This week was filled with stories about the number of people losing health insurance due to Obamacare rising into the millions, far outpacing any alleged numbers of people gaining insurance due to Obamacare, especially since the healthcare website continues to be plagued by problems stemming from far deeper and complex issues than mere site overload, including (as I predicted) security holes.
This week was also filled with Smart People pundit-apologists contorting themselves into painfully myopic and paternalistic theatrics to defend Obama’s now-infamous “if you like your health plan, you can keep it,” insisting that everybody always knew it wasn’t exactly true and besides, you didn’t really like your health plan anyway because it wasn’t any good. These flagrant elitist diatribes have been so ridiculous that plenty of other commentators have already saved me the work of exposing their futility.
Meanwhile, the website’s “woes” could be undermining the demographics required to make the law function by discouraging those “young and healthy” people that need to start paying lots of money into the system (one also wonders if they’re finally starting to realize they’ve been had). Now vulnerable Democratic senators are trying to delay deadlines and keep old plans from disappearing. The lawsuit arguing that the law does not give the government authority to do subsidies on state exchanges is still advancing. And the Obama administration keeps delaying its release of the number of people who have actually signed up – although we just learned that a grand total of six people got through the first day.
Comparisons have been made to Bush’s Medicare expansion, which got off to a slow and glitchy start. But I think the fundamentals here are far more flawed, the glitches far worse, and the pace incomparable; Obamacare may technically be “ahead” on signup numbers, but only if you ignore all the people losing insurance, too.
Now, I must admit I sort of enjoy seeing the lies “narrow untruths” and misunderstandings come home to roost for the politicians and pundits who spent so much time trying to convince us that the “Affordable Care Act” was better and smarter than the status quo. Although it appears that polling still “has not moved much on Obamacare for literally years now,” and it would be easy to overestimate the importance of all of the current hullabaloo; if things really do end up improving in spite of the mess, I’ll begrudgingly but openly admit it. So far, though, everything is vindicating everything I’ve long believed about the inevitable results of the sheer magnitude and complexity of the law, and the lies, lobbying, and corruption that were required to pass it.
But is there any value to my Schadenfreude? If things don’t turn around, we are stuck with both a worse status quo and the question of what happens next. Part of me wants to hope that a spectacular Obamacare failure (along with the continuing NSA revleations) will lead to a backlash against Big Government, that people will look at this boondoggle and conclude that they don’t want to trust government to be even more involved in their health. And I do expect a little backlash, at least in the short-term. Democrats didn’t have the votes for true universal healthcare when they settled for Obamacare and they certainly don’t have the votes for it now.
But the USA government’s dysfunction, no matter how ridiculous it gets, may never provide a convincing case to move back in the other direction. First, I’m not even sure what the other direction would look like. It’s easy to say people shouldn’t be forced into pre-packaged solutions that include maternity care for 60 year olds; it’s much harder to say that people with pre-existing conditions are doomed to the whims of the market and/or charity (though I’m also not sure if you can make the math and incentives work any other way). I wish the government was doing more to eliminate the information asymmetries and hidden pricings that makes all these costs high enough to be an issue in the first place, but I’m not naive enough to believe that even theoretically perfect information flow would make a perfect free market in healthcare, either.
But more importantly, the “single payer” whispers are growing again. And whether that was by design all along or not, I think it’s pretty hard to argue that “Medicare for all,” while technically even more “socialist,” wouldn’t be better than the corporate-crony-socialism hybrid monster we’ve had for some time (and recently kicked into overdrive), except for that fact that we can’t afford it. Yet there are a whole bunch of other countries that at least appear to have successfully implemented “universal healthcare” systems, which provides eternal fuel for the belief that it must be possible somehow!
So what I have in expectations for the next three years are arguments for how America can be successful with universal healthcare from the same politicians and pundits who spent the last three years arguing that Obamacare would be successful. What I don’t have in expectations is any clue about how well that is going to sell.