They Had a Dream
Rule by experts comes a cropper
Jun 2, 2014, Vol. 19, No. 36 • By NOEMIE EMERY
From the beginning, they made it clear that the Obama regime would be different from all others that had come before. The damaged economy was the critical issue, but the creation of jobs took a back seat to boutique left-wing causes. The stimulus, costing more than a trillion dollars, came and went leaving nothing behind it, unlike the spending of FDR’s era, which at least for a while gave jobs to real people, and left behind things like bridges and dams and parks. “Climate change” had become an obsession, symbolized by the refusal to act on the Keystone pipeline proposal, which would have created jobs in Middle America, but which Obama’s Hollywood backers denounced as unclean.
But nothing did so much as the historic, transcendent health care proposal to contradict David Brooks’s contention, in the summer of 2009, that the president “sees himself as a Burkean” and “understands complexity and the organic nature of change.” Social Security had been large, but made no change in the structure of government, and the Welfare Reform Act of 1996 (signed by Bill Clinton at the Republicans’ urging) was based on successful experiments at the state level conducted by governors of both parties. The Affordable Care Act looked for advice to academics, not governors, and proposed the state takeover of an industrial complex responsible for one-sixth of the gross national product based not on what had been proved to work through experience, but on what some intellectuals had guessed might work. If a camel is a horse designed by a committee, this camel was a 2,801-page non-bestseller filled with labyrinthine riddles that nobody seemed to know how to solve. To insure approximately 18 million out of 300-plus million Americans (they confessed the plan would still leave 20 million uninsured), they proposed to spend trillions on a reengineering of the entire system that would in time cause 80 to 100 million of the currently insured to lose and to seek new insurance.
“This system requires coordination of over 288 policy options . . . each with three or more levels of coverage, while simultaneously calculating beneficiary income, tax credibility, subsidy levels, deductibles, not to mention protecting applicant privacy, insuring web security and managing a host of other data points,” the New York Times’s Thomas B. Edsall informed us, adding that all this had to be coordinated with numerous state and federal departments and public and private bureaus and agencies that were not well equipped to assist in these ventures. Apparently, the possibility that the agencies that these experts assumed would coordinate easily with the new health insurance bureaucracy and with each other would not in reality be able to do so did not occur to the experts. They planned to move millions upon millions of people from one set of doctors and networks to new ones heedless of the fact that people form relations of trust with their doctors and would resist losing them. They imposed health-insurance mandates on companies that employed 50 or more people with little consideration that this might apply a strong brake to the expansion of businesses and move millions of people into part-time employment. They levied taxes on companies that manufactured the medical devices that improved and saved lives, with no idea this would lead to fewer inventions. They heaped new levels of regulation and paperwork onto the shoulders of doctors and hospitals, with no idea that this would lead many to think about early retirement. When the practical effects of their theories ran into the realities of human nature, the market, and the political imperative to appease constituents, the result was a blizzard of waivers, exemptions, and extensions of deadlines. At this point, there is barely a deadline that has not been erased or extended, a rule that hasn’t been excised or rewritten to make its impact less lethal, and even the most frantic of changes hasn’t made the system work well.
As Edsall asked, “Is the federal government capable of managing the provision of a fundamental service through an extraordinarily complex system?” The answer is probably no, and even if it is yes, it’s abundantly clear that the uber-class of super-professionals aren’t the people to do it. Their faith in academics and experts had failed this new class of liberals, as would soon become obvious. Their related belief that the opinion of the less-elite classes should not be important would soon fail them, too.
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