By Charles C. W.
Cooke
Thursday, October 10, 2013
It was the question to which, in their heart of hearts,
even the president’s most loyal acolytes must have known the answer: “Obamacare
launches soon. Will it be ready?”
As we have learned this week, it wasn’t ready — and it
was never going to be. “If ever there was a website launch that was ‘too big to
fail,’” Ars Technica’s Sean Gallagher noted, “this was it. So, of course, it
did.”
Nevertheless, the temptation that the administration must
have felt to put on a brave face is politically understandable. Since it was
first mooted back in 2007, Obamacare has been under incessant pressure from a
Republican party whose members have contended almost to a man that the law is
inherently unworkable and destined to be a catastrophe. Add to this the
persistent problems and delays that the scheme has suffered and one can see why
a respectable launch was deemed vital to the narrative. Better to count to
three and pray than to announce yet another embarrassing — almost certainly
illegal — postponement, was presumably the White House’s gamble.
For over a year, the administration managed to strike a
confident figure in public, even as others were warning of grave trouble ahead.
In July, a CNBC survey revealed that only 11 percent of American doctors
expected the exchanges to open on time. This lack of faith was reflected by the
nation’s health-insurance executives, 70 percent of whom answered “no” when
asked whether they believed the claim that “the states and/or the Federal
government will be ready on October 1, 2013, to launch the new HIXs.” With both
these expectations and the ongoing unpopularity of the law at their heels,
Republicans kept their drums beating. Repeatedly, they asked for a delay of the
mandate. Repeatedly, they were rebuffed.
Instead, the Obama administration insisted that all was
well. Among the most bullish of the law’s apologists was Gary Cohen, head of
the federal government’s Center for Consumer Information and Insurance
Oversight and the man tasked with the exchanges’ implementation. “Ten months
from today, people will be signing up for health insurance,” Cohen promised in
December of 2012, and thereafter he steadfastly refused to let reality intrude
upon his fantasy. In January, Cohen assured the progressive advocacy group
Families USA, “Yes, we will be ready.” In March, he upped the ante,
establishing that he was “absolutely confident that every state will have an
exchange that will be functioning and ready” by October 1. It was Cohen’s
assurances that led President Obama to tell journalists in April that he had a
“great team in place,” and that it was “pushing very hard to make sure that
we’re hitting all the deadlines and the benchmarks.”
In the same month, the Health and Human Services
secretary, Kathleen Sebelius, confirmed to Congress that the government was
“determined and on track to meet the October 1 deadline.” The passage of time
only inflated Sebelius’s belief in her timetable, prompting her to promise a
subsequent congressional panel that that she was “very confident that we will
be successful . . . having marketplaces in every state around the country
starting October 1.” The mood was apparently universal: In August, the Charlotte
Observer quoted Marilyn Tavenner, an administrator at the federal Centers for
Medicare and Medicaid Services, reiterating that “online enrollment tools will
be ready October 1.” She did not say that some would be working; she did not
say that experiences would be wildly various; she did not say that systems
would be operating on life support.
As the deadline approached, the administration continued
to make promises it must have known were not true, even as experts warned of
impending chaos. “We’ll be open for business October 1,” an official
nonchalantly told reporters at the Eisenhower Executive Office Building in
September, prompting the Huffington Post to observe, more in hope than
certainty perhaps, that “the Obama administration has never wavered from its
insistence that the health insurance exchanges would be operational on Oct. 1.”
So taken up in the rhetoric was Mother Jones’s Erika Eichelberg that she went
to so far as to question the entire premise of critics’ skepticism, telling her
readers in July that the task of getting the exchanges ready was “no big
thing.” “The insurance exchange roll-out,” Eichelberg wrote, pushing back
against Fox News’s suggestion that the system wasn’t ready,
has been portrayed as a gargantuan task, requiring the Department of Health and Human Services to coordinate 50 separate exchanges, and craft an entirely new online marketplace. But the administration insists the infrastructure for signing all these people up already exists.
This is precisely the sort of magical thinking that
pushed other progressives mindlessly to repeat the president’s peculiar claim
that, because only 15 percent of people would be eligible to use the exchanges,
the undertaking was not a serious one. In a piece titled “Why Obamacare
Implementation Isn’t Actually A Disaster,” ThinkProgress happily quoted the
president’s pronouncement that “all the implementation issues that are coming
up are implementation issues related to that small group of people: 10 to 15
percent of Americans.”
That “small group,” as the president went on to admit, is
“still 30 million Americans” — equivalent to the population of Malaysia. Thirty
million, it seems, is a number that can be big or small depending on the needs
of the speaker. When the president is trying desperately to justify his
health-care overhaul, 30 million people — all of whom do not have health
insurance but apparently want it — is such a vast and unconscionable number
that the entire nation and its constitutional norms need to be upended to
address it. But when he’s trying to push back against fears that his
health-care overhaul won’t work, 30 million is just a “small group of people”
and reform should therefore be a doddle.
The conceit that there couldn’t possibly be any
substantive problems with the enterprise has led in recent days to the
emergence of a new meme: Obamacare’s exchanges are not seriously flawed, they
are just “glitchy.” One wonders in what world those who disseminate this view
live. Asked by CBS to comment on the mess that is the Healthcare.gov website,
Luke Chung, a database programmer and professed Obama supporter, admitted that
“it wasn’t designed well, it wasn’t implemented well, and it looks like nobody
tested it.” Chung confirmed that this had nothing to do with demand or to first-day
bugs. “It’s not even close,” he suggested. “It’s not even ready for beta
testing for my book. I would be ashamed and embarrassed if my organization
delivered something like that.” A similarly brutal piece, from Reuters,
features a web-design expert explaining that the site is a structural mess,
designed so badly that the data flow between the user and the server looks “as
if the system was attacking itself.”
Back in June, when it was easy to write glib and
zeitgeisty pieces about the project without fear that it would be imminently
tested, The Atlantic’s Alex Howard wrote a glib and zeitgeisty piece about the
hip team that was working on the exchanges. In it, he quoted Bryan Sivak,
Health and Human Services’ chief technology officer. “The work that they’re
doing is amazing,” Sivak says, “like how they organize their sprints and code.
It’s incredible what can happen when you give a team of talented developers and
managers and let them go.”
There are few sentences that better sum up the
progressive worldview than that one, echoing as it does the Wilsonian
conviction that if one can just find the “few who are wise” and trust them to
“open for the public a bureau of skilled, economical administration,”
government will finally work efficiently and fairly. As the results have shown
once again, this is a worldview that is not to be trusted. Indeed, thus far at
least, Max Baucus’s famous warning that the law was destined to be a
“trainwreck” is looking remarkably prescient. Under pressure from critics,
Baucus tried to wipe his words from the record. Would that America could do the
same with the turbulent, worthless, ugly little law that he wrote in the first
place.
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