Magazine | November 11, 2013, Issue

Born Under a Bad Site

To fix the problems of the Obamacare website, the administration has promised a “tech surge.” We’re supposed to think of the surge strategy employed by President Bush to push back the Iraqi insurgency and consolidate the war’s gains so that future administrations would have something more significant to throw away. Apparently the word “surge” tests well as a sign of vigorous, renewed determination to tackle a problem, and makes the geeks involved feel all martial ’n’ stuff.

To the list of things that are now the moral equivalent of war, you can add tech support.

Some have suggested that the problems were intentional, in order to create a spontaneous nationwide epiphany that single-payer health care is the answer. This is like selling someone a motorcycle so shoddy that one wheel falls off, so he’ll come back later and buy a unicycle.

Not to disparage single-payer; that’s what we had when I was born. It was called “Dad.” Parents back then saved maternity bills, perhaps to wave at a sulky teen who wanted his allowance raised — ever get me back for this? No? All right then. The bills usually looked like this:

Double-occupancy room: $18

Codeine-soaked leather strap to bite down on: $3.26

The Part Where the Baby Came Out: $87

Swaddling garments: $1.45

Parking: $2.25

Dad paid with a check, or laid out some twenties. If he got a handful of change in return, he thought, “That’s going straight into the kid’s college fund.” Now you’re charged for the rental of the fetal monitor, which informs the doctor that the baby is still in the hangar; forceps depreciation; and a federally mandated “umbilical-cord-disengagement assessment,” which costs $1.68 and funds the distribution of scissors in Third World nations; and there’s probably a mandate that the footprints they take must be in soy-based ink, thanks to a line on page 47,367 of the farm bill.

In the future, the law will probably require the doctor to inform the parents — sorry, that’s presumptuous, the custodial parties — that they may sign up for carbon offsets to minimize the child’s impact on climate change. Signatures will be required, but since this is government, it won’t be a matter of scribbling on an iPad; you will have to john-hancock something in triplicate, and the support staff will fax the goldenrod copy to the EPA Natal Impact Management Board, which will have 190 days to process your request for a subsidy to offset the cost of the offsets. If you qualify. If you do not qualify, you will be assessed an Offsetting Offset Offset to pay for the subsidies for others, although the money actually goes into the general fund and ends up studying the follicles of aquatic plants at the Harry Reid Center for Hairy Reed Research.

#page#And if you object to taxpayer-funded science grants, you hate research because you fear it’ll prove man did not domesticate dinosaurs and use them for steeds.

As for the true cost of birth, or “fetal-relocation assistance,” as it’s probably called at, who knows? The Mystery of Birth is no longer the thing itself, but who pays what. If you have an entity that can both print unlimited amounts of money and borrow as much as it wants, you may be surprised to find that the entity is charged more and more for all sorts of things. No longer do you have Dad, bleary, wearing the same shirt for the second day, stubbled, working on his 47th cigarette since the cramps started, looking at a bill and saying, “It says you charged us for Jell-O. She didn’t get any Jell-O. We asked and they said it would come but it never did. I’m not paying for Jell-O.”

Of course, there are so many more medical marvels now that the cost must increase. When the doctor said “You need a total hip replacement” in the old days, it was another way of saying “Nothing I can do.” That is why we need single-payer: The ruthless efficiencies of government will bend the curve until it snaps and gets little sharp pieces of curve everywhere, and if you step on one and go to the emergency room for a tetanus shot they don’t have to ask for your insurance card, because everyone’s insured. They’ll scan the barcode on your neck and you’re good to go.

Point is, you won’t have insurance companies denying you coverage because you went out of the system. The government will deny you coverage because there’s a shortage of tetanus vaccine. That’s much better. Everyone’s in the same boat that way. Muttering through lockjaw, yes, but equal.

The failure of the government to build the front door to the future of health care should be a lesson to young voters, accustomed as they are to whiz-bang tech that works — a generation that grew up with flat-panel screens connected to a magical network that answered every homework question, served up videos of their favorite song, connected them in a trice to friends who were posting pictures of pumpkin-spice latte, freed them from the dull world of sloth and error, and revealed a world of frictionless exposition of their own individuality. Having seen what private enterprise can do, why would they want to hand over their fate to a government as nimble as a slug on sandpaper? Why would they want single-payer?

Then again, the parents bought the iPhones. The parents paid for the Internet. So it was, like, free.

So what if you have to call 1-800 to get an operator to sign on? That’s a free call too.

– Mr. Lileks blogs at

James Lileks — James Lileks writes the Athwart column for National Review magazine and is a frequent contributor to the National Review website. He is a prominent voice on Ricochet podcasts.

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