Trumpcare Treats the Winner’s Curse

I’m a political centrist receptive to certain conservative arguments, but since big chunks of the Republican Party took the cuckoo train to looney town I’ve had a hard time finding common ground with the GOP. This past week, though, I’ve been surprised to find myself sharing certain attributes with the House Republican caucus on a critically important political issue. To be specific, like most Republicans in that chamber I have neither read the American Healthcare Act of 2017 (ACA) nor do I have an inkling of its real implications.

I’m not surprised I know jack about the ACA. My general impression is that it’s a tangle of bosh and baloney, the sort of legislative sneaky beaky undertaken by partisan bagmen and interest-group special ops. But who knows. It’s a heavy read (full text here) and it’d take days for me to parse out even its broad-stroke ramifications. I can’t be bothered because we professional observers of politics just have too much else on our plates these days. The Trump White House’s typical daily schedule of a morning Twitter calumny, a noon-time peccadillo, the three o’clock scandal, the five o’clock firing, all topped with a busy evening of minions competing for victory in the arch madness bracket, just doesn’t leave us much time for anything else.

So there, I admit I know diddly about ACA except what’s reported in the media, and I’m pretty skeptical about that because I guarantee most of the professional gum-flappers haven’t read the bill either. If you and I lack a full and nuanced understanding of a complicated piece of legislation, though, it’s not supposed to be a big deal. We have tribunes representing our collective interests and they get paid to pay attention to these details on our behalf. So it’s galling in the extreme to discover that scads of them just voted to re-order a sixth of the nation’s economy and adjust the probabilities of millions getting health care coverage without reading any of the fine print or, I’m pretty sure, even the large-print Cliff’s Notes cheater card.

And it really does seem to be the case that many cast votes for this bill while being unburdened by any real understanding of its potential consequences. There was no independent analysis of its costs, no hearings, and it was being heavily amended the night before it was frog marched out onto the House floor for a vote. The ACA was the legislative equivalent of a 300 pound churro and there’s no way anyone choked that down in a few hours. This was never going to end well and it didn’t. Republicans initially took a victory lap, crowing that the ACA was the dog’s bollocks plus a bag of chips. Then reporters started asking all the high-fiving gloaters what was actually in the bill and what did it all mean and the umming, and ahhing began. It became pretty clear, pretty quickly that whatever was in the bill, it was at best a half-baked dogs breakfast and almost certainly political kryptonite for the GOP.

Late-night comedians pounced, and the sheer ineptitude of some of the spluttering gas passers who yayed the proposal nearer to law would be funny if the issue wasn’t so serious (here’s John Oliver making the point). A dawning recognition that they’d just dropped themselves into five fathoms of poo sent the Gang that Couldn’t Toot Straight slinking home for recess and hoping voters didn’t notice the stink. The few Republicans brave enough to face their constituents this week got the rotten tomatoes treatment, egged on by Democrats who were busily organizing schadenfreude squads. Most GOP House members just laid low, only mingling with constituents whose sycophancy qualified as a pre-existing condition. As for the rest of the voters, the GOP crew mostly seemed to be hoping they’d suffer a mass attack of convenience amnesia and forget what a colossal cock-up the House just made of things.

Well, good luck with all that. The real question is why did the House Republicans do this? Forget all the bumpf and babble about how the bill is going to be a huge improvement on what we currently have. Outside the House, even most Republicans don’t buy that. Plenty of GOP Senators, for example, are treating the bill the House just handed them like it was the towel used to clean up after an epic case of the bad-churro squits.

Any way you cut it, the ACA is bad press, bad politics, and almost certainly bad policy. Yes, the jury is still out on exactly what the bill costs and how it will shape health care access and delivery, but the uncertainty is mostly about whether it’s merely awful or catastrophically dire. Voters are ticked at House Republicans, pretty much the entire swath of healthcare-related interest groups are ticked at House Republicans, and even Senate Republicans are ticked at House Republicans. It seems puzzling that the majority of an elected legislative chamber would load both barrels, pull the trigger and perforate their lower extremity with such deliberate gusto.

I think the primary reason for the eagerness to commit this self-inflicted wound boils down to a variant of the winner’s curse. To social scientists, the winner’s curse technically describes the tendency of people to overpay in auctions of common value. Roughly translated into actual English, that basically says that people who aren’t fully aware of the value of something (or its cost), tend to bid up its price. This leads to buyer’s regret, the feeling you get after blowing a hole in your wallet on something that turns out not to be the dog’s bollocks and a bag of chips. That’s the winner’s curse.

And that’s what I think House Republicans have on healthcare. Over the past eight or nine years they have ridiculously bid up what they can fork out for a healthcare plan. They’ve argued Obamacare is a disaster that’s failing and that only they can fix the problem and win the nation a shiny new, super-duper most-definitely-not-Obamacare health plan. Complicating their bid was the spreading realization among voters how much they liked at least bits of Obamacare, especially stuff like preventing insurers from denying coverage, requiring coverage of pre-existing conditions, and keeping children on parental coverage into their mid-20s. And the millions who got healthcare thanks to Medicaid expansion definitely want to keep that.

Well, no worries said the Republicans, you can have all that, plus you won’t have to pay for it. That’s a pretty damn high bid and as long as Obama was in the White House the GOP didn’t have to worry about having it called. Then they won. Everything. And having so fervently promised their frothing base how Obamacare was all death panels and socialist overreach, they had to make good on their bid or look like pikers of the highest order. Problem was, all they had to back their bid was the political equivalent of wooden nickels and monopoly money. They had to lay their currency down, of course, burning through pretty much all their political capital to purchase the bill they so desperately wanted. And finally having closed the sale on an Obamacare repeal they now own it. Indeed, as Nancy Pelosi said, they positively “glow in the dark” with it. They are also belatedly starting to realize their shiny new phosphorescent purchase isn’t worth what they paid. In precise political terms its value is diddly and squat.

Carrying that into the next election really is likely to be a curse, one Republicans cast upon themselves by winning.

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