Obromacare or MotherbroXXX

By Amanda Grigg

Last week everyone from The Atlantic to Buzzfeed covered a new Colorado Obamacare campaign targeting “bros.” The campaign can be found at “gotinsurancecolorado.org and is part of the Thanks Obamacare campaign run by ProgressNow Colorado and the Colorado Consumer Health Initiative. You can also reach the site via “doyougotinsurance.com” which is, clearly, a more bro-friendly url.

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got insurance, bro?

Of course the Colorado campaign’s real aim is to get the attention of healthy, uninsured young people, a group that pretty much everyone agrees is essential to the success of the Affordable Care Act. Because they rarely use medical services these “young invincibles” are cheap to insure, and thus their enrollment is necessary to offset the costs of older, less healthy patients. It just so happens that most of the healthy, uninsured young people (57%) are male. This explains both Obromacare and the Koch brothers’ recent attempts to get bros to “opt-out” via events at campus bars offering free beer and ipad drawinngs. Unfortunately for proponents of the ACA, healthy young men without pre-existing conditions are generally thought to benefit the least from Obamacare, which makes them both vital and possibly resistant to health care form. As a result, we get to watch as everyone and their mother (literally) bro-down.

AARP_ACA_eCard7_600.imgcache.rev1379416663982Efforts to promote the health care law among young invincibles have also targeted mothers. Ads on facebook and recipe websites admonish, “Mom knows best, get insurance!” and cheeky AARP e-cards read “Get health insurance so I can stop pestering you to sign up and start pestering you to get married.” As Democratic pollster Celinda Lake explained to the Washington Post,“it will be the moms of America who are going to decide if their families get coverage…They will decide and then insist their children and husbands sign up.” Polling backs Lake up – many young uninsured people, and particularly young men, cite their mothers as their most trusted source of information about the health care law.

So, a big part of the explanation for these ads can be found in policy and the fact that high enrollment among healthy, uninsured young men is necessary to make Obamacare work. The campaigns are highly gendered because they’re targeting very specific, gendered audiences (mothers and young men). And they’re a little cheesy because bureaucrats and the Koch brothers trying to identify with the cool kids is a little like your parents trying to talk to you about Miley Cyrus. Or your great aunt publicly chastising you for posting bridesthrowingcats.com on facebook because “who would do that to a cat?”

More troubling than the seemingly inevitable pandering to bros is the misleading use of healthy young men as an exemplar of the harms of health care reform. Because of their unique relationship to the ACA, healthy 25 year old men have become the darlings of health care reform critics, who have conveniently held them up as (purportedly) randomly chosen example that illustrate how the healthcare law works and why it will raise rates (Jonathan Chait does a good job of addressing the problems with this tactic). Put simply, the 25 year old healthy male example is a poor one on which to base arguments about the ACA generally because it’s one of very few cases in which individuals may see rates go up, and because the group makes up a small portion of the total population. And as Sarah Kliff explains, the structure of the ACA makes it difficult to generalize even about this relatively small, homogenous group. Most notably, the example is misleading because it’s almost inevitable that in his lifetime this bro will benefit from Obamcare both directly and indirectly if he gets sick, becomes poor, lives past 25, cares about anyone who is or becomes sick, and let’s not even get started on how straight men benefit from the birth control mandate.

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8 thoughts on “Obromacare or MotherbroXXX”

  1. My (and your) cohort aren’t an insignificant group, even though we’re a small portion of the population. We’re the main cohort which drive the heart-wrenching Michael Moore statistics about the number of uninsured Americans (flash image of homeless man with untreated schizophrenia). For people who have a low probability of getting sick, conditioned on being young and healthy and adulteriffic, it’s perfectly rational to not purchase insurance. So we don’t. And the idea that we ought to further-subsidize the inflated health-care costs of everyone who is sick, because of the gross misalignment of incentives that a 3rd-party payer system creates, is totally backward. This is the logic of Obamacare: “Our healthcare costs are massively greater than anywhere else in the world — we better find a way to get more people to pay these ridiculous bills.”

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  2. I don’t think I argue that the cohort is insignificant, just that we can’t generalize about the effects of Obamacare based on that small a group of people. And while it might be rational in the short term not to purchase insurance (though that depends on your tolerance for risk and the actual cost of the insurance) it’s in their interest in the long run for Obamacare to work for the reasons I mention at the end of the post. I think there’s also an argument to be made about gender/race/and class disparities in health – that the good health and low risk enjoyed by portions of this cohort of men (the ones for whom it might be rational to be uninsured) is largely a function of all sorts of privilege and that an alternative justification for requiring them to be insured might not be let’s get more people to pay these ridiculous bills but lets get people to contribute to a system which will inevitably benefit them (potentially not until a bit later) in order to help people (now) who are harmed by the very systems that benefit the rationally(?) uninsured. There’s a veil of invisibility reference to be made somewhere there but I have a dissertation to get back to so I’ll leave it at that.

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  3. This is the problem with current rhetoric on health care. It has nothing to do with policy and magnitudes of effects and everything to do with diffuse ideas of social justice that a preponderance of the American left has been willing to support as long as it doesn’t impact their incomes negatively — which is now happening.

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  4. This is the problem with the current rhetoric on rhetoric. It’s too amorphous and just broad enough to be true about anything.

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  5. Rhetoric is probably the most well-defined of all “modes of thinking and arguing” in the humanities outside philosophy. The major public progenitors of healthcare reform have stirred social justice sympathies using aggregate statistics that don’t represent the populations people are most likely to imagine when glancing at the numbers. Support for Obamacare has derived, like nearly all political decisions on all sides of the spectrum, from these ready-at-hand moral frameworks. I’m drawing on some fairly noncontroversial ideas there. Economists and policy folks have been talking about the underlying incentive incompatibilities which lead to our astounding healthcare costs for nearly a decade now — popular conversation about them has been almost nil. Most Americans think our healthcare system is private — something like 70% of healthcare expenditure is already public — almost all of it going to marginalized groups. There may very well be a good argument for universal healthcare, but it surely isn’t that the marginal expansion of funding to an already badly dysfunctional healthcare sector is going to make the world a huggier place to live.

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  6. In terms of rhetoric, it depends entirely on who you’re talking about. There isn’t really a single rhetoric on health care reform. There are lots of actors talking about lots of different things in different ways. As far as I’ve heard there actually hasn’t been a lot of social justice justification for health care reform, but we could be listening to different people. And I don’t think my brief social justice argument (or hugginess if you prefer) are at all representative of the popular arguments for health care reform. The emphasis rhetorically (by the people actually writing and implementing the policy) seems to have been on the reforms being “common sense” helping families, fixing things that were “broken” in the system etc. – not things I would associate strongly with social justice movements. And the examples being held up by the administration are of (implicitly hard-working) substitute teachers getting health insurance, or (innocent and deserving) children with a lifelong disease who no longer have a lifetime cap on coverage, not a homeless man finally qualifying for Medicaid.

    This also shouldn’t be read as a post on my ideal health care system. I was writing about a very specific aspect of the ACA communication strategy, why, in light of how health care reform is supposed to work, that makes sense and, why this strategy making sense doesn’t mean that critics should hold up this particular group to make generalizations about health care reform.

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  7. I can deflect any joke with a shield of indignation and casual reference to economic topics. This will not end until it has degraded into personal attacks and challenges for citations, resulting in a litany of links to the Wall Street Journal and other blogs.

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