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Nov 20 2013

Needless panicking over Obamacare

The US media acts like a herd, moving as a group from one narrative to another, painting each situation in the most extreme colors, as if they are trying to stampede policymakers into taking rash actions, because nothing is more exciting to the media than rapid changes in policy and actions

During the government shut down and debt ceiling fiasco, the storyline was how the Republican party was destroying itself and would be routed at the next elections unless they changed course immediately.

Then as soon as that standoff ended, that storyline was promptly forgotten and shifted to a new one based on what had been going in the background and that was the problem with the rollout of the Affordable Care Act health exchanges. The new storyline became that the situation was so bad that president Obama and the Democratic party had been hopelessly damaged and that they could be routed at the next election unless they made dramatic changes to the ACA.

Of course, each narrative is overblown. It is unlikely that people in general follow insider politics with the same closeness, or see politics in terms of overarching narratives, the way that the media pundits do. And unlike the media, most people do not take the situation and views that exist right now and commit themselves to actions that are a year away. So what people feel right now because of any one particular issue may not be a good predictor of how they will vote in 2014.

Already the story about the healthcare rollout is shifting as the websites slowly start functioning better. As Michael Hiltzik writes, the whole ‘Obamacare collapse’ panic was always overblown and seemed designed to stampede panicky Democrats into taking stop gap measures that would only make things worse.

Attacks on the Affordable Care Act have stepped up over the last week or so. You’d think that the healthcare reform known as Obamacare is leading to the wholesale loss of affordable insurance by huge sectors of the American public, many of whom will be impoverished by being forced into low-quality health plans at exorbitant prices.

You’d think the entire reform is on “life support,” as the usually judicious National Journal put it today, speculating that Democrats may soon start calling for its repeal.

Don’t buy the hype. The numbers tell an entirely different story. What they also demonstrate is that the myth of Obamacare’s “failure” is a product of the same Republican noise machine that has been working to undermine this crucial reform since Day One. It’s assisted by news reporting about canceled health policies that typically ranges from woefully misinformed to spectacularly ignorant, and even at its best is incomplete.

Indeed, the spectacle of Democrats panicking over bad news on Obamacare resembles the herds of giraffes one sees on the Serengeti being stampeded by swarms of tsetse flies. Here’s a lesson the giraffes could teach the Dems: Stampeding leads only to injuries and death, and doesn’t solve the tsetse fly problem.

The fact is that Obamacare is here to stay. Its customer protections are worth real money to tens of millions of consumers, and it’s vastly expanding the insurance market. The politicians claiming that they’re only out to “fix” a broken program are playing you for suckers, and not for the first time.

I have been involved in educational reform efforts that have been quite major and so have seen what happens when you try to shift a system with massive inertia. Whenever one introduces a complicated change in a large system (like the ACA), there will be problems initially. That is inevitable. When that happens, there will always be people who will either demand that the changes be scrapped or demand that ad hoc changes be made to solve this or that problem. A wise leader will resist such changes and instead take a long view, trying to see if the problems are systemic, in which case they require systemic changes, or whether they are technical problems in implementation, in which case the best thing to do is to hold fast on the policy and address the technical issues

In the case of ACA, the systemic problem is the private health insurance system in the US and the systemic solution is a single-payer system, most easily implemented by opening up the Medicare system to everyone. That is not going to happen anytime soon.

Failing that, the ACA is here to stay, for a long time. Eventually, many millions of people will be enrolled and they are never going to be de-enrolled. The glitches in the system, however major, are still just technical problems and will be solved.

People need to chill out.

7 comments

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  1. 1
    colnago80

    One of the things that this particularly brouhaha exposes is the flaws in the Federal Procurement System. Apparently, the outfit that won the contract to develop the system has a checkered history. They were able to write a good technical proposal and apply sharp pencils to their cost proposal. It is very difficult, given the arcane federal procurement regulations to prove that indifferent past performance indicates a likelihood of technical failure. This of course, is old news to anyone who has had experience from the government side of large project development. This sort of thing happens all the time in large military projects (vis. the F35).

  2. 2
    ShowMetheData

    ANOTHER C-C-C-CRISIS – as heard on CBS 10 minutes ago – the President has to have it all fixed by December 1st or….. He will be held to account

  3. 3
    CaitieCat, getaway driver

    The other part of the message that’s not getting out is that this is only being much of a problem in the states where the government refused to take up the opportunity to build their own exchange. In blue states, where the exchanges were built, the rollout has gone well. California had enrolled about 100 kPeople by mid-November, with their website cooking along comfortably.

    So even the fact that the rollout has been troublesome has been in no small part due to Republican obstructionism; if the state governments had built their in-state exchange, then the rollout for the federal exchange would have been limited to those small-pop states where building the exchange might have been financially out of reach, and would very likely have been able to handle the load easily.

    How to get that message into the mass media is an open question, but I think for one the White House could be doing a lot more to get that positive message out, and the part where the GOP are responsible for a lot of the problems. They may be saving that bit for an official inquiry or something to announce next year before the elections. Anyone think I’m being too cynical? Nah, didn’t think so. :(

    Meanwhile here at home in Soviet Canuckistan, I have a doctor’s appt and an MRI on Friday, to assess my disability (hip joints and spine). I pay nothing more than my taxes for them. If they indicate the problems I expect, then my hip replacement surgery will cost me no more than my taxes.

    And to head off that objection, we made the appointment for the MRI about three weeks ago, not six months as Sarah Palin and the Obstructionists (Worst. Band. EVAR) would have it.

    You have my sympathy, USans.

  4. 4
    snoeman

    Mano,

    A single-payer option is one solution, and there’s no question that it works, but it doesn’t mean that it has to be the answer for us. Both France and Germany have multi-payer systems, and they work quite well. (IIRC, France has about a dozen or so payers, and Germany has over 1,000 sickness funds.)

    The difference, of course, is that their insurance is strictly not-for-profit. The only job of the company or fund is to pay for health care. In contrast, many if not most insurance companies here in the US are for-profit, which means that their interests are inherently not aligned with the people they are insuring. No matter what solution we end up with, that’s a fundamental problem that has to be addressed – removing profit-making from the payment side of the system.

    So, if we did eventually end up with a system like Canada’s, that would be great, but I would be just as happy if it ended up looking like Germany’s or France’s.

  5. 5
    Mano Singham

    I am aware of the French and German systems and also like them and had written about them in the past. I had thought that they were built on a backbone of a single-payer system.

  6. 6
    G. Priddy

    But, but, but Capitalism! Profit means that the free market will bring competition, which automatically lowers prices. Right?

  7. 7
    trucreep

    Profit does not mean that, but if you take the statement to only include “the free market will bring competition,” and change up the end a little to say “which may lead to lower prices,” then you’ve got it ;]

    Here’s where the brilliant trick comes into play. A large company doesn’t want a free market, and every time you hear a politician yapping on about the “free market,” he or she is not talking about a free market at all. The talk is always about retaining or creating a new advantage for an industry, and they try to dress it up as capitalism.

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