Obamacare is presented as a law. Such a description is misleading. Typically a law would be a dictate about how people are to behave. Obamacare contains a lot of such dictates, but it is fundamentally more akin to a construction project or the founding of a new government agency.
And like any construction project, schedules can be more hopeful than realistic. This is especially likely when the money is coming from the taxpayers rather than from an owner with his own fortune on the line.
Perhaps another analogy will help. Obamacare is, effectively, and entrepreneurial startup via Congress. How often do even successful startups meet all their scheduling goals? Is the government going to be any better? As the Wall Street Journal reports:
“Government officials have missed several deadlines in setting up new health-insurance exchanges for small businesses and consumers—a key part of the federal health overhaul—and there is a risk they won’t be ready to open on time in October, Congress’s watchdog arm said. The Government Accountability Office said federal and state health officials still have major work to complete, offering its most cautious comments to date about the Obama administration’s ability to bring the centerpiece of its signature law to fruition. ‘Whether [the government’s] contingency planning will assure the timely and smooth implementation of the exchanges by October 2013 cannot yet be determined,’ said the GAO in twin reports to be released Wednesday.”
Think of all that must go into these exchanges just on the practical side. We need comprehensive databases, internet architecture, and working pay systems, among many other things. Of course, we also need actual health insurance companies who see a reason to compete with others for a market in one of these exchanges. In other words, they have to be convinced that it is worth their investment. So far things don’t look so good.
“The small-business exchanges in particular have had some early setbacks. The federal government said in April that contrary to initial plans, it wouldn’t allow workers in the first year to choose between a range of insurance options offered through employers. For the first year, companies will select one plan to offer to workers. In some states, only one insurance carrier has expressed interest in the small-business exchange. In Washington state, officials have had to postpone the exchange altogether because they couldn’t find a carrier willing to offer small-business plans for all parts of the state.”
Right now, seventeen states are trying to set up their own exchanges and the Federal government is supposed to establish the rest of them for the other states. They have to review and approve the insurance plans according to all the laws and regulations involved in the Affordable Care Act. They also have to train and “certify” “consumer aides.”
Is the government capable of accomplishing this on schedule and on budget? I think one real possibility is that Obamacare might never happen.
Even if it limps along, however, Obamacare is not going to make anything affordable. As people feel the pain, it will be an opportunity to point out how spontaneous free exchanges are always more efficient than centralized government planning.