Patrice has a terrific blog up today on a phenomenon that must have surprised the ObamaCare architects: seems that the people who had health insurance before the advent of ObamaCare are the ones most likely to buy an ObamaCare policy, while the people who were uninsured before remain uninsured and uninterested in becoming insured.
This pattern points to something that the central planners who design big government programs do not take into consideration: the human factor. This is a matter of habits, values, of being responsible or irresponsible. Some people will buy health insurance, and others will make other choices.
Joseph Epstein has a piece on today’s Wall Street Journal on his work as a young man in the federal antipoverty program in Little Rock, Arkansas. The takeaway from Epstein's reminiscences for me is that the antipoverty program planners and the ObamaCare planners live in the same universe. They worked out vast, ameliorative plans but didn’t really know much about the behavior of the people they were supposedly serving.
One of the first things I did was attempt to work out a map illustrating Pulaski County's "pockets of poverty." Little Rock and North Little Rock had blocks and blocks of shotgun houses—a straight shot from the front door to the back—still without indoor plumbing. I remember remarking to a female black schoolteacher, with the heavy irony available to the ignorant, that shabby as these houses were, almost all of them had television sets. "Please don't knock those television sets," she said. "They give these children the only chance they will ever have to hear decent English."
Some of the programs Washington wanted us to administer were fairly exotic. A number of others were merely silly. I remember one called "Foster Grandparents," in which the elderly would be paid to baby-sit the children of officially poor mothers who could then go off to work. Rubbing up against human nature, the program failed to recognize that the elderly do not necessarily long for the company of the very young, or vice versa.
For a while after I left Little Rock for Chicago I kept in touch by phone with Ruth Arnold, who told me that things were fizzling out with the local antipoverty program. Middle-class children were now increasingly going to preschool, which effectively wiped out any true head-start that poor children might have obtained. The poor used legal aid, not to sue the city and the school board, as political-minded antipoverty workers had hoped, but mainly to sue one another: for divorce, debt collection, paternity. As for birth-control counseling, who knew or could know for years to come what its effects would be. …
I’ve not been back to Little Rock for decades, but my guess is that little has changed for the poor since my days as director of the antipoverty program there. The poverty in Pulaski County, make no mistake, was and is real. Only the ways of dealing with it remain in the realm of fantasy.
Like the antipoverty programs that so miserably failed the poor, ObamaCare originated in the realm of fantasy. The uninterested and uninsured, to borrow from Patrice’s language, prove just how different is the behavior of real people from the models of liberal planners.