The recent slowdown in health-care costs is one of those facts, like climate change or the rapid growth after Bill Clinton raised taxes, that flummoxes American conservatism. The slowdown of health-care costs is one of the most important developments in American politics. The long-term deficit crisis — those scary charts Paul Ryan likes to hold up, with federal spending soaring to absurd levels in a grim socialist dystopian future — all assume the cost of health care will continue to rise faster than the cost of other things. If that changes, the entire premise of the American debate changes. And there’s a lot of evidence to suggest it is changing — health-care costs have slowed dramatically, and experts believe it’s happening for non-temporary reasons.
The general conservative response to date has involved ignoring the trend, or perhaps dismissing it as a temporary, recession-induced dip likely to reverse itself. Yesterday, the Wall Street Journal editorial page offered up what may be the new conservative fallback position: Okay, health-care costs are slowing down, but it has absolutely nothing to do with the huge new health-care reform law. “It increasingly looks as if ObamaCare passed amid a national correction in the health markets,” the Journal now asserts, “that no one in Congress or the White House understood.” It’s another one of those huge, crazy coincidences!
Of course, it’s not just that the Journal didn’t predict the health-care cost slowdown. The Journal insisted it couldn’t possibly happen. Indeed, it insisted that Obamacare would destroy — was already destroying — any possible hope for a health-care cost correction, and would instead necessarily lead to a massive increase in health-care inflation.
In a series of hysterical, freedom-at-dusk editorials which were, unbelievably, awarded a Pulitzer Prize for commentary, the Journal expounded extensively on this belief. Health-care costs were exploding in Massachusetts, the editorial bemoaned on March 2, 2010 — “merely a preview of what the entire country will face if Democrats succeed with their plan to pound ObamaCare into law in anything like its current form.” It continued on March 20 of that year, “Once the health-care markets are put through Mr. Obama’s de facto nationalization, costs will further explode.” (Not may, will.) On June 11, another editorial complained that Medicare Advantage, the privatized version of Medicare whose overpayments Obama eliminated, “might eventually liberate the U.S. health market from government price controls,” except that Democrats were “intent on killing” it.
An October 26, 2010, editorial assailed mergers and consolidation within the industry, which it correctly attributed to Obamacare and very incorrectly insisted would snuff out any potential cost-controlling innovations:
A wave of consolidation is washing over the health markets, and the result is going to be higher costs. …
The accountable care movement could do some good if it spreads best practices. But no one should entertain the illusion that it will reduce costs perforce and “bend the curve.” In fact, the most concrete effect of this wave of consolidation may be to increase private health spending significantly.
Now the Journal surveys the health-care scene and insists massive changes had nothing to do with Obamacare. No doubt they would have reached the same conclusion if costs had risen more than expected.
We don’t need to lower ourselves to the Journal’s hackish standard. Coincidences happen. The future is hard to predict. The Journal’s “Markets Good, Government Bad” worldview may give it the confidence to make clairvoyant predictions, which it of course proceeds to forget ever happened, but the correct response is a certain humility and willingness to learn from the data. Still, the fact that the right is being forced to fall back from predicting a staggering rise in health-care costs to explaining away the staggering decline in health-care costs represents real progress.