Barack Obama’s presidency has had its difficult moments. And everybody’s list of those moments is different, depending on his or her political predisposition. Concerned Chomsky-type leftists still haven’t recovered from the thought of Obama coolly scanning a “kill list” for drone operations in Yemen. Net-freedom Pirate Party wannabes loathe the cynical way the President called NSA whistleblower Edward Snowden “not patriotic.” Silicon Valley businessmen grimace over the way Solyndra Corp. took the administration’s green-energy subsidies for a half-billion-dollar joyride. Got beef with Obama and his team? Get in line; the wait is long.
But the ghastly rollout of “Obamacare,” an ambitious reform of American health insurance, is a crisis of a higher order—the kind of thing that can tilt a president’s reputation toward the Jimmy Carter end of the league table. It seems to be a disaster on so many levels that, arguably, it challenges our faith in the long-established ability of American government to tackle large engineering problems. One frets: Could the U.S.A. still send people to the moon if it had to?
The administration’s HealthCare.gov website, intended to be the main conduit for the American uninsured to access newly standardized policies, was supposed to have signed up half a million people by the end of October. But the site has turned into a seemingly bottomless tech disaster, and the Wall Street Journal reported on Nov. 11 that not even 50,000 had been able to wrestle with it semi-successfully and register for Obamacare. Moreover, the states that chose to set up their own health care exchanges are not doing much better.
The whole idea of Obamacare was to discourage uninsured Americans from staying that way, using the threat of a punitive tax to herd them all into the corral of coverage during a limited “open enrolment period.” Insurers can no longer refuse coverage because of pre-existing medical conditions, so healthy O-care enrolees are needed to shoulder some of the added risk from eager sickies; otherwise, or so voters have been warned for years, the whole system is at risk of a “death spiral.”
Meanwhile, as the clock has started ticking on that scenario, self-employed people who were paying for their own health insurance are suddenly finding that the President’s endlessly repeated personal promise—“If you like your health plan, you will be able to keep your health plan”—wasn’t worth the wind expended on it. An NBC News investigation disclosed that, all along, the federal Health and Human Services department had expected some “40 to 67 per cent” of existing policies to fall short of Obamacare standards.
Those policies in the so-called “individual market,” whether they were truly substandard or just noncompliant in some irrelevant technical way, are now being shredded by the insurance companies. The policyholders are being ordered to go take their chances with HealthCare.gov. And those lucky enough to win their fight with the website are often finding that even the cheapest replacement for their old, withdrawn plan will stun their budget.
The White House has promised to have the HealthCare.gov site working smoothly for most everybody in the 36 states it covers by the end of November. That is about as late as a repair can possibly happen if both the existing uninsured and those chopped off from the individual market are going to have policies lined up for Jan. 1, 2014. In the worst case, the stroke of midnight could witness the most absurd Obamacare outcome possible: a massive, instantaneous increase in the number of uninsured, to new record levels.
From a socialist standpoint, or just a Canadian one, it is natural to notice that the introduction of pure single-payer medicare is never accompanied by this sort of nightmarish trouble. For their part, anarchists and libertarians are sure that America could hardly do much worse if health care and health insurance were totally deregulated. The American health insurance system is a insane mishmash of subsidies and social engineering, all implemented, as if superstition demanded it, by means of rent-seeking private companies. Such a “system” cannot help behaving chaotically when it is tweaked even a little bit. That’s the real difference between creating Obamacare and sending astronauts to the moon: In the latter case, the moving parts only include three humans, and only for eight days.