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The Daily Debate - 10/18/2013

By Robert Tracinski

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October 18, 2013

1. The DMV Would Be Better

2. Dispatches

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1. The DMV Would Be Better

A lot of the opponents of ObamaCare warned that putting government in charge would make health insurance function like the Department of Motor Vehicles.

If only.

If I need to deal with the DMV, it may not be quick or fun, but I know that if I'm willing to spend half the morning sitting in a chair listening to Muzak, I can get my new plates or renew my registration. It's a hassle, but in the end it works.

This is an ideal ObamaCare can only aspire to.

ObamaCare is the law that Nancy Pelosi had to pass so we could find out what's in it. One of the things we're finding out is that the implementation of the whole program is totally dependent on the design of its website—that healthcare.gov, along with various online state exchanges, is the primary portal through which people have to deal with ObamaCare and sign up for health insurance. Which means that if the website fails, the whole program fails.

That is precisely what is happening.

Think of the DMV again. It may not be efficient, but I don't have to worry that I'll be subject to fines for driving with expired plates or an invalid license, simply because the DMV won't allow me to comply. Yet that is precisely the situation millions of Americans could be in next year, subject to fines for failing to buy health insurance that the government-run exchanges won't allow them to buy.

And it looks like the problem isn't going to clear up any time soon. Yuval Levin describes how the system failed partly because the Center for Medicare and Medicaid Services decided to act as its own general contractor for the project, despite having no relevant experience with building vast online systems. (This does not prevent some people from trying to shift the blame onto big business by blaming the chief private contractor.) But he also indicates that the well-publicized difficulties with setting up an account in the new system are just the beginning.

"[A]n increase in volume if the user interface issues are solved could lead to huge problems that would be very difficult to correct. CMS officials and the large insurers thought at first that the garbled data being automatically sent to insurers must be a function of some very simple problems of format incompatibility between the government and insurer systems, but that now seems not to be the case, and the problem appears to be deeper and harder to resolve. It is a very high priority problem, because the system will not be able to function if the insurers cannot have some confidence about the data they receive. At this point, insurers are trying to work through the data manually, because the volume of enrollments is very, very low. But again, if that changes, this could quickly become impossible.

"In a couple of ways, then, the severe user-interface problems at the front end of the federal exchange has actually had some advantages from CMS's point of view, because by keeping enrollment volume low it has kept some other huge problems from becoming instantly uncontrollable."

In other words, even if the exchanges begin to succeed, they will still fail.

Jim Geraghty cites this and other catastrophic problems—such as the fact that the "navigators" hired to steer people through the enrollment process are proving to be poorly trained, improperly ceritified, and ineffective—and concludes that the ObamaCare "death spiral" we've been warning about is already beginning.

If ObamaCare doesn't sign up enough healthy young people—and it's not likely to do so at the current rate—then it won't have enough people to subsidize the insurance of older, sicker people. That will cause premiums to go up rapidly, driving even more healthy young people out of the market, and so on, until the whole system collapses.

We all expected this to happen, and there's a case to be made that some of the backers of ObamaCare expected it to happen—eventually, at a long enough delay that they could blame it on the greedy insurance companies and demand a direct "single payer" system, i.e., socialized medicine. What neither side quite expected was that ObamaCare might be designed and implemented so incompetently that it will spiral into the ground on launch.

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2. Dispatches

Due to human error—mine—two of the items in yesterday's Dispatches went out with the wrong links. Here are the corrected versions.

Finally, someone has the common sense to issue a stern warning to college girls that drinking heavily makes them like lambs among wolves.

Alan Weisman writes the anthem of misanthropic environmentalism: "We Don't Need Another Billion People." Oh, yeah? Well, maybe they don't need you.

RCP's Sean Trende examines the electoral aftermath of the government shutdown and finds out that there really isn't any.

As part of their "frog pot" rebellion against decades of expanding government, are conservatives at war with the Republican establishment?

The upside of lurid social media scandals is that scoundrels expose themselves.

Is Bill de Blasio going to take New York City back to the 1970s?

What happens when your language has no numbers. Hint: nobody in the family pictured in this article appears to be over the age of 30.

Academic publishing is obsolete—just like the rest of the publishing industry, only more so. And the case looks pretty hopeless because they're responding the way you would expect academics to respond: by trying to understand "how obsolescence functions as a form of cultural discourse." Man, are these people doomed.

Back when computing power was measured in girls.

Are robots going to replace Starbucks?

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—Robert Tracinski

The Daily Debate

edited by Robert Tracinski

Brought to you by RealClearPolitics.

Robert Tracinski is also editor of The Tracinski Letter.

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