There is a persistent, contra-intuitive, rogue management rule: If it’s not broken — break it.
The argument being that “old think” digs one deeper into comfortable, but not necessarily effective, ruts. Breaking the mold forces all concerned into “new think,” which will be more productive. Unfortunately, all too frequently, for those creative, break-the-mold CEO-inspired ideas, there is a catastrophic consequence.
Thus has will be the result from the Affordable Care Act (“Obamacare”) which is proving to be a tar pit into which an ideologically inspired U.S. government executive branch is slave-driving the United States population.
And one can almost hear the Administration muttering the classic mantra of bad planning, “When I undertook to drain the swamp, I didn’t plan in being up to my ass in alligators.”
Because what is now in process in the United States is massive restructuring of roughly one-sixth of the economy. President Obama has battened upon U.S. health care as his administration’s legacy, through which he intends to expand health care more comprehensively to the American population. Unfortunately, it is being done almost as badly as possible, taking advantage of a unique political circumstance that lasted for a mere two years. (The perfect storm 2008 election wherein Democrats won not just the presidency but both houses of Congress provided this leverage.) Thus Obamacare was instituted without a single Republican vote guaranteeing no Republican has a stake in a positive outcome but, rather, significant stakes in dismantling it.
In historical terms, it is akin to Democratic President Woodrow Wilson assembling a delegation to the Versailles Peace Treaty negotiations that included not a single Republican senator — the resulting League of Nations Treaty was defeated in the Senate. Fast-forward arrogant hubris 90 years into Obamacare. Opponents of Obamacare never forget that it could not be legislated today and are determined to uproot it before — like an invasive species — it devours existing health care.
It was an objective that was unnecessary. Obamacare will turn a functional, high performance system into one that will meld the worst elements of the current system with the worst elements of “single payer” systems throughout the world — at incredible expense. And where does the world go for cutting edge medical care? Cuba? India? Or much-touted France where in the summer of 2003 there were 70,000 excess deaths from heat exhaustion and hospital indifference? Or Canada, where you can pay higher taxes for 50 years — and then wait months for your knee replacement?
The reality of pre-Obamacare U.S. medicine was excellence. The dramatic canard of millions of “uninsured” implied these individuals were dying, scratching at hospital emergency room doors. The uninteresting truth was that hospitals cared for such individuals and, if they couldn’t pay, the hospitals swallowed the costs. And many young, healthy individuals chose no insurance (or “catastrophic” insurance care for extraordinary costs). Normally this decision would illustrate democratic individual choice, rather than nanny state judgment that “we know better than you.” Thus the Obamacare requirement for all to pay for care (or pay a penalty for rejecting it) is a massive tax on the unwilling; a redistribution of income from the healthy to the sick.
The ongoing train wreck of the Obamacare website, which is supposed to guide the hapless through the process of obtaining new insurance, is a pathetic illustration of the maxim: “If you want it bad, you get it — bad.” Clearly, selecting providers of any complex product on the basis of lowest cost doesn’t work. And, again, arrogant hubris insistence on no delays in its launching demonstrated brutally that it was not ready for public consumption. The website debacle reminds one of the 1957 Vanguard rocket rushed for launching immediately after the Soviet Sputnik. As the world watched, it lifted from the launch pad — and promptly blew up.
But the parallel is also that when you throw enough money and technical expertise at a problem, you can solve it. If Amazon and Google can make complex websites work, eventually the USG will also.
This is not to conclude that U.S. health care was perfect. As we all die, health care ultimately fails for all. More specifically, concerns over “pre-existing” conditions preventing insurance for needy and losing insurance when (expensively) ill are obvious concerns. But they didn’t require Obamacare’s nuclear option to resolve.
One can argue that the USA can have the best military establishment or the best medical care, but having both is too expensive. Obamacare will assure that funds for security will be devoted to guaranteeing mediocre medical care.
David T. Jones is a retired State Department Senior Foreign Service Career Officer and a frequent contributor to American Diplomacy. During a career that spanned over 30 years, he concentrated on politico-military issues, serving for the Army Chief of Staff. He is co-author of Uneasy Neighbor(u)rs, a study of American-Canadian bilateral concerns and has published several hundred articles, columns, and reviews on U.S. - Canadian bilateral issues and general foreign policy.