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Obama too intellectually restless for health insurance details

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U.S. President Barack Obama

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U.S. President Barack Obama

WASHINGTON — Two statements explain the huge failure of Obamacare. One is by President Barack Obama, the other is about him.

The first was made in St. Paul, Minn., at the end of the 2008 primary campaign, when candidate Obama predicted that generations would look back and see his nomination as "the moment when the rise of the oceans began to slow and our planet began to heal." Couple this with the assessment of his closest aide, Valerie Jarrett, about his exceptionalism. "He knows exactly how smart he is," she told Obama biographer David Remnick. "And he knows that he has the ability — the extraordinary, uncanny ability — to take a thousand different perspectives, digest them and make sense out of them."

Obama "has never really been challenged intellectually," she went on. "He’s been bored to death his whole life. He’s just too talented to do what ordinary people do."

Or what an ordinary president does, for that matter. A chief executive less bored than Obama would have stayed on top of his signature legislation. Those upset that he didn’t are bedwetters, the White House says, nervous Nellies who can’t comprehend the larger picture of health-care reform that will, in due time, emerge. White House spokesman Jay Carney intones the mantra that the president "is focused on delivering the access to quality and affordable health insurance" and isn’t concerned "about the politics of that."

Shame on mere politicians who worry about the next election rather than the next generation. Obama’s cool enrages even his allies. In 2010, after voting for the Patient Protection and Affordable Care Act, 63 House Democrats lost their seats, a historic rout. And that was before the law actually kicked in and its inadequacies became apparent. (Not least of these flaws is Obama’s broken promise that you could keep your plan if you liked your plan, a facile bumper-sticker line that has cratered the president’s poll numbers — and those of government in general — for trustworthiness and competence.)

The mechanics weren’t as promised. In August, many of the elements needed for HealthCare.gov to function were deemed not ready by the chief contractor, CGI Group Inc., a company hired by the administration despite a poor performance record. As of August, almost nothing worked as promised: Computer systems at the multiple government agencies involved were unable to talk to one another, code was plagued with errors, and the system couldn’t handle even 500 users at a time. What’s more, no one had tended to the even more complicated financial and accounting part of the insurance exchanges.

None of this was enough to rouse the intellectually restless president’s attention. After the Oct. 1 rollout, he seemed as surprised as your average citizen that the exchanges weren’t working. He keeps suggesting the failure should be mitigated by the fact that his opponents were wishing for it. It took him six weeks to apologize, he still hasn’t held anyone responsible, and not one head has rolled. One reason he could say that the fiasco was "on him" is that his head can’t roll.

As polls show Democrats losing to Republicans on a generic ballot and the Senate in danger of going Republican, Democrats are panicking about 2014. To protect themselves, 39 Democrats voted with Republicans to allow insurers to sell canceled plans through 2014, though that’s down from the 100 Democratic lawmakers who had threatened to support the Republican bill before the president’s admission that he’d fumbled the rollout. Vulnerable senators such as Mary Landrieu in Louisiana have written legislation that requires insurance companies to keep people on their current insurance.

Obama, meanwhile, is banking on delays. The first one was to buy time to fix the front end of the website by Nov. 30. There’s been some hedging on that date. This week, Julie Bataille, a spokeswoman for the Centers for Medicare & Medicaid Services, said the system "would be working much better than it did in October," an example for the ages of damning with faint praise.

The more important delay is the one to Nov. 15, 2014, conveniently after the midterm elections. This will be a critical passage, when companies will know whether enough of the unworried young healthies have signed up to offset the cost of insuring the older unhealthies and prevent an adverse selection "death spiral" for Obamacare. Early returns from states such as Kentucky, where the local exchange is working, are troubling. The old and sick are outnumbering the young and healthy.

Over Thanksgiving dinner, arguments over Obama’s putative foreign policy success with Iran could briefly displace those over his domestic policy failure. Come Monday, however, a nuclear pause won’t be enough to divert attention from a website that isn’t up to snuff or doesn’t have the right mix of people to save premiums from rising faster than the oceans. Looking back on shepherding Medicare into existence in the mid-1960s, former Secretary of Health, Education and Welfare Wilbur Cohen said the signature program for the elderly was one per cent inspiration and 99 per cent implementation. He wasn’t so easily bored.

 

Margaret Carlson is a Bloomberg View columnist.

 

— Bloomberg

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