By Lambert Strether of Corrente.
Perhaps this will be a useful metaphor to explain how ObamaCare really works:
Imagine you walk into a hospital seeking health care: Perhaps for something major, like heart failure, or something minor, like a broken arm. You sign in at the front desk and explain your situation to the nurse on duty. In response, they reach under the desk and pull out an extraordinary contraption: A combination, it seems, of a miniature steam engine, the Wheel of Fortune, a cuckoo-clock, and a football scoreboard. There’s a crank on the side of it, which the nurse, having rolled up their sleeves, turns vigorously with one arm, while feeding lumps of coal into the steam engine’s firebox with the other. Clutching your chest (or your arm) you notice two doors behind the desk. They have signs which read: Special Limited Facilities, and Service Grand Royale. The cranking stops: The steam engine emits three shrill whistles: The Wheel of Fortune judders to a halt at $500: you hear “Cuckoo, cuckoo”: and see (in lights) 42. The nurse notes these results, consults a large three-ring binder, and points you to the door marked Special Limited Facilities. Or perhaps it’s your lucky day, and Service Grand Royale is yours, all yours!
Yes, that really is how ObamaCare works: ObamaCare is a machine that delivers random results; unfair results, unequal results. The health care will actually be available to you will vary capriciously by past (and projected (and reported)) income, jurisdiction, geography, family structure, employment on Capitol Hill, age, existing insurance coverage, jurisdiction, and market segment. But the suffering from heart failure (or from a broken arm) is the same for everyone, so why isn’t the same health care available to everyone? So, when ObamaCare apologists say that ObamaCare helped some people* — or, when they want to really pile on the emotional blackmail and start taking hostages, they ask “Why do you want my spouse to die?” — ask them “Why don’t you want to everyone to get the help that some do?” or “Why don’t you want everyone to get the help your spouse does”? And if you get a good faith answer, offer to write a joint letter to the editor with them, supporting single payer Medicare for All. (Congressional offices pay attention to Letters to the Editor as, you will find, do your neighbors.)**
Anyhow, miniature steam engines with integrated Wheels of Fortune and cuckoo clock and scoreboard peripherals present significant systems integration challenges. So — and, readers, I know this will surprise you — ObamaCare, bloatware that it is, has slipped yet another deadline, with 32 days before enrollment begins. Reuters:
Exclusive: U.S. delays deadline for finalizing Obamacare health plans
The Obama administration has delayed a step crucial to the launch of the new healthcare law, the signing of final agreements with insurance plans to be sold on federal health insurance exchanges starting October 1.
Well, that’s a concern, since the Exchanges are supposed to enable plans to be compared.
The reason for the hold-up was unclear [obfuscated]. Sources attributed it to technology problems involving the display of insurance products within the federal information technology system.
Peters said only that the government was responding to “feedback” from the companies, “providing additional flexibility and time to handle technical requests.”
Coming at a time when state and federal officials are still working to overcome challenges to the information technology systems necessary to make the exchanges work [32 days before launch with three (3) years of implementation], some experts say that even a small delay could jeopardize the start of the six-month open enrollment period.
“,” said a former administration official who worked to implement Obama’s healthcare reform.
Of course, administration apologists are already starting to prepare the fallback position: The launch date doesn’t really matter!***
“But having everything ready on October 1 is not a critical issue. What matters to people is January 1, which is when the coverage is supposed to start. If that were delayed, it would be a substantive setback.”
Uh huh. So there are “substantive” deadlines, and, I suppose, non-substantive deadlines. Alrighty then.
Meanwhile, the sort of people who invent such obfuscatory verbiage are profiting mightily from the rental extraction opportunities created by the very artificial complexity they themselves created (especially the cuckoo clock makers). From The Hill:
ObamaCare has become big business for an elite network of Washington lobbyists and consultants who helped shape the law from the inside.
More than 30 former administration officials, lawmakers and congressional staffers who worked on the healthcare law have set up shop on K Street since 2010.
One might almost imagine these glowing prospects had something to do with single payer being systematically kept off “the table.”
Major lobbying firms such as Fierce, Isakowitz & Blalock, The Glover Park Group, Alston & Bird, BGR Group and Akin Gump can all boast an Affordable Care Act insider on their lobbying roster — putting them in a prime position to land coveted clients.
Veterans of the healthcare push are now lobbying for corporate giants such as Delta Air Lines, UPS, BP America and Coca-Cola, and for healthcare companies including GlaxoSmithKline, UnitedHealth Group and the Blue Cross Blue Shield Association.
Ultimately, the clients are after one thing: expert help in dealing with the most sweeping overhaul of the country’s healthcare system in decades.
“Healthcare lobbying on K Street is as strong as it ever was, and it’s ,” [Ivan Adler, a headhunter at the McCormick Group] said. “What’s at stake is huge. … Whenever there’s a lot of money at stake, there’s a lot of lobbying going on.”
So, the very things that make ObamaCare a technical disaster and a project manager’s nightmare — the triaged requirements, the slipped deadlines, the crazy pants secrecy — are, from K Street’s perspective, a gold mine, a veritable fountain of information arbitrage and billable hours. Good to know.
Finally, AFL-CIO’s Richard Trumka throws the membership under the bus. (For those who came in late, “Mistakes were made” is a classic Beltway non-apology apology, the key point being that questions of good faith don’t enter. Anybody can make a mistake!) The Hill:
AFL-CIO President Richard Trumka on Thursday said “mistakes” were made [!!}in the writing of ObamaCare.
Nobody could have predicted that a statute crafted by a health insurance company vice president wouldn’t take organized labor’s concerns into account!
“It still needs to be tweaked,” said Trumka, who pointed to the possibility that union members will lose their health insurance because of the inability of some union plans to qualify for federal tax subsidies.
ObamaCare’s failures are systemic, a consequence of its complex steam- and cuckoo clock-powered system of eligibility determination; “tweaks” are not the answer. As they say in the Navy: “You can’t buff a turd.”
“We have been working with the administration to find solutions to the inadvertent holes in the act,” Trumka said. “We are working to try solve problems, just like they tried to solve problems with employers, with large business and small business groups.”
“Problems” which Obama fixed immediately for business, and not at all for you. Are you sensing a pattern? Bueller? Bueller? Bueller?
For my money, the only way to get anything out of Obama at all is to threaten him: That’s what the gay bundlers and the Hispanics did before election 2012, and they got something, however pathetically inadequate. Trumka didn’t do that, and so of course he gets nothing, and so his membership will suffer. Well done, all.
NOTE * Ursula LeGuin had something to say about this mode of thought in Those Who Walk Away From Omelas.
TROLL PROPHYLACTIC ** Yes, ObamaCare will help some people; a program so large could hardly fail to do so; ObamaCare isn’t HAMP, after all. Of course, that’s not the issue.
NOTE *** Sarah Kliff frames the “deadlines don’t matter” argument this way:
Oct. 1 [can be viewed as] a completely arbitrary date, one that never shows up in the text of the Affordable Care Act and that has little bearing on the health law’s success or failure.
The space between October and December is viewed, by many standing up [insiderese alert] the health care law, as as soft launch: the time to make their new Web sites live, sort out the kinks and get the site in prime condition for the beginning of 2014.
The Affordable Care Act never set an open enrollment period. It directed the secretary of Health and Human Services to set “an initial open enrollment.” HHS Secretary Kathleen Sebelius’s agency set Oct. 1 through March 31 as the initial period when Americans purchase coverage.
Open enrollment begins in October, but any health insurance coverage sold on the marketplaces cannot take effect until Jan. 1, 2014. So, on the exchanges, there’s no difference in when you begin to receive coverage whether you buy it this Thanksgiving, Christmas or New Year’s Eve.
So it’s when coverage begins that matters, and not when choice begins? Bollocks. Insiders don’t have to worry about what their fate will be under ObamaCare or the exchanges. The rest of us would like to know our fate under the Exchanges sooner rather than later, so we can plan our lives accordingly. The choice deadline was supposed to be October 1, and choice is substantive. The promise was made by Sebelius, and now the Democratic nomenklatura wants to weasel out of it because they can’t deliver.