We don’t need to malign the good intentions of those who delivered the ACA to us as we’ve needed serious, honest healthcare reform for at least a generation. But it’s our sad fate to cobble together a system that tries to re-engineer human behavior by creating a better “exchange market” for the production and distribution of an essential good. This is akin to trying to improve on Mother Nature, an experiment that has been tried and failed on a much more catastrophic scale than national healthcare. The sadness relates to the fact that none of this is or was necessary, but it does reflect the incredible hubris of the technocratic mindset. It seems we always choose to learn these simple truths the hard way and being able to say “I told you so,” will offer little consolation to anyone.
From the WSJ:
Website problems don’t matter when your intentions are good.
The White House pitched President Obama’s Rose Garden event on Monday as a new transparency, but the event amounted to an infomercial, complete with a 1-800 number. Operators are standing by and “the product is good,” the President said. He even encouraged Americans to bypass the website and apply for benefits over the phone or by mail.
Too bad this infomercial lacked tangible information. Mr. Obama might have explained what went wrong, and why, and where the buck stops, or if there is even a provisional timetable for when the exchanges will function properly. Instead he minimized the severity of the problems, perhaps for political reasons. Or maybe he didn’t say because the defects are so deep that no one can identify the specific solutions.
By the way, we called the hotline on Monday and the automated menu redirected us to Healthcare.gov, which in turn told us to get in touch with someone at the call center.
In an era where Google is making self-driving cars and Amazon offers next-day delivery for just about anything, the White House plunged ahead with a system it knew to be defective and is relying on the technology of the 19th century as the fall-back. Five days before the exchanges launched, the Health and Human Services Department increased the Virginia information technology company Serco’s $114 million contract by $87 million—to help process paper applications. Are contingency plans in place to sign up via telegraph?
The consequences of this mismanagement go beyond the technical. Mr. Obama bragged that millions of people are using the website and many (he didn’t say how many) are signing up for coverage. But this overlooks that no one knows what the risk profiles on the exchanges will look like.
The danger is that those who manage to enroll will mainly be the most expensive patients. Younger and healthier patients who don’t need ObamaCare will have to cross-subsidize the sick and old or else the premiums won’t cover the cost of claims. So the 36 malfunctioning exchanges could take an entire market down with them.
Insurance companies are also already sending out notices to millions of consumers cancelling individual policies because they are non-compliant with ObamaCare’s new mandates. Kaiser Health News, usually a cheerleader for the law, reports that “Florida Blue, for example, is terminating about 300,000 policies, about 80 percent of its individual policies in the state.” Kaiser Permanente in California has sent notices to 160,000 people, Highmark in Pittsburgh is dropping about 20% of its individual market customers, and Independence Blue Cross of Philadelphia is dropping about 45%.
Remember when Mr. Obama said you could keep your policy if you liked it?
The White House could have asked Congress for a delay to get the exchanges right and avoid this debacle. Liberals claim to be in favor of “what works and what doesn’t,” as Mr. Obama likes to say, and the exchanges clearly belong to the latter category.
But the exchanges fiasco is revealing the larger truth that ObamaCare’s claim to technocratic expertise was always a political con. It won over the New Yorker and made ObamaCare designer Peter Orszag a celebrity. But it was all a veneer for ObamaCare’s real goal, which is to centralize political control over health care.
That false front is clear now as we are told to ignore the faulty rollout because it will get fixed, eventually, and in any case the law is really about reducing inequality. At least now Democrats are being honest. The actual results will always matter less to liberals than their good intentions and expanding the reach of government.
In a blog post over the weekend, the Health and Human Services Department sought to assure Americans that “Our team is bringing in some of the best and brightest from both inside and outside government to scrub in with the team and help improve HealthCare.gov.” HHS won’t even disclose who these ringers are. Just wait until the Independent Payment Advisory Board gets up and running and starts to review individual medical treatments without explaining its data or the reasons for its decisions.
Mr. Obama did identify one culprit on Monday—naturally, the Republicans who he claimed somehow sabotaged Healthcare.gov despite having nothing to do with its development. “I just want to remind everybody, we did not wage this long and contentious battle just around a website,” he said. Yes, and that’s what should really scare the public.