Imagine how much more affordable health care would be if these programs had never been adopted - or if they were abolished.
2. Gruber doesn't just ignore the indirect effects of Medicare and Medicaid on health costs. He repeatedly panders to the populist view that near-total insurance is good. He brags that Obamacare will close the "enormous gaps" in many private insurance policies. He frowns on insurance policies that place any ceiling on annual or lifetime payouts. He even reassures readers that, under Obamacare, the government's "comparative effectiveness research" cannot legally be used by private insurance companies to restrict health insurance coverage. Gruber's happy to blame "Cadillac" health insurance policies for raising medical costs. But private insurers' many efforts to restrain spending earn nothing but criticism from him.
3. More generally, Gruber ignores almost everything government does to increase the cost of health care. There's no discussion of
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