Obamacare Doesn’t Save Many Lives. But Why Do We Focus So Much on That?

Fight disinformation: Sign up for the free Mother Jones Daily newsletter and follow the news that matters.


Ross Douthat raised a common conservative talking point in his column this weekend:

It’s worth raising once again the most counterintuitive and frequently scoffed-at point that conservatives have made about Obamacare:

It probably isn’t saving many lives.

One of the most powerful arguments in the litany that turned moderate Republican lawmakers to jelly was that they were voting to “make America sick again,” to effectively kill people who relied on the Affordable Care Act for drugs and surgery and treatment….So far the evidence is conspicuously missing.

The words probably and many are doing a heavy lift here, but let’s set that aside. Douthat is almost certainly right. Here’s why:

People in the US don’t die much before age 65, so health insurance for working-age folks has never been likely to have much effect on death rates.1 Below age 55, it’s even less likely: the death rate is so minuscule that it would take a miracle to invent any kind of health-related practice that had a measurable effect on life expectancy. If the crude death rate is already below 0.5 percent, there’s just no way to reduce it much more.

And yet, people like health care anyway. They like it so much that we’re collectively willing to spend vast amounts of money on it. As you’ve probably heard many dozens of times, health care is one-sixth of the economy. On average, that means we all pay about one-sixth of our income to provide health care for ourselves.

Why? At the risk of repeating the obvious, most medical care isn’t about lifespan. Before age 65, almost none of it is about lifespan. It’s about feeling better. I’m taking a very expensive chemotherapy drug that probably won’t delay my eventual death by much, but it will improve my life considerably in the meantime. Ditto for the antidepressant I take. And for the arthroscopic knee surgery I had a couple of decades ago.

The same is true for putting a leg in a cast; prescribing an asthma inhaler; replacing a hip; treating an infection; inserting an IUD; treating a hernia; removing a cataract; prescribing a statin; or a hundred other medical procedures. Only a small percentage of what doctors do is lifesaving.

It’s a measure of our impoverished sense of empathy that we spend so much time focused on whether health care saves lives. Liberals do it because it’s the only thing guaranteed to get a positive reaction. Even stone conservatives don’t want people dying in the streets. If progressives focused instead on the fact that health coverage saves money and makes you feel better, there’s a good chance that support for wider health coverage would suffer substantially. To an awful lot of people, just making others “feel better” doesn’t seem worth paying taxes for.

So instead we end up in a proxy war about people dying. It’s not the sign of a mature society, but then again, who ever said we were a mature society?

1The big exception is dying at birth or during the first year of life. The United States has an appallingly poor record on that score, especially among the poor and non-white.

AN IMPORTANT UPDATE

We’re falling behind our online fundraising goals and we can’t sustain coming up short on donations month after month. Perhaps you’ve heard? It is impossibly hard in the news business right now, with layoffs intensifying and fancy new startups and funding going kaput.

The crisis facing journalism and democracy isn’t going away anytime soon. And neither is Mother Jones, our readers, or our unique way of doing in-depth reporting that exists to bring about change.

Which is exactly why, despite the challenges we face, we just took a big gulp and joined forces with The Center for Investigative Reporting, a team of ace journalists who create the amazing podcast and public radio show Reveal.

If you can part with even just a few bucks, please help us pick up the pace of donations. We simply can’t afford to keep falling behind on our fundraising targets month after month.

Editor-in-Chief Clara Jeffery said it well to our team recently, and that team 100 percent includes readers like you who make it all possible: “This is a year to prove that we can pull off this merger, grow our audiences and impact, attract more funding and keep growing. More broadly, it’s a year when the very future of both journalism and democracy is on the line. We have to go for every important story, every reader/listener/viewer, and leave it all on the field. I’m very proud of all the hard work that’s gotten us to this moment, and confident that we can meet it.”

Let’s do this. If you can right now, please support Mother Jones and investigative journalism with an urgently needed donation today.

payment methods

AN IMPORTANT UPDATE

We’re falling behind our online fundraising goals and we can’t sustain coming up short on donations month after month. Perhaps you’ve heard? It is impossibly hard in the news business right now, with layoffs intensifying and fancy new startups and funding going kaput.

The crisis facing journalism and democracy isn’t going away anytime soon. And neither is Mother Jones, our readers, or our unique way of doing in-depth reporting that exists to bring about change.

Which is exactly why, despite the challenges we face, we just took a big gulp and joined forces with The Center for Investigative Reporting, a team of ace journalists who create the amazing podcast and public radio show Reveal.

If you can part with even just a few bucks, please help us pick up the pace of donations. We simply can’t afford to keep falling behind on our fundraising targets month after month.

Editor-in-Chief Clara Jeffery said it well to our team recently, and that team 100 percent includes readers like you who make it all possible: “This is a year to prove that we can pull off this merger, grow our audiences and impact, attract more funding and keep growing. More broadly, it’s a year when the very future of both journalism and democracy is on the line. We have to go for every important story, every reader/listener/viewer, and leave it all on the field. I’m very proud of all the hard work that’s gotten us to this moment, and confident that we can meet it.”

Let’s do this. If you can right now, please support Mother Jones and investigative journalism with an urgently needed donation today.

payment methods

We Recommend

Latest

Sign up for our free newsletter

Subscribe to the Mother Jones Daily to have our top stories delivered directly to your inbox.

Get our award-winning magazine

Save big on a full year of investigations, ideas, and insights.

Subscribe

Support our journalism

Help Mother Jones' reporters dig deep with a tax-deductible donation.

Donate