Making a false argument for an impossible process based on untrue data.

From Useful Idiots Kristof Edition by Scott Johnson. Kristof is making an argument on the superiority of the single payer model based on his understanding of results from Cuba and ropes in the trope of people being financially ruined by healthcare costs.

Johnson, rudely but accurately, pillories him for trading in false information.

The trope of financial ruin being driven by healthcare costs is a product of Elizabeth Warren's research, long since destroyed as methodologically unsound. She found what she was looking for by only looking for what she was seeking.

That there is frequently financial ruin attendant to bad health is not a surprise but that was not the argument. The argument was that medical costs are the cause of financial ruin. It doesn't take much of a second's thought to appreciate that in complex systems, outcomes are almost always the product of multiple causal variables, not single variables.

What causes good health, for example? DNA is a leading candidate. Dietary choices is a second. Then there are choices around exercise, living conditions, personal hygiene, risk taking, etc. There are lots of factors that go into good health. To claim that only one is the primary cause of an outcome is at best misleading. Same with the claim that medical costs are the cause of personal bankruptcies. As soon as you enter into the real discussion - which factors are most causal under what circumstances - you have a better and more interesting pursuit of truth. But truth and ideological ambitions are rare bedfellows.

Same with this idea that Cuba has a lower infant mortality rate than America. I looked into this probably twenty years ago and found much of what Johnson is reporting. That outcomes are heavily influenced by incentive structures, by measurement systems, and by definitions. I don't recall which OECD country it was at that time, but they omitted any child who died within twenty-four hours of birth, defining it as tantamount to a stillborn. Their infant mortality rates looked perfectly fine because they were using a different definition.

Kristof has been around long enough to know this, and especially to know that in closed dictatorships such as the Soviet Union or China or Cuba, the statistics say what the government wants them to say, not what is necessarily an accurate reflection of reality.

We shouldn't forget that right up to the time of the fall of the Berlin Wall, the CIA was way overestimating the economic might of the Soviet Union and its allies. I recall they thought East Germany was the 8th largest economy in the world. There was a lot of criticism when the wall fell. Critics alleging that the CIA got their basic facts wrong and the CIA claiming that they might have had the facts wrong but their narrative forecasts were right. From a sample report at that time just for a flavor of the debate.

The agency estimates that in 1989 Soviet G.N.P. was roughly 51 percent of the United States G.N.P. of $4.2 trillion. Mr. Boskin and many others place the Soviet Union much lower, at about 35 percent, and one prominent Soviet economist at the American Enterprise Institute seminar, Viktor Belkin, claimed it was less than 28 percent.

To support their lower estimate, the critics cite shockingly poor living conditions in the Soviet Union, new figures on waste and spoilage in industry and farming and new proof of deliberately inflated figures from some Soviet industries, like cotton farming.

We didn't have the concept of truthiness at the time, but it would have come in hand in the CIA's defense of itself.

It is a mystery why the Mandarin Class of nominally educated pundits choose to consistently shill for ruthless repressive statist regimes while bad-mouthing open economies with democratic systems of governance. They make their arguments with scarcely the grace to acknowledge that they are at best deceiving.

The subtitle of his opinion piece is:

Many Americans would welcome some traits of the island’s free, universal health care system.

That's no argument at all. All systems are an amalgamation of trade-offs. It is impossible to pick and choose the best of each system and hope to staple them together into some sort systemicus novus, conjured by magic. You want single payer, government provided healthcare? OK, that either provides superior or inferior results. Now what do you trade-off for single-payer government provided healthcare? You get higher taxes, lower economic growth, greater poverty, greater inequality/poverty, less choice, more decisions made by individuals who are unaccountably distant from your circumstances, etc.

If you think that is a good trade-off, fair enough, but I would advise asking the Venezuelans first. But if you prefer those other things to a greater extent, then you might pursue a different health model. The aggregate of trade-off decisions are neither right or wrong. They are the average of all the individual choices. Or, at least, that is the case in most open systems of government. Not so in statist systems.

The fact that globally migration trends tend to be from such Kristof-preferred systems to the immoral and corrupt systems of free governance and economic competition which he apparently so despises seems to indicate that the world does not agree with the worldview of the Mandarin Class pundits. Even in the US, internal migration also tends to be from high tax more single-payer like states to their inverse.

Kristof continues with his fantasy:

Fernández lives in a cramped apartment on a potholed street and can’t afford a car. She also gets by without a meaningful vote or the right to speak freely about politics. Yet the paradox of Cuba is this: Her baby appears more likely to survive than if she were born in the United States.

Cuba is poor and repressive with a dysfunctional economy, but in health care it does an impressive job that the United States could learn from. According to official statistics (about which, as we’ll see, there is some debate), the infant mortality rate in Cuba is only 4.0 deaths per 1,000 live births. In the United States, it’s 5.9.

How is this possible? Well, remember that it may not be. The figures should be taken with a dose of skepticism. Still, there’s no doubt that a major strength of the Cuban system is that it assures universal access. Cuba has the Medicare for All that many Americans dream about

WHAT? He is pursuing this fantasy that you can arbitrarily pick-and-choose the best of each system AND he also acknowledges that the facts he deploys might not even be true.

What a putz. Obviously there is a market for such cognitive pollution and it likely is the self-regarding Mandarin Class. But pretending to make an argument based on facts which are known not to be true in pursuit of a unicorn dream that you can have it all is simply insulting.