Gross generalization time: Liberals tend to be liberals because they believe fundamentally that government is competent, good, able to fix big problems without causing bigger problems. Conservatives tend to be conservatives because they believe this isn’t true; that big federal programs often fail, that the law of unintended consequences means that well-meaning government actions can lead to unforeseen problems down the road. Both sides have evidence to support their claims; both are right some of the time. So let’s start there.
Obamacare, otherwise and officially known as the ACA–the Affordable Care Act–is a big federal program. It’s also kind of controversial–you may have heard. The funny thing about it is that conservatives absolutely hate it right now, despite the fact that it’s essentially a conservative program (first proposed by a conservative think tank, the Heritage Foundation; first implemented in a state with a Republican governor, Mitt Romney, in Massachusetts). Liberals find themselves in the position of defending something which we have never been more than lukewarm about. It’s a program that one side hates and the side is pretty ‘meh’ about. (Most liberals would much have preferred a single-payer option. Personally, I would simply have expanded Medicare to cover everyone).
And yet, it passed. It’s the law of the land. All constitutional and everything. Boom. And the first day of implementation was a rousing success. Six whole people were able to negotiate the website and buy insurance on the exchange. That’s six actual human Americans. Six. 6. Hey, better than nothing.
The Healthcare.gov website, let’s face it, is a mess. It simply wasn’t ready for prime-time. A company called CGI Global was given the main contract for building the website despite a track record of proven failure. Turns out, they’re a company that’s good at lobbying–just bad at building complicated websites. This article in the Daily Beast does a nice job of laying out all the specific failures that led to the current fiasco. The wrong people were given a job they weren’t up to, and now other smarter people are having to fix it.
And this is nothing new. Big government programs are often initially plagued with difficulties. Take Medicare, for example. This story details the problems that arose in 1965 when it was rolled out. Medicare was a program where eligibility was tied to age–you were eligible for it at the age of 65. But forty percent of the population in that age category didn’t have birth certificates. 1890-1900, birth certificates weren’t as routine as they are now–some states didn’t issue them. So people were hauling in family Bibles to try to prove they were 65 or older. One dude famously was declared eligible based on a chest tattoo. It was a huge boondoggle. Plus there was tons of misinformation out there–a lot of older folks were suspicious of Medicare, and wouldn’t sign up. Bob Hope and Jimmy Durante did PSAs, to no avail. (Old folks were stubborn then, too!). Initially, Medicare didn’t work well at all.
Neither did Social Security. This story lays it out–it was a mess, back in 1937. Angry rhetoric, furious Congressional hearings, accusations of disloyalty, even. It looked like a catastrophic failure. Now: works great.
As a liberal, I wish Obamacare had been better designed, I wish the website worked, I wish the whole process had been a lot more transparent. Above all, I wish President Obama hadn’t lied about it. His frequent assertion ‘if you like your current (health insurance) policy, you’ll be allowed to keep it’ isn’t true, wasn’t true, and he knew it wasn’t true when he said it. To be fair, he was trying to defend a program that had been attacked repeatedly and mendaciously and ferociously. Remember some of the ridiculous nonsense we kept hearing, like Obamacare provided for ‘death panels’? Orwellian scenarios in which faceless government bureaucracies would decide who lived and who died? President Obama was combating that rhetoric. He was saying, in essence, ‘it’s not what you’ve been hearing. It’s actually a fairly minor change to how health insurance works.’ Which was basically true.
The problem was the word ‘like.’ Lots of people had high deductible, catastrophic care only, low benefits, low premium policies. If they were healthy, they ‘liked’ those policies just fine. They liked not paying much for them. They came to ‘dislike’ those policies only if they got seriously ill. President Obama knew perfectly well that one of the goals of Obamacare was to prevent insurance companies from issuing crappy low benefit policies. And he had to know that healthy young people who had those crappy policies liked ’em just fine, because they were cheap. So now, when lots of people are getting cancellation notices from their insurance companies, they’re furious, and they feel like they were lied to. And they were lied to, by the President. Hey, politicians lie sometimes. It happens.
So the conservative critique of government turns out to be quite accurate. A bad company was given the contract to build a website, a contract they got because they were well connected. They messed it up, and it’s going to have to be fixed, and that’s going to cost more money. And poor Secretary Sibelius has to go before Congress and get beat up by angry Republicans, who are simply reflecting the entirely justifiable anger of their constituents.
(The House Republican response, by the way, is really pretty comical, when you think of it. They’ve spent months and months screaming about how Obamacare is worse than slavery, how it’s going to Destroy America. Plus, now, it’s hard to sign up for! “That restaurant, the food there is terrible! Worst food in the city! Plus the portions: so small!”)
The federal government in 1965 had to know that lots of Americans eligible for Medicare didn’t have birth certificates. They didn’t know that, and the result was a big ugly mess. A comical mess, with people showing up to sign up for it baring their chests to show off their tattoos proving their ages. And today, Medicare is the most effective delivery system for medical care in the United States. It works brilliantly, with much lower administrative costs than any private insurance company can hope to match. It delivers outstanding health care to elderly Americans. I just got off the phone a couple of hours ago with my parents, age 80 and 78. They talked about their doctors, how good they are and what excellent care they’re receiving. Medicare’s a brilliant success.
Conservatives would point out at this point that Medicare has a demographic problem; that it’s going broke. What I’m saying, though, is that, yes, that’s a problem. And it’s going to be fixed. And it’s going to be fixed because the American people won’t allow it not to be. They’re going to get all over their elected representatives until it gets fixed. That’s how representative government works.
Same with Obamacare. Yeah, the roll-out was ugly. But it’s going to work. We know that, because there’s no substantial difference between Obamacare and Romneycare, and Massachusetts residents like it a lot.
So every part of the conservative critique of the federal government turns out to be right, and especially in regard to Obamacare. It’s a big, ugly, mess. And a President lied about it. And cronyism was rampant. And the implementation of the program has been terrible.
But the liberal response will also turn out to be justified. It’s going to work just fine. Medicare rolled out badly, and look at it now. Social Security was one butt-ugly baby, which grew up to become a perfectly lovely adult. The Obamacare fiasco, it turns out, is just a glitchy website. It happens. It’s not going to be allowed to keep happening.