Obamacare is Sick, But Worth Fixing
Who would have guessed that President Obama's signature program would roll out with more glitches than the computer program in Mitt Romney's campaign that crashed on Election Day?
You may recall how the Romney campaign's much-touted ORCA program caught a lot of blame after the Republican presidential nominee's defeat. Among other problems, technology writers reported, the system was not adequately designed or tested before the day when the campaign needed it most.
While the Obama campaign's web-based get-out-the-vote program earned praise, ORCA, as one Romney aide said, "is lying on the beach with a harpoon in it."
That sounds familiar now after the botched roll-out of the Patient Protection and Affordable Care Act (ACA), also known as Obamacare. Now it is Obama who looks as luckless as Romney did on Election Day. Now the president is the numbers guy who suddenly is deprived of his numbers.
Like ORCA, the Obamacare website was not adequately tested before it was put online, according to a Washington Post report Monday. Before the Oct. 1 launch of HealthCare.gov, the online marketplace website crashed during a simulation in which just a few hundred people tried to log on at the same time, the Post said. Yet federal officials plowed ahead, despite the failures.
Now it is the president and his Secretary of Health and Human Services Kathleen Sebelius who are sounding uncomfortably vague about the numbers of site visitors who actually have been able to visit the site but also to sign up.
Republican critics of Obamacare predictably are calling for Sebelius to be fired, which in today's polarized Washington probably means her job is safe. But fortunately she also agreed, if grudgingly, to testify before a House committee about the website's problems. She has a lot of explaining to do.
Obama has vowed to fix the glitches while also pointing out repeatedly that frustrated site visitors can also shop for insurance and enroll by telephone. True, but the program also needs a functioning website, especially to attract the younger and healthier folks. Their participation is needed to fund health care for the less healthy.
Whether the ACA is a disaster or not depends on which information bubble you live in. I try to listen to both, which is about as comforting as a helicopter ride through a hurricane.
On the positive side, the president makes a good point in saying that Obamacare has helped even those of us who already have insurance to be more secure. It has removed lifetime limits on coverage or exclusion because of a childhood illness and has reduced chances that sudden health catastrophe will lead to bankruptcy.
Unfortunately, now that we can see actual price menus, we can see in many cases that insurance premiums, deductibles and co-pays are rising. But, after decades of rising rates and reduced benefits, as well as rising health care costs, it's hard to tell how much of the increase would have happened anyway.
For the most part, Obamacare opens up competition that, if free market principles work as they should, will reduce the rises in cost. As The New Republic's health care specialist Jonathan Cohn notes, overall premiums have been lower than expected for "a product ... that in most places insurers never offered before."
Yet the program's relative success in those states that operate their own websites indicates that it mostly is at the federal level that officials bit off a bigger techno task than they could chew.
As numerous Internet startups have demonstrated, starting out smaller is better. The website was produced by 55 contractors working on a system that passes information back and forth between other systems and agencies, plus the private insurance industry, which brings to mind the old saying about too many chefs spoiling the gumbo.
Republican opponents predictably conclude from the website's meltdown that the law itself is bad. Yet important glimmers of hope can be found in the 14 states that opted to operate their own online marketplaces. They've experienced much less grief than the feds.
As the Jan. 1 deadline approaches for Obamacare coverage to go into effect, the law, like the federal website, needs more work. But it's worth the effort.
E-mail Clarence Page at firstname.lastname@example.org.
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