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John Culleton: Despite faults, Obamacare will work

There are times when I feel sorry for the Republicans in Congress.
Sure, from a liberal point of view they are mostly a pack of villains. But they manage to mess up their villainy.
Take Obamacare for example. This is a system first proposed by the Heritage Foundation, a very conservative think tank, and first implemented very successfully in Massachusetts by Republican Gov. Mitt Romney. Obamacare, modeled after Romneycare, was and is the signature achievement of President Barack Obama. Therefore the Republicans must destroy it.
First the Republicans in the House of Representatives delayed the reconciliation step of budget-making past the end of the fiscal year. Then they tried to defund Obamacare in the necessary continuing resolution, a vehicle that allows spending to continue as if we were still in the previous fiscal year. But the Democrats in the Senate and of course the president would have none of it.
Then the House Republicans proposed to delay Obamacare for a year. Again no sale. Meanwhile, the implementation date for a major part of Obamacare came, and initially it was a computer and networking disaster.
That story got buried under the larger debates over the continuing resolution and the debt ceiling. There weren't enough servers to handle the initial rush, and software glitches that should have been discovered in Beta testing weren't discovered until the system went live nationally. Beta testing is the phase where you allow a limited group of real customers to actually use the software for a period of time. This phase apparently was neglected or sharply limited for political reasons. A phased state-by-state roll out would have been a huge improvement but politically impractical.
In the rush to correct software mistakes on a system that has already gone live, more mistakes will be made. A new version of the underlying system software is reportedly being rushed to completion. Experience shows that this hurried release may well cause still more problems. As a former programming manager in both industry and government, I have been there.
There are indeed deficiencies in Obamacare beyond the glitches. The underlying imperative to keep the payment process in the hands of private insurance companies is a major complication and cost factor.
Obama ruled out the so-called public option at the start, in order to gain political and financial support from the big insurance companies and appease conservatives. Although Obamacare will ultimately succeed and even save some money overall, we will still be stuck with the complexities and costs of multiple insurance vendors, some of whom are more interested in denying claims than paying them.
Medicare does it better, and cheaper. Single payer is much less complex. That is the Medicare model that should have been taken.
Obamacare, like its model Romneycare, will solve the health-care coverage problem. However, significant reduction of our national health-care costs will require more radical changes in both the provider and payer aspects. We have twice the health care costs per citizen compared to other countries in the world. Obamacare does little to attack this problem.
There are more successful models we need to look at, like that of France. In the French system, notably missing are the big and greedy national insurance companies. Originally employment-based, it has recently been broadened to cover all citizens. Yes, it is socialized medicine, and it provides better overall care at half the cost of our health care when measured against each country's GDP. France is tied for fourth in overall life expectancy; we rank 33rd.
Will conservative ideology continue to frustrate needed health-care improvements and cost savings? Time, and the 2014 elections, will tell. Meanwhile Obama has Obamacare and the Republicans are stuck with the shutdown. They are in a hole and keep on digging.

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