Debunking Ben Shapiro's Healthcare Arguments in Politicon Debate vs. Cenk Uygur

 

Photos: Gage Skidmore/Wikimedia Commons; Gage Skidmore/Wikimedia Commons

 

Ben Shapiro recently debated Cenk Uygur of The Young Turks at Politicon, and in the process, he made a series of sloppy arguments and false claims that I'm going to break down and refute in this post. Let's jump right into it.

 

"The truth about health care is this: There are three qualities of health care that you can have: You can have affordability, you can have universality, or you can have quality. You can have two of those three things, but not all three."

 

This is nonsense. On the surface, this might seem like a neat little set of guidelines to help us determine what the best approach to health care is, but this is just an assertion—an assertion that you'll discover is untrue if you look at the evidence. 

Ben Shapiro frames this debate in a way that we can describe as a false trichotomy. The implication is that moving the United States in the direction of a taxpayer-funded, universal health care system would either cause prices to skyrocket or quality to plummet. Supporters of such a system are supposed to hear this and think, well shit, I support universal health care, but do I want it to be affordable and low quality, or unrealistically expensive and high quality?

The reality of the situation is that you can have all three things: universality, affordability, and quality. In fact, the health care systems of several other nations offer health care of a higher quality that is universal and significantly cheaper than the health care provided in the United States.

A 2014 Commonwealth Fund study ranked the United States health care system as dead last, overall, in a comparison of 11 nations. The quality of care was ranked 5th, access was ranked 9th, and efficiency, equity, and healthy lives were all ranked 11th.  

Per capita health care spending is dramatically the highest in the United States, at $8,508. Compare that to the second-highest nation, Norway, at $5,669, and the lowest nation, New Zealand, at $3,182.

OECD data from 2013, which compares all 35 OECD nations, also shows that the United States spends the highest amount on health care—by a long shot—as a percentage of GDP: 16.4% compared to the OECD average of 8.9%, with the second highest percentage being only 11.1%. 

All of these countries in the Commonwealth Fund study—except the United States—have universal health care systems, all of them are cheaper on a per capita basis, and four of them surpass the United States in the overall quality of care: the United Kingdom, Australia, Switzerland, and New Zealand, with the Netherlands being tied with the United States for fifth place.

One thing that I like about this particular Commonwealth Fund study is that it doesn't just cherrypick isolated bits of evidence that could be used to support a particular position. For example, somebody could point out that the timeliness of care received in Norway is less than ideal, and therefore, they might conclude that we should dismiss the health care system of Norway altogether because it has this singular defect. 

Now it's clear from this data that no nation's health care systems are perfect. Every one of them has its defects—and each nation should strive to improve. But it's clear from the data that the United States health care system is the most defective, overall.

With all of this in mind, let's return to Ben Shapiro's claim:

 

"The truth about health care is this: There are three qualities of health care that you can have: You can have affordability, you can have universality, or you can have quality. You can have two of those three things, but not all three."

 

This is plainly untrue, as several nations do, in fact, possess all three qualities. And when you compare the United States to countries which offer universal health care, you find that all of them surpass the United States in affordability, and several of them also surpass it in quality.


 

"What they actually need to do is relieve the regulatory burden that is driving up the cost of health care"

 

As we can see, Ben Shapiro's opening arguments quickly turned into a parade of unjustified, stale, right-wing talking points. Oh, so it's the "regulatory burden" that's driving up the cost of health care? What an absurd misunderstanding and oversimplification this is. 

We need to be precise when we talk about these things, because different regulations will have different effects. For example, imagine a regulation that had the net effect of requiring doctors to spends 2 hours filling out paperwork before they can perform a harmless, routine test. A needless regulation like this probably would have the effect of decreasing the quality and efficiency of our health care system while increasing the costs. But on the other hand, imagine a regulation that said something like:  "The cost of prescription drugs will be arrived at through negotiations between the government and the pharmaceutical industry—rather than simply allowing this industry to price them as high as they want to." A regulation like this would decrease the cost of prescription drugs and would thus lower health care costs. 

So the point is: Simply accusing regulation of driving up the cost of health care is thoughtless and lazy, because regulations are not intrinsically cost-increasing. What effect regulations will have depends entirely upon the content and goals of these regulations. Thus, they need to be evaluated on a case-by-case basis—and not denounced wholesale in such an irrational manner. And this is a principle that applies not just to health care, but to regulations, generally.

And even if certain regulations do drive up the cost of something, this is not the end of the analysis. More important to ask is: What is the ultimate effect of this regulation? Safety regulations on cars might make them more expensive, but how many thousands of lives do they save each year? Regulations on meat factories might make your cheeseburgers a bit more costly, but they also make your cheeseburgers much less likely to infect you with some horrific, deadly illness.

So, you might ask, if not over-regulation, then what is the explanation for why health care in America is so expensive and continues to become even more costly? Well, there isn't just a one-word answer to this question. A lot of different factors play a role. For starters, as Maggie Mahar writes in the Institute for New Economic Thinking,

 

"What makes American healthcare unique — and uniquely expensive — is that the U.S. is the only country in the developed world that has chosen to turn medicine into a for-profit enterprise."

 

Our for-profit system directs a lot of health care industry money towards things other than actual health care—including marketing, advertising, lobbying, etc. The Huffington Post compared the efficiency of privatized, profit-driven health care against taxpayer-funded health care in an article entitled "Insurance Companies Just Accidentally Made The Case For Medicare For All." As they write:

 

"America’s Health Insurance Plans, the trade group for commercial health insurance companies, published an infographic this month breaking down how the industry spends every dollar it receives in premiums . . . 

The graphic shows that about 80 percent of every premium dollar goes toward medical expenses ― prescription drugs, doctor visits, hospitalization and other services. Approximately 18 percent goes to administrative costs, and some 3 percent is profit."

"By contrast, Medicare, the largest U.S. public insurer, paid just 1.5 percent of its budget to administer traditional insurance plans for seniors and workers with severe disabilities in 2015, according to official data. The rest of Medicare’s budget went to paying doctors, hospitals, drug companies and other health care providers.

When you account for administrative costs of Medicare’s private plans, which cover some one-third of Medicare beneficiaries, Medicare’s overhead approaches 6.4 percent of its budget.

The comparison shows that expanding Medicare to cover the entire population ― or adopting a single-payer health insurance system ― would significantly reduce health care costs by eliminating a whole lot of expenses that aren’t related to medical care. That’s in part because Medicare does not have to advertise its services, make a profit for investors, or reward its executives with multi-million-dollar compensation packages, as private insurers do."

 

And as we can see here, in data provided by the Center for Responsive Politics, the pharmaceutical and health product industry, in recent years, has spent well over $200 million annually lobbying our government, while the insurance industry has been spending about $130 million annually doing the same thing.

Spending this kind of money ensures that many politicians won't support legislation that would chip away at the profits of these industries and radically alter our system in a way that would ultimately reduce health care costs. Thus, legislation that would allow the government to negotiate with the pharmaceutical industry to determine the price of drugs, for example, gets blocked, because this very industry spends money to corrupt politicians who then block any efforts to move in this direction. So instead of the government regulating the industry, in America, the industry regulates the government.

This is in stark contrast to how things work in the rest of the developed world. To again quote Maggie Mahar

 

"In Western Europe, a hybrid healthcare system includes both private insurance and government plans. The government regulates it [healthcare], deciding how much doctors, drug-makers, hospitals and insurers can charge, but it doesn’t run the system.

By contrast, Canada & the UK have 'single payer systems' controlled by the government. Everyone must have insurance and everyone must pay taxes to fund it."

 

But in America, our government specifically set up roadblocks to prevent any such interference in the pricing of drugs. As the Kaiser Family Foundation writes,

 

"Notably, Congress added language to the [Medicare Modernization Act of 2003], known as the 'noninterference' clause, which stipulates that the HHS Secretary 'may not interfere with the negotiations between drug manufacturers and pharmacies and PDP sponsors, and may not require a particular formulary or institute a price structure for the reimbursement of covered part D drugs.'

In effect, this provision means that the government can have no role in negotiating or setting drug prices in Medicare Part D. This is in stark contrast to how drug prices are determined in some other federal programs; for example, the statutory requirement for mandatory drug price rebates in Medicaid, and a requirement that drug manufacturers charge the Department of Veterans Affairs (VA) no more than the lowest price paid by any private-sector purchaser."

 

So when it's completely up to the pharmaceutical industry to decide what to charge for certain drugs, they can just jack the prices up and profit enormously. This is a big part of why we often see the United States charging far more than other nations do for its prescription drugs. Bloomberg compared the prices of top-selling drugs in the United States to other countries and found that we were paying vastly more than other nations do. As they write,

 

"Prices for brand-name drugs are typically higher in the U.S. than other developed countries. The drug industry has argued it's misleading to focus on U.S. list prices that exclude discounts struck behind closed doors with insurers.

A Bloomberg News analysis finds that even after these discounts, prices are higher in the U.S. than abroad. Seven of eight top-selling drugs examined still cost more in the U.S. than most other countries."

 

So for Crestor, a cholesterol-lowering pill, we pay well over twice as much as other nations do. For Lantus, long-acting insulin, we pay the most. Same goes for Advair, an asthma medication, and Januvia, a diabetes medication. For Sovaldia, a Hepatitis C medication, we pay about the same as the rest of the world after the discounts are applied—although in certain countries, the price is far lower than this. For Humira, a rheumatoid arthritis drug, Herceptin, a breast cancer treatment, and Gleevec, a leukemia medication, we pay the most, by a long shot.

Take a minute to disconnect yourself from the purely economic question and just think about how perverse this is. These aren't needless items like flatscreen TVs or fancy sports cars that people are overpaying for in the United States. These are necessary, life-improving, and sometimes life-saving, medications that these profit-driven companies jack the prices up on just to make more money. We hear a lot of talk about American exceptionalism, and here is a clear example of how Americans get exceptionally screwed over by the corporate sector.

And, finally, much of why our health care spending is so high compared to the rest of the world can be encapsulated in one word: waste. As a 2007, Dartmouth Medicine publication writes,

 

"With its decades of data, Dartmouth has exposed the incredible waste in the U.S. health-care system. Sizing up the evidence, Wennberg estimates that up to one-third of the over $2 trillion that we now spend annually on health care is squandered on unnecessary hospitalizations; unneeded and often redundant tests; unproven treatments; over-priced, cutting-edge drugs; devices no better than the less-expensive products they replaced; and end-of-life care that brings neither comfort nor cure. As Dartmouth’s 2006 paper, 'The Care of Patients with Severe Chronic Illnesses,' points out, if this waste were eliminated, 'the Medicare system could reduce spending by at least 30% while improving the medical care of the most severely ill Americans.'"

 

As we can see, many factors contribute to the high cost of health care in the United States, and it is laughably inadequate to simply decry "overregulation," as Ben Shapiro did. In fact, a lack of regulation in certain areas, such as drug pricing and campaign contributions to politicians, partly explains why our health care is so expensive in this country. 


 

"What we can't do is suggest, as the Bernie Sanders left does, that health care is an inalienable right, and therefore, you can put a gun to my wife's head—she's a doctor—and you can force her to provide care at any cost you want to pay."

 

Really? We're putting a gun to your wife's head? Isn't this the same guy who's constantly stressing the importance of facts over feelings? Yet here he is, making this inane and emotional argument. What a dramatic, hyperbolic, crybaby!

Ben Shapiro has his priorities completely backwards here. Instead of being upset at the fact that the health care industry can charge whatever obscenely high prices it wants to—in matters of health, personal well-being, and even life and death—Ben Shapiro is outraged that people have the audacity to call for the government to play a role in bringing these prices down from the stratospheric heights that they're at when compared with the rest of the world. Tear-filled as your eyes might be as you contemplate this right-wing fetish of men with guns oppressing the humble yeoman as he toils under the government lash, you do not have the moral high ground here, Ben. Allowing the health care industry to charge whatever absurdly high prices it wants to—when people need these medications and treatments to improve or even save their lives—simply is not the ethically superior position. 

And it's laughable that he frames this issue as one of the modest, meek, individual doctor languishing under the tyranny of government, while he completely leaves out of this picture the healthcare executives in their penthouses and private jets laughing all the way to the bank while reaping stupendous profits at the expense of the vast majority in this country. What a distorted image of reality that this guy is presenting.

And it's not just the "Bernie Sanders left" in America that says the government should have a role in determining the pricing of health care; As I quoted earlier

"In Western Europe, a hybrid healthcare system includes both private insurance and government plans. The government regulates [health care], deciding how much doctors, drug-makers, hospitals and insurers can charge, but it doesn’t run the system."

So this isn't just some kind of dystopian fantasy of sinister progressives in America; this is a very real system operational in many countries around the world, and contrary to the dark, Orwellian picture painted by Ben Shapiro, there is no mass movement of doctors in these countries taking to the streets to protest the government oppression in health care. 

If you look at the polling data gathered on primary care physicians in these countries, you'll find that the vast majority of them are satsified with both their practice and the pay they receive. 

As Managed Care magazine wrote in 2016,

". . . a survey published in Health Affairs . . . looked at [primary care physicians] in 10 countries [Germany, the Netherlands, Norway, Australia, New Zealand, Switzerland, the United Kingdom, the United States, Canada, and Sweden]. . . The study . . . states that while 'the vast majority of primary care doctors across countries are satisfied with their practice and income, the themes of frustration with administrative burden and insurance hassle resonate across many of the countries. This is particularly true among those with multipayer private insurance systems (Germany, the Netherlands, Switzerland, and the United States).'"

So it turns out that the more frustrated doctors are actually the ones in countries where the private sector has a large role in health care, like the United States. Thus, overall, Ben Shapiro is completely talking out of his ass here. 


 

"The problem with Medicare for all is that when people say that it's affordable, this is affordable to the person who has the Medicare; it is not affordable to the country. In fact, it is so unaffordable to the country that the state of California—which is a nutjob, leftist state—just refused to even pass Medicare for all because it would have immediately doubled the debt."

 

This is another steaming pile of nonsense. How is is that Medicare for all is unaffordable if the many other countries that have tax-financed health care systems similar to Medicare have managed to make it work and make it affordable?

Having such a health care system is, in fact, much more affordable than our current health care system. Once again, just compare the amount that we spend on health care in the United States to any other country, and you see that Ben Shapiro's affordability argument evaporates before your eyes. It's easy to say: "Oh my goodness, tax-funded health care would cost a lot of money. Look at the big number that it would cost us!" But in order to provide any kind of rational, useful, informative analysis, you need to actually compare the amount that is spent, per capita, in our country under our current system, versus other countries that have tax-based health care systems.

People would ultimately be spending less money, in America, on health care, if we had a tax-funded health care system. Instead of paying out of pocket, to profit-driven insurance and pharmaceutical companies, we would instead pay via our taxes into a much more efficient system. So while taxes might increase, the net amount that we spend, per capita, on health care, would decrease. You can see this if you compare America to other countries, and you can see this is you compare Medicare to private insurance companies.

So when people talk about how taxpayer-funded health care would increase the amount of revenue that the government needs to generate, while this is true, the other side of this equation, commonly overlooked, is that people would have the excess money to fund this government program because they would no longer be spending money on health care individually, as they currently do. 

Saying that we can't afford a taxpayer-funded health care system is a nonsensical statement, because it is tantamount to saying: We can't afford to spend less money than we're currently spending. Ben Shapiro is ultimately arguing that making health care more affordable would make health care unaffordable. This is a complete absurdity.

And regarding the specific example of California, a series of explanations were provided by the California legislature for why they didn't pass that bill. As New Republic writes

 

"In a statement, [Speaker of California's Assembly Anthony] Rendon said the bill was 'woefully incomplete' because it did not address serious issues such as 'financing, delivery of care, cost controls, or the realities of needed action by the Trump administration and voters to make SB 562 a genuine piece of legislation.'"

 

But the following information, provided by the International Business Times, is worth sharing: 

 

". . . the groups opposing the single-payer measure [in California] have delivered more than $1.5 million to Democratic assembly members since the 2012 election cycle. In all, the 55 Democratic members of the 80-seat Assembly have received more than $2.7 million from donors in the pharmaceutical and health insurance industries in just the last three election cycles.

Complicating matters for this year’s single-payer bill was the fact that the pharmaceutical industry had just spent more than $100 million to defeat a 2016 ballot measure in California aimed at lowering drug prices."

 

I think it's fair to say that this infusion of corporate cash had something to do with the fate of that legislation.


 

"The idea that all of these socialized medicine countries have it so much better than we do, particularly in terms of cancer care, is a joke. We are still number one in terms of 5-year cancer survival rate here in the United States."

 

This is a textbook example of cherry-picking one particular data point that supports your perspective—as opposed to looking at the totality of the evidence. It is virtually a statistical certainty that every country in the world—at least every developed country—has at least one area where they're superior to all other countries in terms of health care. Just as a matter of probability, this is to be expected. So seizing upon one data point like this is far from an indication of the overall quality of our health care system compared to the rest of the world. 

That Commonwealth Fund Study cited earlier ranks the quality of health care in the United States as 5th out of the 11. But the way they went about ranking this wasn't by cherry-picking bits and pieces of evidence, in a self-serving, ideologically-driven manner like Ben Shapiro is doing here; they looked at the quality overall—not just in one particular niche of health care.


 

"One of the things that's happened with Obamacare is that you've gotten closer to universality, but you haven't any gotten closer to either affordability or quality. And the Republican party seems to be falling into the trap of basically just copying what the Democrats do, except being worse at it."

 

It is true that Obamacare has gotten us closer to universality, as more people have health care as a result of it, but Obamacare is not the only plausible way to get us to universality. Even if we granted, for the sake of argument, that Obamacare was a disaster, this wouldn't mean that universal health care, generally, is a disaster. Even if Obamacare didn't increase affordability or quality, other systems that provide universal health care could. And, in fact, as the data shows, this is exactly the case.

Now I don't view Obamacare as the most brilliant piece of legislation ever crafted, but just as a matter of fact, I would argue that it does contain some provisions that have increased both the quality and affordability of our health care. Regarding quality, we read the following on Wikipedia

 

"[Obamacare includes] incentives to reduce hospital infections . . . 

The Hospital Readmissions Reduction Program (HRPP) was established as an addition to the Social Security Act, in an effort to reduce hospital readmissions. This program penalizes hospitals with higher than expected readmission rates by decreasing their Medicare reimbursement rate."

 

So what have been the results of this program? Wasfy et al. write the following in a 2017 study entitled "Readmission Rates After Passage of the Hospital Readmissions Reduction Program: A Pre–Post Analysis,"

 

"After controlling for prelaw trends, an additional 67.6 (95% CI, 66.6 to 68.4), 74.8 (CI, 74.0 to 75.4), 85.4 (CI, 84.0 to 86.8), and 95.1 (CI, 92.6 to 97.5) readmissions per 10,000 discharges were found to have been averted per year in the highest-, average-, low-, and lowest-performance groups, respectively, after passage of the law." 

 

In other words, as intended, there has been a tangible, detectable reduction in hospital readmission rates since the passage of Obamacare. It might not be the most earth-shattering improvement in health care quality that you can conceive of, but it's something.

How about affordability? Well, note that the previous provision goes hand-in-hand with affordability, because if people are being readmitted to the hospital less, they're going to be spending less on health care. Aside from that, Obamacare contains several provisions that make health care more affordable for low-income Americans, specifically. First and foremost are the subsidies that it provides. As Wikipedia writes,

 

"Households with incomes between 100% and 400% of the federal poverty level [are] eligible to receive federal subsidies for policies purchased via an exchange. Subsidies are provided as an advanceable, refundable tax credits. Additionally, small businesses are eligible for a tax credit provided that they enroll in the SHOP Marketplace."

 

ZaneBenefits.com features the following chart in an article entitled "A Guide To Obamacare."

As we can see, under Obamacare, health care premiums are capped at a certain percentage of a person's income based upon how their income compares to the Federal Poverty Level. For example, if you make 200% of the Federal Poverty Level, your health insurance premiums are capped at 6.34% of your income, which works out to be about $123 per month. 

This Obamacare provision provides real savings to people. The Kaiser Family Foundation provides the following chart on their website.

As we can see, the monthly premium cost of a silver health care plan for a 40-year-old non-smoker making $30,000 per year would be, in 2017, $492 in Birmingham, Alabama if there were no such tax credits. But with the tax credit, this person instead ends up paying only $207. Look at Anchorage, Alaska. $904 dollars per month? I think I'd rather just die of cancer. Thanks to the Obamacare subsidies, however, the monthly premium is only $163, so people in Anchorage have the luxury of contemplating suicide for reasons other than health care premiums.

Another provision of Obamacare is the Medicaid expansion. As Wikipedia writes, 

 

"[Obamacare] revised and expanded Medicaid eligibility starting in 2014. Under the law as written, states that wished to participate in the Medicaid program are required to allow people with income up to 133% of the poverty line to qualify for coverage, including adults without disabilities or dependent children . . ."

"[Despite the fact that] the Supreme Court ruled in NFIB v. Sebelius that this provision of the ACA was coercive, and that the federal government must allow states to continue at pre-ACA levels of funding and eligibility if they chose . . . as of December 2016 there were 32 states (including Washington DC) that had adopted the Medicaid extension."

 

And, lastly, under Obamacare,

 

"Medicare Part D participants received a 50% discount on brand name drugs purchased after exhausting their initial coverage and before reaching the catastrophic-coverage threshold. The United States Department of Health and Human Services began mailing rebate checks in 2010. By the year 2020, the donut hole will be completely phased out."

 

And in case you're unaware or in need of a refresher, as Wikipedia writes,

 

"The Medicare Part D coverage gap (informally known as the Medicare donut hole) is a period of consumer payment for prescription medication costs which lies between the initial coverage limit and the catastrophic-coverage threshold, when the consumer is a member of a Medicare Part D prescription-drug program administered by the United States federal government. The gap is reached after shared insurer payment - consumer payment for all covered prescription drugs reaches a government-set amount, and is left only after the consumer has paid full, unshared costs of an additional amount for the same prescriptions."

 

Now somebody at this point might argue, "But aha! If these cost-reducing measures are funded by the federal government, then these aren't real spending reductions, because instead of us paying directly for these things, we're just paying indirectly via our tax dollars! So ultimately, we're spending the same amount, and we've just created the illusion of savings by shifting the money around!"

Clever point! I would respond by pointing out that we have a progressive taxation system, and thus, people on the lower ends of the economic spectrum wouldn't be funding these subsidies to the same degree that people on the higher end of the economic spectrum would. 

As Time writes in an article entitled "How is Obamacare paid for?"

 

"High-income taxpayers also help pay for Obamacare. The health law requires workers to pay a tax equal to 0.9% of their wages over $200,000 if single or $250,000 if married filing jointly to finance Medicare’s hospital insurance. It also imposes a 3.8% surtax on various forms of investment income for taxpayers whose modified adjusted gross income is over $200,000 if single or $250,000 if married filing jointly. Those provisions will account for $346 billion in revenues by 2025, according to the CBO."

 

I can only speak for myself, but I don't exactly lie awake at night weeping at the prospect that people living comfortable, luxurious lives, making six figure incomes or above, will end up paying a bit more in taxes to provide the lower and middle class with some badly needed financial relief on health care. And if this does bother you, maybe you should get your priorities in order.

What about the impact of Obamacare on health care costs, generally? First, let's look at health care premiums, which are "the amount you pay for your health insurance every month. In addition to your premium, you usually have to pay other costs for your health care, including a deductible, copayments, and coinsurance."

As the Kaiser Family Foundation writes,

"Since 2011, average family premiums have increased 20 percent, more slowly than the previous five years (31% increase from 2006 and 2011) and more slowly than the five years before that (63% from 2001 to 2006)."

And here we see this data represented graphically:

So while health care premium costs are still increasing, the growth rate of this increase has been declining. Also, I'm not sure whether this data factors in the subsidies that some people receive to help them pay for health care.

At the same time, however, deductibles have been increasing more sharply.

And deductibles, for you health care rookies, are "The amount you pay for covered health care services before your insurance plan starts to pay. With a $2,000 deductible, for example, you pay the first $2,000 of covered services yourself."

So it appears that this reduction in the growth rate of health care premiums has been partially offset by the increase in deductibles that has been taking place at the same time. And the analysis is complicated even further than this. As Wikipedia writes

 

"While health insurance premium costs have moderated, some of this is because of insurance policies that have a higher deductible, co-payments and out-of-pocket maximums that shift costs from insurers to patients. In addition, many employees are choosing to combine a health savings account with higher deductible plans, making the impact of the ACA difficult to determine precisely."

 

We also need to be careful not to commit the post hoc, ergo propter hoc fallacy, which translates from Latin to "After this, therefore, because of this." Just because something preceded an event doesn't necessarily mean that it's the cause of the event. If a person started uttering prayers when they got sick, and they also took medication, the fact that they prayed, and then got better, doesn't mean that the prayer is what caused their return to normal health. Similarly, just because the passage of Obamacare coincided with, for example, a reduction in the growth rates of health care premiums doesn't necessarily mean that it's the cause of this reduction; other factors might be at least partially responsible for these trends.

With all of that said, I would argue that, at the very least, the subsidies, Medicaid expansion, and donut hole closure implemented as a result of Obamacare does make health care more affordable for the Americans who receive these benefits. 

And we should also distinguish between the quality of health care that we receive, and the quality of the health care system. Making health care more affordable and more accessible does improve the quality of the health care system even if the quality of health care remains the same.

So to return to Ben Shapiro's claim, I would disagree on both points, that Obamacare has not increased the quality or affordability of our health care. And, once again, even if he was correct about this, Obamacare is not synonymous with universal health care; other systems could—and do—reduce the cost and improve the quality of health care while also providing universality.

The last thing he says here, in the context of discussing Obamacare, is that "the Republican party seems to be falling into the trap of basically just copying what the Democrats do, except being worse at it."

This strikes me as completely backwards, because Obamacare—championed, of course, by Democrats—shares many key elements with health care legislation that was originally proposed by Republicans in 1993! As Politifact writes:

 

"Republican Sen. John Chafee of Rhode Island was the point man. The bill he introduced, Health Equity and Access Reform Today . . . had a list of 20 co-sponsors that was a who’s who of Republican leadership. There was Minority Leader Bob Dole, R- Kan., Sens. Orrin Hatch, R-Utah, Charles Grassley, R-Iowa, Richard Lugar, R-Ind., and many others. There also were two Democratic co-sponsors.

Among other features, the Chafee bill included:
An individual mandate;
Creation of purchasing pools;
Standardized benefits;
Vouchers for the poor to buy insurance;
A ban on denying coverage based on a pre-existing condition."

 

The bill never passed, but nonetheless, Ben Shapiro seems to have it backwards here: this is actually an area in which Democrats are the ones falling into the trap of basically copying what the Republicans do, except they're better at it, because they actually got the legislation passed. And this is just part of a much broader trend of the mainstream, political left in America shifting towards the right over time on a variety of issues. 


After reading this post, I hope it's clear to you that many of Ben Shapiro's arguments on health care simply don't stand up to scrutiny. If you actually investigate the claims that he makes, you'll find that many of them are just completely false. These arguments that he presented and that I've refuted are a sampling of some of the standard, unjustified right-wing talking points that you hear on health care, so hopefully, moving forward, you'll be more equipped to debunk these arguments when you encounter them.