Sunday, May 25, 2014

Tour de force on Obamacare

"They Had a Dream: Rule by experts comes a cropper"

by Noemie Emery in Weekly Standard


Social Security had been large, but made no change in the structure of government, and the Welfare Reform Act of 1996 (signed by Bill Clinton at the Republicans’ urging) was based on successful experiments at the state level conducted by governors of both parties. The Affordable Care Act looked for advice to academics, not governors, and proposed the state takeover of an industrial complex responsible for one-sixth of the gross national product based not on what had been proved to work through experience, but on what some intellectuals had guessed might work. If a camel is a horse designed by a committee, this camel was a 2,801-page non-bestseller filled with labyrinthine riddles that nobody seemed to know how to solve. To insure approximately 18 million out of 300-plus million Americans (they confessed the plan would still leave 20 million uninsured), they proposed to spend trillions on a reengineering of the entire system that would in time cause 80 to 100 million of the currently insured to lose and to seek new insurance.

“This system requires coordination of over 288 policy options .  .  . each with three or more levels of coverage, while simultaneously calculating beneficiary income, tax credibility, subsidy levels, deductibles, not to mention protecting applicant privacy, insuring web security and managing a host of other data points,” the New York Times’s Thomas B. Edsall informed us, adding that all this had to be coordinated with numerous state and federal departments and public and private bureaus and agencies that were not well equipped to assist in these ventures. Apparently, the possibility that the agencies that these experts assumed would coordinate easily with the new health insurance bureaucracy and with each other would not in reality be able to do so did not occur to the experts...


Doubtless, Obama and crew had fully expected their project to be popular, owing to two tenets of liberal theory—that a crisis always makes people more open to large and expansive federal government and that people never turn away from free stuff. But this assessment was drawn from the New Deal experience, when the crisis was much graver, government was much smaller and had more room to grow, and examples of what could occur when government became too big and expensive were not yet in anyone’s mind. Even at that, FDR waited to introduce Social Security until well after the financial panic was quelled, while Obama introduced his big, expensive, and far more complex program while the crash had not yet abated.

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