Jonathan Chait has an interesting idea about Obamacare. It is also really dangerous. He suggests that if the websites for the healthcare exchanges are not working properly by December, the federal government should delay the individual mandate for the first year. His argument is that the government shouldn’t penalize people for not getting something that is very hard to get. Fair enough. But my problem with the whole law has always been that the government shouldn’t force people to go to the private health insurance market and pay excessive prices for it. (We pay about twice what people pay for insurance in other advanced economies.) The whole of Obamacare is crony capitalism of the most blatant kind. That too makes getting healthcare harder. But I have seen damned few of my fellow liberals calling for that.
But it is very likely that the administration will have to do exactly that if the websites don’t get fixed soon. The issue is not really the state websites. Covered California seems to be working fine. The problem is with the Republican controlled states where the federal government has to do all the work. So not getting these problems worked out is a major problem. It will only embolden the Republicans to continue their efforts to kill the program with a thousand cuts. What’s more, it will tell the state-level Republicans that they were right to deny federally paid-for healthcare for their current uninsured poor.
Chait’s idea gets even worse in that he isn’t calling for a complete delay in the individual mandate. He only wants to delay it in those states where there is a problem. Again: these are the states where Republican legislatures and governors have not set up exchanges simply out of spite. Chait is offering to give the worst behaved politicians in the country exactly what they want: a delay in the new healthcare law. So what extremist Republicans couldn’t accomplish on the federal level, Chait thinks it is fine to allow them to accomplish on the state level.
The situation is very bad. And the federal government has to fix the problem and fast. It reminds me very much of all the building projects in Iraq after the war. In this case, I really wonder about the contractors that the government hired. My friend Will and I do different kinds of projects: setting up network labs and that short of thing. But it is very easy for us to be passed over for a job because some slick company comes in that spends 90% of its money on marketing. I suspect that the same thing is going on with the Obamacare exchange websites. The truth is that if the government had its own office to do this kind of thing, they’d probably do a great job for far less money. But the trend for the last four decades has been to outsource and that’s a constant problem.
I don’t consider myself any kind of a technical genius, but I have a very clear picture of the technical challenges facing the people working on the system. And they really aren’t that great. Basically, it is just a highly distributed database application. The main problem is making all the different parts work together. It ain’t rocket science. Unfortunately, as I’ve noticed in high tech there is a real prejudice against older techs and against anyone with colorful backgrounds. I’ve had many experiences working in groups where well over half the people were worthless. I’m sure in the bloated consulting firms that the government loves to hire, this is exactly the kind of thing that is going on. But I’m also sure that there are some great people working on the problems.
I think it is way too soon to start talking about granting waivers. What we should be doing is focusing on solving the problem by any means necessary. I really can’t imagine the system being so screwed up that people can’t use it in December—and probably November. And if it does come down to granting waivers, giving them only to the states that have worked the hardest to kill Obamacare is not the way to go. The waivers should go to everyone. Most people without insurance really want to get it. They won’t be doing it to avoid a $95 penalty on 15 April 2015.