Lot’s of hubbub lately about Obamacare. The website stuff is embarrassing but predictable and typical anytime ‘American government’ and ‘IT’ get together, but eventually it will get resolved at the ‘just barely functional’ level.
The website failure is only a symptom of a dysfunctional governance structure in which nothing can get done right and on time if it crosses jurisdictional boundaries and requires agencies to coordinate without a Czar in charge of the entire project and actually empowered to order people around. Hint: The Secretary of the Department of Health and Human Services can’t do this. That’s the problem.
UPDATE: Quote from the WP, How political fear was pitted against technical needs:
On one side, members of the economic team and Obama health-care adviser Zeke Emanuel lobbied for the president to appoint an outside health reform “czar” with expertise in business, insurance and technology.
Nearly a century after Nicholas II, the ‘czar’ is already our knee-jerk, go-to concept for what we have to do to actually makes things work in our government. /End UPDATE
So when things do get built that ‘work’, people are so traumatized by the experience that they refuse to revisit the issue for an entire generation. At least.
People complain that Obama’s principal staff has embarrassingly little private sector experience. I worry that they have even less understanding of how things actually work in the public sector because they’ve never been at the ground floor level of anything. Have they actually ever typed anything into a major government computer system? The better ones have just recently caught up to 1998.
For example, soldiers, who could be ordered to submit their information to any new digital system no matter how awful and insecure, are still required to personally carry paper medical and dental records around from base to base when they change stations, because the military, with all its authority over them, and exemptions from civilian requirements, still can’t make an automated medical system that actually works. And even though there is an entire industry dedicated to providing it. The Brits could tell a similarly sad and expensive tale.
For example, the CHCS system is – I kid you not – still running in a DOS program. You can try and learn it yourself, just login as a ‘new user’ with any made-up email address:
Look; I’ve seen things man! Monsters normal people born after 1980 just can’t understand because, outside government, they went extinct and disappeared a generation ago! In the 21st century, I’ve seen grown men switching out big reels of magnetic tape and storing information on cassette tapes.
I’ve seen giant, laser-disc-like hard drive plates that fit in a stack in something that looks like a washing machine but holds slightly more data than an old floppy disk. I’ve seen billion dollar weapon-launching platforms just recently upgraded to Windows NT. There are space-control systems running on PDP-8’s or some original-generation but immortal Unix box surrounded by lead-acid-batteries, forgotten in a locked closet with a painted-over door and a random custodian who wonders where that fan noise is coming from and why a few random cables seem to be going directly into the wall. That abandoned, lonely box permanently buried alive behind the drywall, remains prepared to play its microscopic role is unleashing annihilation and is what keeps you safe at night.
Machines that never die and can’t be killed! Systems that can’t be hacked only because no one knows how their proprietary protocols work anymore; they outlasted all the paper manuals which were never digitized or translated into Mandarin and which disintegrated long ago. I’m not too proud to admit I pissed my pants in fear and awe when they showed me the shoe boxes full of punch cards and the machine that read them, or that 300 baud MODEM that fits onto a handset! Things so dripping with toxic heavy metals you can’t even scrap them or move them out of an office; so there they will sit until the end of time.
Whoa, take a breath; these flashbacks to the distant past of the Obama administration are crazy intense. You can imagine how this all looks to a new recruit, born with a cell phone in his hand, and who has no memories prior to the end of the original internet bubble.
Despite all this, they’ll fix the damn website somehow. What won’t get resolved, however, are the millions of people experiencing ‘rate-shock’ and ‘plan-churn’ (i.e. cancellation).
Conservatives warned that the very structure of the plan would inevitably produce this result, not as a side-effect, but on purpose and by design because it was essential to the redistributionist scheme. After all, Obamacare is universal and mandatory and accomplishes most of its subsidy distribution obscurely by implementing price controls on premiums through the insurance companies. Nothing else but what we see today was even possible, and anyone who claimed otherwise was lying.
In order to counter that accurate narrative, the President accused the Republicans of mendacious fear-mongering and lied when he promised, “If you like your health care plan, you can keep your health care plan.” The suckers bought it. They wanted to believe it was true. Duh, it wasn’t. Sorry Abe, turns out you can lie to all the people all the time.
The answer – as with any legal-ish issue in our modern, overcomplicated, over-lawyered, and inaccessible society – is that practically the only people who can actually know anything about anything are those who are paid to know it. Professionals well-studied in the field, specialists, experts, etc.
One of the downsides of our hyper-specialized, niches-in-niches, subcultures-of-subcultures, lower-and-lower-dungeons of
usenet reddit, all-effort-on-the-frontiers-of-diminishing-returns economy is that it’s difficult for an ordinary man to even grasp the basic outline of the overall terrain.
Forget the renaissance man; he’s walled-in by default. You have to be a kind of amateur connoisseur of anything these days to even know the names of the real connoisseurs. All you can do is ride the waves of others and rely on the weird subculture enthusiasms of the SWPL’s to bring some obscure 1% improvement at a 1000% increased cost to your local Whole Foods.
For instance, perhaps you think you know salt. Not the chemical term, just the stuff you add to food. What could be simpler than salt?! Well, you don’t. How can you!? There’s a whole world out there. Mark Bitterman wrote an entire salty tome and even blogs the salt news. How do you like this line?:
Each quality described above have about 10 nuances each that are important, but which would take pages more, and perhaps a few Martinis, to do full justice.
Important nuances of gradations of subtleties wrapped in trace distinctions? About salt? Important!? I guess I’ll have to take your word for it, Mark. I’m just going to tolerate injustice in this instance. But seriously folks, this is exactly how your government works. Or ‘works’. Like that website.
But apply this to the health care market. Ordinary people, as usual, can’t have known anything about what their government was doing. But the category of people ‘who knew’ certainly includes the large army of executives, finance specialists, analysts, and actuaries in the ‘private’ health care industry who definitely were crunching the numbers in the earliest stages of debate and undoubtedly knew the score as well as anyone could years prior to implementation. That’s outside the legion of similarly specialist government workers, but it makes sense that the civil servants would be easy to silence. Explaining silence in the private sector is another matter.
In other words, there were, at least, tens of thousands of people to whom none of this was (indeed, could not have been) any surprise whatsoever and who were under no governmental obligation to shut up about it. So, why in our society, with its so-called ‘freedom of speech’, did none of them speak up?
It’d be nice if any of them had spoken at the time of debate when Obama lied, of course, but getting publicly involved in active political debates discomforts many people. We can cut them a little slack. But you’d think the coast would have become a little clearer after the bill was signed and became law.
But no. Maybe they’re a little concerned on getting on the wrong side of the administration and how that might impact their certification to do business with the entity paying all the bills? Like so?
And what of all the journalists who are supposed to educate the people in a democracy about the working of their government? Ha ha … ah. A big joke.
As Ross Douthat notices, many of the folks getting hit with these unpleasant non-surprise surprises are exactly the same people who were doing exactly the kinds of things that all smart policy people have insisted that they would want them to do in a genuine marketplace; economizing, prioritizing, avoiding unnecessary expenditure, shopping around, choosing amongst competitive options for solutions best tailored to their individual preferences and circumstances, etc.
But actually the policy people were just paying lip service to those quaint capitalist notions. Everybody knows people are too dumb to know what’s best for them and not get scammed. I mean, look at the Tea Party!
Understanding Obamacare is important because it tells us a lot about the nature of the people who wrote it. So, we ask, what is Obamacare? For that answer one must understand what the Progressives who wrote it really wanted it to do. Where does it come from in an ideological sense? What do Progressives really want? We know they don’t want Socialism; only stupid, paranoid, and delusional Tea Party crazies believe that nonsense; as Sunstein explained to us. So what do they want?
A bridging strategy. They want a way to transition from the absurd and awful American Health Care system SNAFU, where most health care benefits are paid for by employers (because of the legacy of WWII labor price-controls) or an insane crazy-quilt of government agencies to a single National-American-Socialized-Institution Health Service for everyone.
In the (near?) future, everyone will pay for the NASI-HS in their (progressive!) taxes, and everyone will receive equal service, whatever their income or ailments.
From each according to ability (to pay), to each according to needs (for medical treatment).
Jeder nach seinen Fähigkeiten, jedem nach seinen Bedürfnissen! – Karl Marx, 1875
Or Morelly, 1755.
Or maybe even the Apostles, 50(?)
Well, I’m bound to get a lot of comments on that last one. But what about our favorite group in American History, the Puritans?
Well you may have heard from such crazy, evil, idiot propagandists as Glenn Beck and Rush Limbaugh that they originally lived according to a collectivist Socialist scheme so egalitarian even some youths were equal in status with adults, but which was failing and was abandoned in favor of restoring private property and ensuring everyone belonged to patriarchal households.
The New York Times and Professor Budiansky are here to help and tell you it was, in fact, not a Socialist communal agricultural operation, like a Soviet or Chinese collective farm, or Israeli Kibbutz, or Shaker Communalism. [You may notice that all this stuff gets tried repeatedly in History and except for cults with high turnover, or the Amish, is always effectively privatized in due time]. No, instead, it was all about private corporate profit, and it was all working well enough except for some griping and complaining over nothing, and also all the lazy aristocrats who couldn’t be bothered even to save their own lives by working the land. Nothing ideological to see here, please move on.
But let’s engage in a bit of Slow History and read Governor Bradford’s commentary on the Socialist scheme from the 1620’s in his History of Plymouth Plantation: [some clarifying punctuation, paragraphination, and emphasis supplied. Sometimes I used modern spelling.]
All this whille no supply was heard of; neither knew they when they might expecte any. So they begane to thinke how they might raise as much corne as they could and obtaine a better crope then they had done that they might not still thus languish in miserie.
At length, after much debate of things, the Govr with the advice of the chiefest amongst them, gave way that they should set corne every man for his owne perticuler, and in that regard trust to themselves in all other [activities that were collectivized] before.
And so assigned to every family a parcell of land according to the proportion of their number for that end only for present use but made no devission for inheritance and ranged all boys & youth under some familie.
This had very good success for it made all hands very industrious so as much more corne was planted then other ways would have been by any means ye Govr or any other could use, and [thus] saved him a great deall of trouble and gave farr better contente.
The women now wente willingly into ye feild and tooke their litle ones with them to set corne which before would aledge weakness and inabilitie whom to have compelled would have been thought great tiranie and oppression.
The experience that was had in this common course and condition, [‘collectivization’] tried sundrie years, and that amongst godly and sober men, may well evince the vanitie of that conceite of Platos & other ancients applauded by some of later times [the applause never stops] that ye taking away of propertie and bringing in comunitie into a comone wealth would make them happy and florishing as if they were wiser then God.
For this comunitie so farr as it was was found to breed much confusion & discontent and retard much imploy met that would have been to their benefite and comforte
For ye young men that were most able and fitte for labour & service did repine that they should spend their time & strength to worke for other mens wives and children with out any recompence. [You mean like this guy in the LA Times?]
The strong, or man of parts, had no more in division of victuals & clothes, then he that was weak and not able to doe a quarter the other could, [and] this was thought injustice.
The aged and graver men to be ranked and equalised in labours and victuals, clothes, etc. with ye meaner & younger sort,thought it some indignity & disrespect unto them.
And for men’s wives to be commanded to do service for other men – as dressing their meat, washing their clothes, etc. – they deemed it a kind of slavery. Neither could many husbands well brooke it.
Upon this point, all being to have alike, and all to do alike, they thought them selves in ye like condition and one as good as another, and so if it did not cut of those relations that God hath set amongest men, yet it did at least much diminish and take of ye mutuall respects that should be preserved amongst them.
And would have been worse if they had been men of another condition. [he means ‘by less righteous men’] Let none object [that] this is [all due to these] men’s corruption and not [caused by the] the course itself. I answer, saying [that] all men have this corruption in them. God in his wisdom saw another course fitter for them.
Thank you Governor. I’m sure the whole world closely studied your text, took your words to heart, learned the lesson of the Puritans, and avoided many predictable tragedies over the next four centuries. Oh, wait, no they didn’t.
Fail at a utopian scheme once with some less-than-fatal consequences? Shame at naive optimism. I mean, “Who Knew?”
Fail, over and over, for over a dozen generations, with plenty of available literature on the subject, with dozens of millions of pointless deaths, and shame on … who? Shame on what?
What was the driving impulse here? Why did the Puritans set up the system the way they did and not in some more traditional manner? And why do we never learn; why does it never go away?
The answer to the last question is that every generation thinks ‘this time is different’ and that, with various new capabilities unavailable to their predecessors – new knowledge, management techniques, communication, transportation, technology, unprecedented levels of wealth resulting from high-productivity, etc. – they can do it better and, finally, actually make it work.
I’ve mentioned repeatedly elsewhere that the beginning of the 20th century was one of such radical and rapid technological change, and generated such intense excitement, awe, and optimism that the progressives of the time can, perhaps, be forgiven for believing that we had ‘gone hyperbolic’ and irreversibly broken away from the past, and, soon, anything and everything would be possible, materially and politically, so why not try?
Add to that an endless list of excuses. They were dealing with Old Men, and the stubborn, lingering corruptions of the obsolete past, but we will wipe all that clean, and make New Men, and start fresh! But, unlike the endless multiplication of new excuses, the new men never come.
It’s kind of like the flu. It comes around periodically, it’s always bad, some instances are much worse than others, and we never seem to achieve immunity. We know it’s coming, but we can’t stop it.
It’s also like really wanting to invade Russia. Lots of people before you have really wanted to invade Russia. They tried, but failed, usually catastrophically. But even though you know it’s been an utter disaster in the past, hey, now you’ve got the Luftwaffe! Substitute ‘Afghanistan’ and ‘Counterinsurgency Doctrine’ accordingly. And maybe China too will make both of these mistakes later this century.
The mistakes keep repeating because the seductive dream that numbs our senses never dies. In the invasion case, the dream is the logic of geopolitics as an extension of the fundamental human drives for winning power, status, and resources and defeating competitor rivals.
And in the Communism case, it’s the fundamental appeal of the idea of equality, and even human uniformity. The appeal is not of just of equality under the law, or equality as an ideal, but of the notion of creating and building the utopian equal society via the mechanism of law and coercive governance. It’s an actionable ideology and by joining the cause you actually get to see things done and feel like you’re part of it and doing something too.
Let’s get back to the Progressives like Cass Sunstein. They all insist that they are neither Communists nor even Socialists, and it’s silly and paranoid to suspect they are. They say it’s ridiculous for Tea Partiers to think that progressives are going to use gimmedat-democracy and changing demographics to establish New-Deal-Era-style one-party rule and gradually collectivize the country into the ground. Should we trust them?
In order to trust them on this matter, you have to understand the motivation force of their dream. They don’t like gulags or border walls, ok, but every time you look, Progressives are going on and on and on about inequality, especially of the racial and gender and income types, but really about anything at all. They’re obsessed with it. It’s the single lane in their one-track mind. And they never met a collectivist scheme or redistributionist program they didn’t like. If they fail in the past, they just wait because, in due time, they’ll take that second bite at the apple. Or the third or fourth or whatever it takes.
In other words, when Tea Partiers accuse Progressives of being crypto-communists, they are simply saying that they, very reasonably, do not trust other human beings not to pursue their longstanding dreams when they have the chance and power to do so.
If absolutist egalitarianism social justice is not the Progressive dream, what is? What limiting principles, moderating tendencies, or institutional commitments do we observe that can be trusted to contain their urge to ratchet the society ever further in that direction? The Constitution? Please.
America Is A Communist Country because it has been pursuing this dream, and spreading it by the sword, since it was born. For every two steps forward it takes a reckless action and tries for a bridge too far, stumbles, gathers its senses for a brief moment, and then reacts and takes a step back away from the cliff. The Pilgrims restore private property; Reconstruction ends, the country returns to normalcy; It’s morning in America.
But some collectivist innovations become permanently part of each new foundation, and the space for restorative corrections shrinks and shrinks. When Obamacare fails, as it was designed to do (it’s large purpose is mostly to break the link between employment and insurance), it will no longer be possible to establish a genuinely private-sector healthcare system in America. It’s a ratchet and it’s never going back.
If the Tea-Party-exorcised Republican party still exists by that time, their entire freedom of maneuver will be restricted to the role on the ‘Conservatives’ in Britain: being the stingy face that tries to keep the NASI system afloat, while the Democrats pillory them with insults, find a little girl dying of the world’s most expensive – so untreated – disease, and promise voters that they’ll be more generous with rich people’s money. And after losing ten elections in a row, some Republican strategist who thought using the word ‘Socialist’ was beyond-the-pale will look back, shrug his shoulders, and ask, “Who Knew?”