When Projections Attack

There are lies, damn lies, statistics and now, apparently, also Congressional Budget Office estimates. In January researchers at the C.B.O. released some new numbers about the expected long-term impact of the Affordable Care Act. To make their hard-to-parse estimates seem a little more real, the authors projected that by 2024, the health care act would lead to the loss of 2.5 million jobs as Americans left the U.S. labor force. That number proved irresistible to Obamacare haters, many of whom seized upon the report, even before reading it, in denunciations that scorched across Twitter feeds, conservative blog sites and the Bizarro World of cable news.

People who actually read the report quickly understood there was a little more nuance to the C.B.O.’s projection. Far from deathpanelling America’s employment stock, the A.C.A. would “reduce the total number of hours worked…almost entirely because workers will choose to supply less labor.”

What does that mean? The C.B.O. report suggests that health care reform would have the long-term effect of allowing people to leave work if their only reason for remaining employed was to keep a connection to health insurance. So the projection did not imagine employers erasing jobs, but workers freed from the bonds of health care insurers and perhaps following their bliss for a change. The media narrative quickly adapted. Now the C.B.O. report was not detailing job destruction caused by health care reform, but a new Hydra head of the Obama entitlement monster, a “disincentive” to work created by relieving mass anxiety over health care.

This new narrative attached itself to the resilient depiction of the “Obama-nation of takers” pitted against the stalwart “makers,” those who are ruggedly individualizing out there in the U.S. economy, entrepreneuring like crazy and creating wealth that the Obama sheeple are madly redistributing. Now, because of the A.C.A., a whole new cohort of takers too lazy to hang on to jobs in which they felt trapped are being liberated by a new entitlement.

There is, of course, more than a whiff of scolding Calvinism in this new reading of the C.B.O. projections. What might a more charitable interpretation of the same look like? In the Catholic tradition in the United States, work is a meaningful and rewarding aspect of co-creation, but so are things like raising a family and sufficient time to enjoy the beauty and blessedness of creation. We are not our best possible selves merely yoked to a job  producing income and propping up the gross national product. Holding a child, visiting with neighbors, painting a landscape and, yes, even leaving a job we hate to raise a child, care for a sick family member or start our own businesses are also valuable expressions of a fully realized life. In other words, it should be hard for a Catholic to think less of a working senior who seizes on the option granted him by the A.C.A. to finally go ahead and retire or to admonish working parents who take advantage of the A.C.A. to be where they would rather be—at home raising their children.

How should health care be measured in a balancing of the common good? In a sharp contrast with the more communally minded members of the industrialized West, in the United States it has become nearly an article of faith that health care is a commodity on more or less equal footing with other consumer choices. Some believe the privilege of accessing it is reserved to the consumer wily enough to prepare to afford it. Of course, the Catholic tradition considers access to decent health care not a social privilege doled out to the astute and salaried, but a basic human right, a minimum guarantor of a just society, offered to all according to need.

In his second inaugural address, President Obama argued that “the commitments we make to each other—through Medicare, and Medicaid and Social Security—these things do not sap our initiative; they strengthen us.  They do not make us a nation of takers; they free us to take the risks that make this country great.” The new “entitlement,” access to decent, dependable health care, may soon be spoken of in the same way, as a modest step toward—not a nation of takers—but maybe a nation of brother’s keepers.

This article appears in March 10 2014.