What Obamacare has wrought

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No one knows yet just how much worse this is going to get.

But the people the healthcare overhaul was supposed to help are mostly not being helped, and the people who were supposedly safe in the system they preferred have mostly lost that safe haven. President Obama was not able to deliver what he promised, and even when he was warned to stop promising it, he persisted.

He was the one who made it sharply and divisively political from the start, giving leadership of the Republican party  no voice at the table to negotiate necessary healthcare reform. Something as major as the redesign of health care in America should have been a joint effort, but alternative plans never got a hearing.

Wall Street Journal columnist Peggy Noonan summarizes it, to this point, here. She makes very good and important points, and particularly one I’ve focused on while so much attention in the early unraveling of Obamacare centered on the stunning website failures. That was misdirected focus, though that crash definitely occurred, definitely cost a ton of money and most definitely didn’t have to happen, with technology experts able to handle something like this with far less lead time and at far less cost with vastly more ease of use. That’s all true. But Noonan focuses on what I’ve wanted to see addressed, which is the main point.

So the program debuts and it’s a resounding, famous, fantastical flop. The first weeks of the news coverage are about how the websites don’t work, can you believe we paid for this, do you believe they had more than three years and produced this public joke of a program, this embarrassment?

But now it’s much more serious. No one’s thinking about the websites. They wish you were thinking about the websites! I bet America hopes the websites never work so they never have to enroll.

The problem now is not the delivery system of the program, it’s the program itself. Not the computer screen but what’s inside the program. This is something you can’t get the IT guy in to fix.

Yes, it’s the program itself. It was always that.

They said if you liked your insurance you could keep your insurance—but that’s not true. It was never true! They said if you liked your doctor you could keep your doctor—but that’s not true. It was never true! They said they would cover everyone who needed it, and instead people who had coverage are losing it—millions of them! They said they would make insurance less expensive—but it’s more expensive! Premium shock, deductible shock. They said don’t worry, your health information will be secure, but instead the whole setup looks like a hacker’s holiday. Bad guys are apparently already going for your private information.

Many people may have missed that, but HHS Secretary Kathleen Sebelius had to admit under oath in her testimony before a Senate Finance Committee hearing that healthcare ‘navigators’ hired by the federal government to help people sign up for healthcare online and thus take sensitive personal information from them just may be felons.

Sen. John Cornyn asked if federal background checks were a prerequisite for the hiring of the individuals tasked with walking people through ObamaCare enrollment.

“The president is in Dallas, Texas today touting the navigator program, which as you know are people who are hired to navigate the [Affordable Care Act], but I would just like to ask you this question,” Cornyn said to Sebelius. “Isn’t it true that there is no federal requirement for a navigator to undergo a criminal background check, even though they will receive sensitive personal information for people they help sign up for the Affordable Care Act?”

“That is true,” Sebelius responded. “States can add an additional background check and other features, but that is not part of the federal requirement.”

“So a convicted felon could be a navigator and could acquire sensitive personal information?” Cornyn asked.

“That is possible,” Sebelius said. “We have contracts with the organizations, and they have taken the responsibility to screen their navigators and make sure that they are sufficiently trained for the job, and there’s a self attestation, but it is possible.”

Noonan has a suggestion.

Maybe [oversight committees] could even call in some people from the White House and Congress, the ones who helped write and interpret this famous law that you had to pass before you could know what was in it, and ask: “Did you ever meet a normal human? Did you understand what you were doing when you produced this thing?”

Maybe they could even ask the president: “In your entire life, from community organizer to lawyer to politician, did you ever buy an insurance policy? Were you always on your wife’s plan, or immediately put on a plush government plan? Did you ever have to do anything like what you’re telling the people of your country to do?”

What are the odds those questions will be asked? Though the media are now, finally, asking questions and turning up information about pressure politics to avoid transparency on the healthcare overhaul.

We deserve transparency, the president and all elected officials deserve scrutiny by an informed electorate, because we’re all affected by it.

The idea that “only” 3 percent of Americans will end up on the short end of a 2,700-page law remaking the nation’s health care system seems as fanciful as the President’s pledge that anyone who likes their current plan could keep it.

The facts are clear: Obamacare isn’t just unfair for a small percentage of Americans; it’s unfair for the entire country.

There were alternatives. Here are some that didn’t require policy wonks.

It didn’t have to be this way. The Affordable Care Act may have been designed to be a socialized monstrosity of health care displacement and governmental control, but it need not have been. Creating a means whereby people who wanted health insurance could purchase it (and younger people in good health could choose limited, catastrophic coverage, or none at all) needed only two things: a willingness to put common sense over politicization, and a genuine respect for the notion that people understand their individual needs better than anyone else.

Common sense, and respect for the people they have ostensibly been elected to serve, are currently in short supply in our nation’s capital. The Affordable Care Act was passed by one political party while it was in control of two branches of government and feeling disinclined toward discussing (or even acknowledging) design alternatives.

That’s a shame because creatively exploring and expanding upon just a few of these framework ideas might have solved the problems of the uninsured without severely disrupting much of anything:

A) Begin where you are: Why should all roads lead to Washington DC when local communities are best able to identify those in need and to reach out? In 2000, then-Mayor Rudy Giuliani, went to the New York City Council with the simplest of plans: Take a pro-active approach and reach out to the uninsured who are not even aware of what programs already exist, which helped to insure several hundred thousand in New York City alone. Before upending anyone, get the right people enrolled into the appropriate, existing programs.

B) Invite-in can still avoid federal intervention: Healthcare infrastructure is all about managing risk by spreading it. If the most economically efficient plan is the one covering as many people as possible, then why not create extensions that offer the uninsured the opportunity to buy into the very same insurance plans offered to any state’s government employees, which are usually excellent?

C) Open the markets: Perhaps because it is both the simplest and the most commercial of ideas, and the least political, there appears to have been no discussion of allowing insurance to be sold across state lines, which would have immediately broadened the market competition and thereby lowered costs for everyone, across the board. Rather than opening coverage availability, the ACA appears to narrow it.

Read the account there of cancer patient Edie Littlefield Sundby:

Before the Affordable Care Act, health-insurance policies could not be sold across state lines; now policies sold on the Affordable Care Act exchanges may not be offered across county lines. It would seem the ACA would have the effect of geographically trapping people, effectively keeping them from pursuing new in-state opportunities and adventures for fear of again losing insurance and having to re-start the research and purchasing process. It is another narrowing, rather than enlarging, effect of Obamacare.

The column concludes with a presumption that perhaps something may still be done, by people of common sense, before this gets much worse. Maybe that’s not possible, maybe it is. But there’s no telling right now.

As this unpopular policy we call Obamacare begins to crumble from the weight of its own incompetent over-reach and mendacity, the opportunity may soon arise for policy reform, but if other voices do not have alternative plans already designed, thought through and set for discussion when an urgent solution is called for, there will be no option left in the political imagination but a single-payer program—managed by these same incompetents—and a nation full of frightened, uninsured people willing to turn to it.

The latest political class punditry holds that there’s no turning back now from the inevitable impact of such a massive federal program already in place. We’ll see.

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