Obamacare is in trouble, a victim of its own complexity.
Enacted in 2010 as a 2,700 page bill, the law called for the creation of more than 150 new federal boards, commissions, panels and programs. It has spawned more than 20,000 additional pages of regulation so far—and that’s after only three years of an eight-year implementation schedule. Welcome to the future!
There’s a reason for this mind-numbing complexity: Obamacare is the boldest attempt at government central planning in American history. The law gives federal officials power over all major decisions in American health care: what kind of health plans, benefits and levels of coverage Americans must buy; what is permissible for insurers in terms of administrative costs, profit levels, or premiums; what’s acceptable as preventive care; what benefits business owners, religious organizations and charities must offer; how states must run their new, untested health insurance exchanges… the list goes on and on, including new mandates and hundreds of billions of dollars in new taxes and fees—not to mention fines and penalties for noncompliance.
In the era of Obamacare, what you want in health care is irrelevant; you will get what government officials tell you that you must have. This is classic central planning. And history teaches us that central planning on this large a scale is doomed to fail.
Official Washington already is struggling with the economics of this monster. Last year, Health and Human Services (HHS) Secretary Katherine Sebelius announced her department could not implement the long-term care component of Obamacare. Financially, she said, it was simply not workable. And just this month Sebelius announced that she was postponing a program designed to allow small businesses to offer more than one plan for their workers. Meanwhile, more than half the states have declined to set up a ‘health insurance exchange” under the burdensome terms and conditions of the law, leaving it to Washington to do it for them.
Enrollment starts on October 1, 2013. But can Washington figure out how to do it without a monumental managerial mess?
Henry Chao, an HHS official involved with implementing the health insurance exchanges, says he is hoping that in setting up and enrolling millions of Americans in the exchanges that we all don’t have a “Third World Experience.” That may turn out to be an even bigger insult to the Third World than Chao intended.
Bet on more excuses. “We need more time” is the ultimate bureaucratic plea (edging out even “not enough money,” “not enough staff” and “the software doesn’t work right”). But time is not the real issue here. Indeed the problems that HHS is trying to tackle will become even more complex with the passage of time, making future planning and implementation even more difficult. The problem is that central planning in any complex sector of the economy is unworkable—a lesson that Washington progressives either cannot or will not learn.
And, yes, look for Obamacare apologists to launch the blame game. It’s always somebody else’s fault. None of this would be happening if the governors would just be more compliant, if the doctors would enroll in obedience school, or if the people would just stop squawking and accept what the bureaucrats are jamming down their throats.
But the progressives miscalculated the politics as well as the economics of Obamacare. In the run up to passage, poll after poll showed the proposal losing in the court of popular opinion. But the president and his allies in Congress did not care. They knew what was good for us, and they were determined to give it to us—whether we liked it or not. And so, they passed a purely partisan bill, chock full of broken promises, with the full support of big corporate lobbyists whose clients gained greater access to taxpayers’ money.
Three years on, the polls show Obamacare remains a loser. And lawmakers who created this monstrosity are getting as nervous as Dr. Frankenstein. Distancing themselves from the implementation, they are using words like “train wreck” (Sen. Max Baucus, D-Mont.) and “ beyond comprehension” (Sen. Jay Rockefeller, D-WV).
Perhaps blaming the bureaucrats may yet prove a successful strategy. But in passing Obamacare, it was the lawmakers themselves who guaranteed higher costs, massive disruption of Americans’ existing insurance coverage, and a level of federal intervention into health care decisions that is unprecedented. And they own it – all of it.
Robert E. Moffit Ph.D is a senior fellow at the Heritage Foundation and a co-author of 'Why Obamacare is Wrong for America.'
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