Readers of this site will recall that on the first day the Obamacare exchanges rolled out it was plain that they were complete failures. Their woes were not due to high traffic or minor glitches but something more fundamental. I wrote: “the problems experienced were the direct consequence of the length of the law and its attendant regulatory complexity. These regulations are often called “business rules,” and they have to be implemented in software. The Obamacare ruleset is now reportedly eight times the length of the Bible and still growing. This has had unavoidable results.”
The problems were caused by the “business rules.” But the initial belief among liberal pundits was the opposite. they delightedly concluded they were witnessing a massive success; in the words of one tweet the sound of the exchanges crashing was the sound of ‘millions of Americans buying affordable health insurance and nothing the Republicans can do about it.’ That celebratory shout dwindled to Ezra Klein’s recent whimper. He now believes Obamacare really does have technical problems and the administration should ruthlessly purge these wreckers from the ranks of its contractors.
But they still believe that nothing is fundamentally wrong with Obamacare that the efforts of Stakhanovite programmers won’t fix. Megan McCardle, who is by no means a mindless acolyte of everything liberal, follows this thread at its face value, asking a developer what ’soon’ might mean in this setting. She received this reply.
One person familiar with the project says it’s only about 70 percent of the way there, and has heard estimates of somewhere between two weeks to two months to fix it. As a programmer I know points out, “two weeks to two months” is the programming equivalent of “40 days and 40 nights”: “A long time, but I have no way of knowing how long.” When I used to hear estimates like that, I used to assume it would be coming in on the late end of that range, earliest.
But I disagree. This is not just a case of programmers missing their code quotas; nor just a 40 days and 40 nights problem. As I noted from the first, it is a “business rules” problem. The thing is specified wrongly. Gordon Crovitz, writing in the Wall Street Journal says the same thing.
The functional failures of the Affordable Care Act websites are well-documented, but the fundamental flaw is the law’s mind-numbing complexity. The officials who planned ObamaCare blame their Web engineers, but they’re passing the buck. ObamaCare is a hugely complicated approach to addressing problems in health care that have simpler solutions. …
The Government Accountability Office last year calculated that for the IRS alone, implementing ObamaCare would be a “massive undertaking that involves 47 different statutory provisions and extensive coordination.” Among them: “disclosure of taxpayer information for determining subsidy eligibility,” “drug manufacturer tax” and “high-cost health plan tax.” Senate staffers created a mind-boggling graphic showing ObamaCare’s various agencies and regulators, which can be viewed at http://1.usa.gov/acamess.
Readers should click on the site to see the chart, but for the convenience of those who don’t have the time here is a thumbnail of that diagram.
Program that. And program it so that nobody ever winds up in jail.
Remember that many of those neatly drawn boxes actually represent complex legal objects the violation of which may result in penalties or even jail. From the current condition of the system it is evident — even to Ezra Klein — that the Obamacare ship has put to sea with the shipwrights still aboard. This much is already consensus.
The question the diagram raises is actually different. What the blueprint above asks is whether this ship can ever float in principle. It asks whether the architecture by itself is proof of incompetence; whether it is ipso facto an act of criminal negligence.
But then maybe we’re not looking at the diagram of a ship at all. Avik Roy at Forbes concludes that our puzzlement evaporates the moment we realize the blueprint represents a completely different object. The purpose of the machine depicted in the chart is to transfer money from your pocket to another pocket and power over your health choices from you to the boys who run this gizmo. That’s what it does. And maybe it does this brilliantly.
The answer is that Obamacare wasn’t designed to help healthy people with average incomes get health insurance. It was designed to force those people to pay more for coverage, in order to subsidize insurance for people with incomes near the poverty line, and those with chronic or costly medical conditions. …
This political objective—masking the true underlying cost of Obamacare’s insurance plans—far outweighed the operational objective of making the federal website work properly.
If that is its purpose then the problem of Obamacare goes beyond the implementing code. It goes to right to the design and the questions are fundamental. Is Obamacare intended to provide “affordable health care” or is it designed as an income transfer machine as Avik Roy alleges?
If it’s designed to provide cheap and quality health care then maybe we’re S.O.L. since some things seem doomed from their conception to fail due to some fundamental violation of the rules of physics or mathematics. As a health care system it appears perverse. But as something else … why …
The question anyone who looks at Obamacare as a healthcare system should ask before sending the programmers down to the shafts for their 40 days and nights of Stakhanovite labor, is “what does this do?”
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