OCare (Carried Away)

Obama got carried away with health care reform: Column

Glenn Harlan Reynolds 6:02 p.m. EST November 3, 2013

Maybe the next elected president will think before he enacts big change.

Story Highlights
    •    The website's problems bode poorly for the rest of the plan, if anyone ever manages to sign up.
    •    Data formats are corrupted, multiple files are requested at once and the whole thing is just a mess.
    •    The technology needed for nationwide health insurance is so complex that the government couldn't handle it.
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Back when President Obama was first elected, the folks at Amazon offered a presidential reading list. My own recommendation for him was James Scott's Seeing Like A State: How Certain Schemes To Improve The Human Condition Have Failed. Obama should have taken it.

Scott, a Yale professor and no right-winger, produced a lengthy catalog of centrally planned disasters: Everything from compulsory villagization in Tanzania, to the collectivization of agriculture in the Soviet Union, to the "Authoritarian High Modernism" that led to immense, unlivable housing projects and the destruction of urban life in cities around the world. The book stands as a warning to hubristic technocrats: You may think you understand how things work, and how people will respond to your carefully (or, often, not-so-carefully) laid plans, but you are likely to be wrong, and the result is likely to be somewhere between tragedy and farce. The world is more complicated than planners are capable of grasping -- and so, for that matter, are the people who inhabit it.

So far, of course, the Obama administration's health care policy hasn't even gotten to the point of being tripped up by these sorts of issues, because, for the past month, the website hasn't been capable of enrolling enough people to matter. But the inability of the world's most lavishly funded government to produce a working website after more than three years of effort ought surely to encourage caution about its ability to administer the plan that the website was simply intended to enroll people for.

The website's problems, however, seem to bode poorly for the rest of the plan, if anyone ever manages to sign up. Apparently, the reason it's a debacle is that the HealthCare.gov website has to work smoothly with many other servers: insurance company servers that contain plan details, government servers that provide information on eligibility, and so on. But although the various pieces of the system were designed and implemented separately, once up and running they don't all work together: Data formats are corrupted and garbled, multiple files are requested at once, and generally, the whole thing is just a mess.

Well, the information technology needed to set up a nationwide health insurance plan for 317 million people is complicated. In fact, as it turns out it's so complicated that the federal government couldn't handle it. But as complicated as the computer stuff is, the actual insurance part is even more complicated, and will require more parts to work together smoothly. If the federal government can't handle the website, how's it going to do on the rest?

Not well, judging from the number of people already facing cancelled policies because of Obamacare -- a number that's so large Politico suggests that it might be the next decisive voting bloc in American politics, the way "Soccer Moms" were back in the 1990s.

If so, perhaps that voting bloc will remember that big programs organized by technocrats very often fail miserably when the technocrats turn out not to be as smart as they thought. And perhaps the next person elected to the presidency will be smart enough to read Seeing
Like A State before getting carried away with big plans. We can hope.

Glenn Harlan Reynolds is professor of law at the University of Tennessee and the author of The New School: How the Information Age Will Save American Education from Itself. He blogs at InstaPundit.com.