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Core Incompetency


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December 1 has come and gone without the Obama administration’s having delivered its promised “fully functioning” health-care website — another item in President Obama’s catalogue of broken health-care promises, another example of his administration’s utter incompetence at anything other than campaigning. When it comes to making speeches, the president is pretty good; when it comes to getting things done, it’s a clown show. And now the clowns are running your health care.

Even the president’s media cheerleaders are out of excuses. When a CNN reporter logged in to the new, improved HealthCare.gov to demonstrate its smoothed-out functionality, it crashed on television. Ezra Klein, the liberal Washington Post commentator whose dedication to the president’s health-care agenda is positively abject, writes that “the site still suffers a disastrous outage rate judged by the standards of major retail Web sites — and that’s not counting the time it spends down for scheduled maintenance.” Administration officials promised that, after a few meetings, they would be “operating with private-sector velocity and effectiveness,” but the actual private-sector entities — the insurance companies that have to deal with the mess the administration is creating — are in a panic as the system transmits data that is full of errors, or fails to transmit it at all, and warn that even those few Americans who have managed to sign up for coverage through HealthCare.gov may show up at their doctor’s office in January only to learn that they did not purchase the insurance they think they purchased.

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The Department of Health and Human Services blames “inadequate management oversight and coordination” — in a word, leadership — for these problems. Whose “inadequate management oversight”? HHS does not seem to want to dwell too long on that embarrassing question. The administration simply could not bring itself to admit that the problem of health insurance is more complex than it let on with its facile campaign promises of expert management and technocratic competence. So, for purely political reasons — which is to say, for reasons of unadulterated self-interest — it brought onto the market a product that is defective, destructive, dangerous, and incomplete, without adequate testing and zero in the way of quality control. If this were a pharmaceutical company, the responsible parties would be prison-bound. If this were a hospital, it would have been shut down before it was opened. If a physician had the same error rate as HealthCare.gov, he’d be sued out of practice and into penury.

And politics continues to guide the effort to fix HealthCare.gov, which is why the effort is focused on the user experience — which is public, embarrassing, and therefore politically relevant — rather than the back-end problems, which are substantive and serious. Much of the website still has not been completed, including its payment mechanism for subsidies. The applications that it does manage to process are error-ridden: Subsidies are improperly calculated, consumers are misidentified, relationships are misstated (one customer was surprised to learn that he had three wives instead of one wife and two dependents), and, in an unknown number of cases, the information simply is not being transmitted to insurers at all. A website that sometimes seems to work for consumers, whether it’s crashing 50 percent of the time or 10 percent of the time, in fact does not work at all if it is not sending accurate and complete information to providers. The exact prevalence of faulty information in Obamacare applications is not yet known, but the experience of insurers thus far suggests it is high. The administration seems to be willing to accept 90 percent functioning as the standard on the front end; if that’s the standard on the back end, then millions of applications will be based on bad information, and millions of consumers will suffer for it.

There is something critical to be learned here. The New York Times writes that the effort to rehabilitate HealthCare.gov is in truth part of a broader project, “a frantic effort aimed at rescuing not only the insurance portal and Mr. Obama’s credibility, but also the Democratic philosophy that an activist government can solve big, complex social problems.” We’ve been having that debate for a long time, and, while it may not yet be settled to everyone’s satisfaction, we have answered the narrower question of whether this administration can solve big, complex social problems: It can’t even solve its own website.



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