In the week
since
video surfaced of Obamacare architect Jonathan Gruber saying that
“lack of transparency” and “the stupidity of the American voter”
were critical to passing the health law, two more videos of
Gruber making statements with similar themes or tones have received
attention.
Both clips reveal a gleefully dismissive attitude toward public
concerns about the law, and offer a telling reminder of the
attitude that played a crucial role in shaping and selling the law
to the public.
In the first
video, recorded in March of 2010, just a few days before the
law would pass the House, Gruber argues that the public does not
really care about the uninsured. What it cares about is cost
control. Therefore, he says, the law had to be sold on the basis of
its cost control.
Yet as Gruber admits in the video, the bill was not primarily
focused on cost control—the bill “is 90% health insurance coverage
and 10% about cost control.” Indeed, the problem with cost control,
he says, is that “we don’t know how” to do it.
The primary quote. Via CNN:
“Barack Obama’s not a stupid man, okay?” Gruber said in his
remarks at the College of the Holy Cross on March 11, 2010. “He
knew when he was running for president that quite frankly the
American public doesn’t actually care that much about the
uninsured….What the American public cares about is costs. And
that’s why even though the bill that they made is 90% health
insurance coverage and 10% about cost control, all you ever hear
people talk about is cost control. How it’s going to lower the cost
of health care, that’s all they talk about. Why? Because that’s
what people want to hear about because a majority of American care
about health care costs.”
Elsewhere in the same speech, Gruber says:
“The only way we’re going to stop our country from being a
latter day Roman Empire and falling under its own weight is getting
control of the growth rate of health care costs. The problem is we
don’t know how.”
Remember, this is what Gruber was saying as the law was still
being debated. It didn’t
pass in the House, the critical step before hitting President
Obama’s desk, until more than a week later. And what Gruber was
saying, even before the bill was law, was that supporters had
intentionally emphasized parts of the bill that were relatively
minor, and that were not certain to even produce their intended
effects.
This is not lying, exactly; the bill did in fact include some
attempts at cost control, although as Gruber said, it was unclear
at the time if or how well they would work. But, especially in
combination with the other video released this week, it indicates
that Gruber believed that the law’s advocates were not being
completely straight with the public, that supporters of Obamacare
were telling the public what they believed the public wanted to
hear instead of giving them the full story, and that they were
doing so on the understanding that telling the full story would
make the bill impossible to pass.
What it shows, in other words, is Gruber openly embracing a
strategy of messaging manipulation and misleading emphasis even
while the bill was still being debated. If the public understood
the bill clearly, he believed, they would reject it. It was more
important to pass the bill.
Another video,
posted today by The Daily Signal, shows Gruber taking a
similarly dismissive attitude toward public concerns about the
bill. At a meeting with the Vermont House Health
Care Committee, Gruber is presented with a question about whether
systems like those described in a
report by Gruber and Harvard health economist William Hsiao,
might result in “ballooning costs, increased taxes and bureaucratic
outrages” as well “shabby facilities, disgruntled providers” and
destructive price controls.
Gruber’s response begin with: “Was this written by my adolescent
children by any chance?” It’s intended as a joke, and it reveals
little about the health care law (the reforms in question are
specific to Vermont). But it says plenty about Gruber, and the
flippant, arrogant way he treats concerns and criticism.
This is the person whom the White House relied on to help craft
the bill; he was
paid handsomely to model its effects (a fact he
did not disclose, even when asked), and he was
in the room when important decisions were made about how it
would work. He claims to have helped write specific portions of the
law himself. Gruber was not the sole architect of the law, but he
was one of its biggest single influences on both its design and on
how the media, which quoted him repeatedly, reported and understood
the law.
The
White House and its
allies are
desperately trying to distance themselves from Gruber right now
by downplaying his role in the law’s creation. But the record of
his involvement is clear enough: At The Washington Post,
Ezra Klein has variously described Gruber as “one
of the key architects behind the structure of the Affordable
Care Act” and “the
most aggressive academic economist supporting the reform
effort.” The New York Times in 2012
described his role as helping to design the overall structure
as well as being “dispatched” by the White House to Congress to
write the legislative text. Gruber’s work was
cited repeatedly by the White House, Democratic leadership, and
the media.
So when he describes the thinking about how the law was crafted
and sold to the public, it’s worth taking note. This is the posture
of one of the law’s authors and chief backers. It’s part of the
spirit in which the law was created and passed. Gruber’s ideas were
embedded in the law’s structure and language, and so was his
attitude.
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