In reading the stories about Obamacare, it surprises me that there has been so little focus on the issue of information security. Thousands of people have tried to navigate the system to apply for insurance, and have been disappointed that they were not able to do so. But it strikes me that many of those who were able to apply may end up being worse off.
To get coverage under Obamacare, applicants have to give out detailed information, among other things, about family, income, and employment, and applicants are repeatedly asked for their Social Security numbers. Has anyone asked whether a system that is so dysfunctional is able to protect the information that it receives? All of us are aware of the warnings not to give out Social Security numbers and financial information over the Internet, except for compelling reasons and to highly secure systems. I’m sure that the contractors who built the application system were supposed to include features that protect the information received. But they were also supposed to design a system that could actually process applications. They failed in that most basic function. How can they have any certainty that the information they do get is protected against theft? It would be ironic if the only people who figure out how to consistently navigate the system are hackers and identity thieves.
And it’s all so unnecessary. The number of uninsured people in the United States stands at 45–50 million people. Many of those people don’t have insurance because they don’t want it.
The group that has a real need consists largely of those who 1) have a chronic medical condition (and therefore need but can’t find affordable insurance on the individual market), but 2) don’t work for an employer who provides health insurance, and aren’t married to someone who does; 3) don’t qualify for COBRA; 4) aren’t old enough for Medicare coverage; 5) aren’t poor enough, or otherwise don’t qualify, for Medicaid; 6) aren’t disabled and therefore can’t get SSI; 7) aren’t retired from military or federal service; and 8) aren’t retired from a state or local government that provides retiree benefits and aren’t married to someone who is.
The number of these people is not small, but it’s not overwhelming either. So it’s risible to defend the Affordable Care Act by saying that there is no other alternative for helping the uninsured.
Remember that Obamacare is going to cost the taxpayer at least $100 billion per year. The cost is actually much higher, because the law forces younger people to pay more for health insurance in order to subsidize the older, less healthy people that the law is supposed to help; the higher insurance premiums that healthier people pay is effectively a tax. Assuming the government is prepared to spend huge amounts of the taxpayers’ money, there are, and always were, lots of alternatives for helping the uninsured. For example, most of the states have high-risk pools, where people in the situation I have described can buy health insurance at a subsidized cost. The simplest thing — not necessarily the most efficient, but the simplest thing — would simply have been to use federal funds to reduce the cost of participating in those pools.
There was never any need for a federal monolith, nor a need to interfere with the health care of the tens of millions of Americans who are able to get insurance on their own. The people who are losing their health insurance, or paying more for less, have been hurt and wounded for nothing. That, not an unworkable or even insecure application process, will prove to be the worst aspect of Obamacare