Okay, so candidate Barack Obama told a bit of a fib about his mother. From the New York Times:
During his presidential campaign and subsequent battle over a health care law, Mr. Obama quieted crowds with the story of his mother's fight with her insurer over whether her cancer was a pre-existing condition that disqualified her from coverage…
But in "A Singular Woman: The Untold Story of Barack Obama's Mother," author Janny Scott quotes from correspondence from the president's mother to assert that the 1995 dispute concerned a Cigna disability insurance policy and that her actual health insurer had apparently reimbursed most of her medical expenses without argument.
The candidate's tale was fabricated. Ann Dunham did not have to struggle with her health insurer or worry whether her family would be left with the bills. Was it an outright lie? Ann Althouse thinks so. Meagan McArdle is more inclined to be charitable.
A lot of the right is no doubt going to jump on Obama as a liar, but I think it's entirely plausible that this is how he remembered it: it was a terrible time, and memory is unreliable.
McArdle thinks Obama should have checked, and that is good enough for me. What is important is that, when we mortals misremember things, we often do so according to a script. I seem to remember that there has been a lot of this going around: folks telling stories about denial of coverage and denied care that turn out to be phony.
Michelle Malkin, one of those on the right who jumped on Obama, has a nice catalog of such stories. Some of them, frankly, concede something to the other side. Insurance companies sometimes do have to be compelled by public pressure to do the right thing. Of course the same is true of all government agencies.
What is obvious is that proponents of big government health care reform have not found it easy to come up with juicy stories without, consciously or not, doing a lot of embellishment.
All of this, however, confuses two important but distinct questions: would a better health insurance system ensure financial security for more people, and would a better health insurance system make more people healthier?
One of the things that reform proponents like to say is that better health insurance coverage would save lives. If I remember correctly (see above) my friend Cory Heidelberger has said so. If fact, there is little reason to believe that health insurance improves health. Meagan McArdle has argued to the contrary in The Atlantic. I strongly recommend that you read that whole piece. In a recent Atlantic blog post she points this out:
To illustrate the problem, note that many of the studies that show big mortality impacts from being uninsured show even bigger mortality impacts from being on Medicare and Medicaid, even after controlling for age and income: you are more likely to die if you are on government insurance than if you have no insurance at all. Is it probable that going on Medicare or Medicaid kills you?
McArdle argues not, but I would point out that it surely doesn't indicate that going on Medicare or Medicaid will save you.
In that same post, McArdle examines a recent study of an experiment conducted by the State of Oregon. File under "federalism, laboratories of democracy". Oregon opened up Medicaid to a number of low income adults, selected by lottery. A lot of ObamaCare cheerleaders are cheering about the results, but what did they show?
What the study found is moderate but significant impacts on finances and self-reports of less stress and better health. Giving people free health insurance does in fact make them feel better about their situation. There was some increase in utilization, including such things as health screening. That's supposed to be one of the magic bullets of government guaranteed health insurance. But it the increase was not impressive. From the actual report:
First, we examined hospital utilization for seven conditions of interest and of reasonably high prevalence in our population: heart disease, diabetes, skin infections, mental disorders, alcohol and substance abuse, back problems, and pneumonia. We found a statistically significant increase in utilization (both extensive and total) only for heart disease.
Well, that's something. But what about the bottom line: did it save lives? No.
As for lower mortality--economist-speak for "confirms that Medicaid does, indeed, save lives", the authors didn't find any such thing. I quote: "Panel A shows that we do not detect any statistically significant improvement in survival probability."
The problem with the health care reform movement is that it has never been much interested in health care. It has been about expanding government control over the health care system. That may or may not be a good idea, but if that is your most precious idea, you won't bother paying attention to real indicators of health. You already know what the good thing is. You won't be tempted to step back and examine the system as a whole. You won't be much interested in what really works on a local level. You will see the Oregon study as a great vindication, despite the conspicuous lack of real results. You may even be tempted to fib about your mother.