Darryl PaulsonSecond of two parts.
Almost everyone, except the most hardened progressive ideologues, believes that the Obamacare rollout is a mess.
After three years and $300 million spent on preparing the website, few people have been able to log on, let alone register for health care.
The exact number who have successfully signed up for a health-care plan is as secret as nuclear launch codes. The administration refuses to release the information either because the numbers are so low it would be embarrassing, or the administration has no clue how many have signed up.
Supporters call the problems “glitches” or “snafus.” I’ll opt for snafu, but only because I know what the acronym means.
The administration now says the website will be fully functional by Nov. 30, or a full two months after its launch date. It better work by then, or it may not survive.
The first question that needs to be answered is can the website be quickly fixed? As Julianne Pepitone of CNN Money suggested, “To fix the Obamacare website, blow it up, start over.”
David Kennedy, CEO of information security company Trusted Sec, estimates that 20 percent of the 500 million lines of code need to be rewritten. That could take six to 12 months.
Will the website be secure from hackers? “If the information gets hacked,” notes Kennedy, “you’re talking about one of the biggest breeches in American history.” Many critics describe the site as a hacker’s paradise.
Will visitors to the site get accurate information about the cost of health-care plans? CBS reports that the cost estimator provides grossly inaccurate information about the cost of plans.
For now, everyone is lumped into two groups: those under age 49 and those over 50. The plan cost for those under 49 is based on a 27-year-old; the cost of those over 50 is based on a 50-year-old. Neither reflects the real cost, which is partly determined by the applicant’s age.
Even assuming the website issues are resolved, there are many others that that need to be addressed. Will the program implode due to its cost? All governments and, especially the federal government, seldom give reliable cost estimates for programs. When Medicare was enacted 50 years ago, it was estimated that Part A (hospital services) would cost $9 billion by 1990. The actual cost was $67 billion or 644 percent over estimates.
Part B (physician services) was estimated to cost $500 million in federal appropriations. Last year the cost was $163.8 billion or 4400 percent higher than estimated.
Original estimates place the cost of Obamacare at $250 billion. What if that estimate is far short of reality!
Will the public continue to support the program if it experiences massive increases? Americans have always supported health care; they have never supported paying for health care.
Will enough young people, who are critical to the success of the health-care exchanges, sign up for Obamacare? While those lacking health care will try and try again to register for insurance, primarily because most will get insurance at no or low cost, younger individuals will not try to register after being rejected 10, 15 or 20 times. They will simply give up.
Will Obamacare install trust that government can handle such a large issue, or will it further corrode confidence in government?
Will we end up with more people with health insurance, but many who can’t find a doctor? When Massachusetts adopted universal health care in 2006, waits for new patients seeking an internist averaged between 50 and 128 days.
Will the government cutting back financial support for Medicare and Medicaid exacerbate the shortage of doctors? Many doctors are refusing to see Medicare and Medicaid patients.
Doctors are fleeing private practice and working for hospitals because of paperwork requirements that will only grow under Obamacare. Other doctors are setting up “concierge” medicine where they accept patients who pay an annual fee of $500 to $3,000 annually in exchange for physician access.
Will individuals prefer to pay the $95 tax instead of signing up for one of the exchanges and, what will happen when they find out that the law specifies a $95 fee or 1 percent of income, whichever is greater? For someone making $75,000 a year, the tax will amount to $750.
Will Obama and the Democrats moderate the ACA provisions to save the rest of the law, or will they continue their “damn the torpedoes, full speed ahead” policy?
As Megan McArdle writes in her article, “Why Obamacare Is Like 3 Mile Island,?” the ACA is interdependent on its many pieces. Will the Administration keep it going with as many parts as possible in the hopes it will not blow up, or will they compromise and reduce the chance of systemic failure?
