It’s not just the healthcare mess, it’s green jobs, shovel-ready stimulus, the ‘reset’ in foreign policy, closing Gitmo, climate change, bailouts… The M.O. is the same: bold promise, failed implementation, exempt your friends.
Writing in The New York Times, David Brooks says there’s Health Chaos Ahead
I’ve been talking with a bipartisan bunch of health care experts, trying to get a sense of exactly how bad things are. In my conversations with this extremely well-informed group of providers, academics and former government officials, I’d say there is a minority, including some supporters of the law, who think the whole situation is a complete disaster. They predict Obamacare will collapse and do serious damage to the underlying health system.
But the clear majority, including some of the law’s opponents, believe that 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.
What nobody can predict is how health care chaos will interact with the political system. There’s a good chance that Republicans will be able to use unhappiness with what is already an unpopular law to win back the Senate in 2014. Controlling both houses of Congress, they will be in a good position to alter, though not repeal, the program.
The law’s biggest defenders will then become insurance companies and health care corporations. Having spent billions of dollars adapting to the new system, they are not going to want to see it repealed or replaced.
The experts talk about the problems that lie ahead in cascades… [structural cascade, technical cascade, cost cascade (“Nearly everybody not in the employ of the administration agrees this law does not solve the cost problem, and many of the recent regulatory decisions will send costs higher.”), adverse selection cascade, provider concentration cascade]
In other words, more or less everything we critics predicted. But at least it’ll be free health care.