Facts are easy. You can check facts. What supporters of the Affordable Care Act are doing, on the other hand, transcends factual bungling. It’s far more advanced: a warping of reality so debauched it looks like something out of a tale by H.P. Lovecraft.
The highest form of charity, argued the 12th-century Jewish philosopher Maimonides, is when the help given enables the receiver to become self-sufficient.But our systems of state charity — aka welfare — have too frequently had the opposite effect: They have actually created dependency. It is time to rethink the way we help people.I’m going to […]
Recent difficulties with implementing the Affordable Care Act have increased opposition to the program. A majority of Americans now oppose it. Problems with the HealthCare.gov website are in all likelihood temporary. However, there are serious long-term problems, particularly considering long-term finance and labor supply issues. Given the mounting difficulties with and growing concerns about the […]
Do you trust your doctor? Most patients assume their doctor is working in their best medical interests whenever he or she orders a diagnostic test or recommends a particular treatment. Customers might wonder whether an unscrupulous auto mechanic is being truthful when he recommends a brake job or a new transmission. But most patients trust […]
The faces of the Detroit bankruptcy are the thousands of pensioners whose promised benefits are suddenly part of the restructure negotiation. When Motown filed for Chapter 9 last July, the city had $11.5 billion in unsecured liabilities. The vast majority of this was pension and health care benefits owed to retired city employees.The images of […]
So you’ve maneuvered the Obamacare website, plugged in your top-secret information and found out how much you are forced to pay to avoid a fine.And for some of you, it turns out you qualify for a government subsidy — making the premium sound like a bargain. But signing on that line to accept the government’s […]
The New York Times published an interminable article on health care recently. Plenty of facts — how scrupulous are these journalists! — but the article displayed absolutely no comprehension of the basics of cause and effect. I was left wondering about the whole point.The article details how the health care system rewards specialists to an […]
Dr. William C. Padgett is a retired optometrist who has been trying to bring an elderly care facility to Beaufort County, North Carolina, for over a decade.“Our senior citizens,” he laments, “are finding that it is difficult and in many cases impossible to find an appropriate long-term care facility locally.” Though he has received several […]
Professor John H. Cochrane of the University of Chicago had an op-ed in the Wall Street Journal on Dec. 25, in which he gave a brief description of (among other things) a market in which individuals buy our own health insurance — and not from an Obamacare exchange.According to Professor Cochrane: “…we should transition to […]
A new survey from Harvard University found a large majority of young Americans do not believe the law will save them money, do not believe it will improve their health, and do not intend to sign up for insurance through the new exchanges.
Liberal supporters of the Affordable Care Act specifically, and big government in general, are quick with excuses for all the problems that Obamacare has been experiencing in these early days. We have heard: they did not have enough time, it’s complicated, it’s the insurance companies’ fault, we just need to make a few adjustments, and […]
I opened a new bottle of probiotics this morning, and it had one of those circular seals on the top. You know, the one that reads, “Sealed for your protection.”And that seal got me thinking… how much protection do we need? How much security is enough?How much homogenization, pasteurization, disinfection, national security, etc…. do we […]
As the fallout continues over the cancellation notices sent to millions of people covered by health plans in the individual insurance market, it is becoming clear that millions more workers and their families are expected to lose their employer-based coverage as the Affordable Care Act (ACA) is implemented.According to the Congressional Budget Office (CBO), 156 […]
A president stands disgraced. Congress is scattering. Bureaucrats are baffled. Pundits are reaching. Industry is scared. Politicians are scrambling to do something, anything, to make it better. One political party is in meltdown and the other loving every minute of it, hoping to ride the calamity to electoral gains.The so-called Patient Protection and Affordable Care […]
Any married couple that earns more than 400% of the federal poverty level -- that is $62,040 -- or a family of two earns too much for subsidies under Obamacare. But if that same couple lived together unmarried, they could earn up to $45,960 each -- $91,920 total -- and still be eligible for subsidies through the exchanges in New York state.
The president assures us he is not responsible for the wave of health insurance policy cancellations. The insurance companies are. OK, so where is the other side?
The saying goes that things have to get worse before they get better. But with Obamacare, things just keep getting worse — and then they get worse still. In private, even many critics of the law are at least a bit surprised by how poorly the rollout has gone. The question that many are asking […]
Though the rollout of the Affordable Care Act (ACA) exchanges has dismayed even the law’s supporters, the problem the ACA is designed to address is real enough: Millions of Americans, even those with insurance, lack access to adequate health care. In a voluntary society, civil-sector groups would step up to provide social services, like health […]
It is such a kick to read the transcripts from the White House’s health care “war room” in the first days of release. What a meltdown, and you get to watch it all in real-time.I’m not trying to be cruel to the kindly despots who have wrecked so much of what worked in the existing […]
Obamacare certainly has made history. It has set the record for the fastest-failing Big Government program in world history. This isn’t only about a website flop; it is about the failure of government to accomplish the aims of Obamacare in general, and in a way that has profoundly touched millions of individual lives.“Train wreck” is […]
A handful of reports last week suggested that the Obama administration had moved to delay the health law’s individual mandate — the penalty the law imposes on those who are uninsured. That’s not quite right: Instead, the administration will align the 2014 penalty date, which had been February 15, with the end of Obamacare’s open […]
A common argument made in favor of government-financed health care is that it is inherently cheaper than a private system. Strangely, however, the people who celebrate the government’s ability to hold down health care spending would be horrified at the same argument applied to other public-sector functions. It’s a seriously inconsistent position held by advocates […]
You didn’t want to be the guy chosen to tell Stalin that the wheat crop failed or the production quotas on trucks and cars were not met. Why?Because despots always blame people, not systems.In the same way, you don’t want to be the guy chosen to tell Obama that his health care websites are a […]
Lately, many have characterized this administration as socialist, or having strong socialist leanings. I differ with this characterization. This is not to say Mr. Obama believes in free markets, by any means. On the contrary, he has done and said much that demonstrates his fundamental misunderstanding of and hostility toward the truly free market. But […]
As the health care debate rages on, there is one reality that even the proponents of this hostile takeover of health care by government cannot ignore — and that is money. The government simply does not have the money for a new, expansive, public health care plan.The country is in a deep recession. The last […]
The online Internet exchanges created by the Affordable Care Act are up and running.OK, they’re up. Uhh, OK, some of them are sort of up.It has been almost a week since last Tuesday’s initial launch, and there have been more than a few problems.Website crashes, excessive response times and other problems have plagued the exchanges. […]
A growing consensus of IT experts, outside and inside the government, have figured out a principal reason why the website for Obamacare’s federally sponsored insurance exchange is crashing. Healthcare.gov forces you to create an account and enter detailed personal information before you can start shopping.This, in turn, creates a massive traffic bottleneck, as the government […]
Obamacare certainly has made history. It has set the record for the fastest-failing Big Government program in world history. This isn’t only about a website flop; it is about the failure of government to accomplish the aims of Obamacare in general, and in a way that has profoundly touched millions of individual lives.
“Train wreck” is a good term here. You know it is coming. You can see the maps. You can predict the timing and the damage. But there is still something stunning about seeing the spectacular explosion actually happen in real life. For students of shoddy government attempts to mimic the market, it’s been a beautiful confirmation of everything we know.
Back to the speed of the disaster. It took decades for Social Security, Medicaid, Medicare, and all the rest to enter into the unsustainable, unintended-consequences phase. It was a generation before the costs blew up and the service dwindled. Most welfare programs begin with at least the appearance of a net win.
Not this one. It took only a few days after Obamacare was released for it to enter the archetype phase into which all forms of compulsory government systems eventually collapse. Never have the rotten tomatoes flown so fast and so furiously.
The ridiculous cost overruns were, of course, there from the beginning. The website alone: $600 million. More striking has been the astonishing fact that that program designed to give more people access to health care has already resulted in the exact opposite. More people have been kicked out of their existing service than have successfully signed up for a new one. The intended beneficiaries — the uninsured — have little or no interest in it, while the already insured are more scared about the future than ever.
The American health care system has been a mess for a long time, but this much can be said about it: It has been somewhat stable. The costs have been high and rising, but not completely unaffordable. And because of the genuine market-based elements remaining in the existing system, American health care has at least been innovative with lifesaving technologies. Doctors got paid and medical services were profitable.
Suddenly, the future seems uncertain and even scary for nearly everyone. If one day you can get a letter from a provider that doubles premiums and makes them equal to the full wages of a salaried employee, there is a serious problem. Not even the worst predictions about Obamacare imagined such a thing.
All the more maddening has been the way the president himself seems hopelessly confused about the nature of the technological failure of the main delivery system. He seems to be living in the past, in which a website was nothing but a billboard or a static information provider.
That’s not the way websites are today. Websites are both portals to and extensions of the real world. They must mirror and even drive thinking and behavior of all users. And contrary to what people believe, they are not easy to build. A great website is every bit as complex as an elaborate good in the material world.
To build one requires a blithering array of decisions among trade-offs. Most people see only the user interface, but this is like paint on a car. The engine itself can be enormously complex and subject to infinite bugs. You can write code or go with existing structures. You can choose among thousands of possible languages and management systems or build your own. Database structures are a science unto themselves.
It is a challenge enough in the private sector. To build a website for something like The New York Times or Twitter is a monumental task that never ends. This is one reason that startups are better at building websites than large corporations. Large corporations have to cut through their own bureaucratic apparatus to get it done right, whereas startups are fortunate to have a clean slate from which to build code.
For government, it is far more difficult, if not impossible. Governments are not used to having customers in a traditional sense. They have consumers of their products, but their profitability does not fundamentally depend on them. The government way is to extract revenue by force and spend it according to political priorities. Profit and loss do not matter and, in fact, can’t even be calculated. That’s because government is not a wealth producer. It is a wealth consumer.
There is a reason that governments can’t build websites. A website is like the market itself. It is always in development. For a site to be useful, it must always be adapting to change. There is no final release that is also not a tombstone. Governments are horrible at this task. Governments want to freeze time and enforce compliance with the plan, users be damned. So the failure of HealthCare.gov is not an accident; it is a reflection of the failure of government itself to be a productive, efficient, and useful part of the social order.
This is why a website fix seem so untenable. Note from the congressional hearing that politicians doing the grilling do not understand the first thing about computer code. They can’t understand the language. They can’t understand the functionality. What’s more, it is not clear that Republicans have any real incentive to intervene in the meltdown. This is the first time in perhaps six years that the Republicans have a chance to ride high.
The prospect of how Obamacare can permanently wreck the legacy of this administration is tantalizing, indeed!
What lessons can we learn here? This is about the failure of one type of socialism, but it is a different type from nationalization. Obama and his friends never attempted to end the market. They attempted to set up a market that operates like a real one, but with politically expedient results. In other words, they are attempting to “play market” while subverting crucial market institutions like fees, private property, freedom of choice, authentic competition between providers, and experimental entrepreneurship.
The idea that government could “play market” was the fallback position of post-socialist planners of the 1940s and 1950s. Austrian economist Ludwig von Mises predicted that this would never work. You can assemble the world’s smartest people, give them maximum power, throw massive resources at the problem, and still end up with what Mises called “planned chaos.” That’s the best description of the health care world since Obamacare was unleashed on the world.
Some predictions for the future of Obamacare: It will not be repealed. It will be intolerably tightened. More physicians will leave the system. More of the uninsured will choose fines over premiums. The market will continue to provide ever more options outside the system. Leaving the country for surgery and other services will become more common. Buying prescriptions from emerging markets will become mainstream.
Through fits and starts — and with many victims along the way — a market for health care will emerge, but it will be outside the official channels. Eventually, Obamacare will collapse of its own weight.