“It was always going to be difficult to implement Obamacare,” explains columnist David Brooks, “but even fervent supporters of the law admit that things are going worse than expected.” Now how could that be?
Things got off to a bad start “because the Obama administration didn’t want to release unpopular rules before the election.” Now everybody is anxious and insurance companies “don’t know what federal parameters they have to meet.” Businesses are likewise befuddled and even Obamacare booster Sen. Max Baucus sees a “huge train wreck coming.” Brooks, who seldom raises his voice, cites other supporters of the law “who think the whole situation is a complete disaster” and predict “Obamacare will collapse and do serious damage to the underlying health system.” At best “we’re probably in for a few years of shambolic messiness, during which time everybody will scramble and adjust, and eventually we will settle down to a new normal.”
But maybe we won’t because “A law that was very confusing has become mind-boggling,” with a “technical cascade,” a “cost cascade” and an “adverse selection cascade.” The direction of a cascade is usually down. Regulatory regimes, Brooks explains, “can be simple and dumb or complex and sprawling.” He doesn’t get into specific Obamacare complexities such as a book of medical codes 10 times bigger than the one Medicare currently uses. As John Stossel recently noted medical code W6161XA means a patient “has been bitten by a duck” but code W6162XA means a patient has been “struck by a duck.” So it’s all very fine tuned, with our benefit in mind.
Obamacare has been a convenient make-work project for federal regulators but for the populace, as David Brooks confirms, it shapes up as Obamabuse, something to be endured and overcome. That’s why books are appearing with titles such as Beating Obamacare: Your Handbook for Surviving the New Health Care Law. But according to David Brooks, you’ll need some good luck with that. “Train wrecks” and “shambolic messiness” will doubtless be the “new normal” in health care.