In the Arena

Obamacare Incompetence

The key incentive for small businesses to support Obamacare was that they would be able to shop for the best deals in health care superstores — called exchanges. So why hasn't the Administration built them?

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JONATHAN ERNST / REUTERS

U.S. President Barack Obama at Port Miami on March 29, 2013

Let me try to understand this: the key incentive for small businesses to support Obamacare was that they would be able to shop for the best deals in health care superstores — called exchanges. The Administration has had three years to set up these exchanges. It has failed to do so.

This is a really bad sign. There will be those who argue that it’s not the Administration’s fault. It’s the fault of the 33 states that have refused to set up their own exchanges. Nonsense. Where was the contingency planning? There certainly are models, after all — the federal government’s own health-benefits plan (FEHBP) operates markets that exist in all 50 states. So does Medicare Advantage. But now, the Obama Administration has announced that it won’t have the exchanges ready in time, that small businesses will be offered one choice for the time being — for a year, at least. No doubt, small-business owners will be skeptical of the Obama Administration’s belief in the efficacy of the market system to produce lower prices through competition. That was supposed to be the point of this plan.

Certainly, the Republicans who have stood in the way of these exchanges — their own idea, by the way, born in the conservative Heritage Foundation — deserve a great deal of “credit” for the debacle. But we are now seeing weekly examples of this Administration’s inability to govern. Just a few weeks ago, I reported on the failure of the Department of Defense and Veterans Affairs to come up with a unified electronic health care records system. There has also been the studied inattention to the myriad ineffective job-training programs scattered through the bureaucracy. There have been the oblique and belated efforts to reform Head Start, a $7 billion program that a study conducted by its own bureaucracy — the Department of Health and Human Services — has found nearly worthless. The list is endless.

Yes, the President has faced a terrible economic crisis — and he has done well to limit the damage. He has also succeeded in avoiding disasters overseas. But, as a Democrat — as someone who believes in activist government — he has a vested interest in seeing that federal programs actually work efficiently. I don’t see much evidence that this is anywhere near the top of his priorities.

One thing is clear: Obamacare will fail if he doesn’t start paying more attention to the details of implementation, if he doesn’t start demanding action. And, in a larger sense, the notion of activist government will be in peril — despite the demographics flowing the Democrats’ way — if institutions like the VA and Obamacare don’t deliver the goods. Sooner or later, the Republican Party may come to understand that its best argument isn’t about tearing down the government we have, but making it run more efficiently.

Sooner or later, the Democrats may come to understand that making it run efficiently is the prerequisite for maintaining power.

1958 comments
DuaneBietz
DuaneBietz

From personal experience as a patient, a physician, a resident in training at four different government institutions, I can personally testify to the very high quality of VA programs and a level of technical expertise in the management of Electronics, medical records, radiologic records that is second to none and has been for many years.  The nonsense that is being spewed by totally uninformed, by personal experience, people is astounding.

Choo-Choo
Choo-Choo

Mr. Klein claimed the VA does not have a unified medlcal records system. Actually, it has had one for at least twenty years using Mumps/Cache. He probably is referring to the disinformation that updating that system will cost several billion dollars. SAIC, a politically connected software firm, wanted the contract so it scuttled an existing effort to update the system for pennies on the dollar. Another example of private greed at the expense of public need.

AndreiBilderburger
AndreiBilderburger

Mr. Klein is engaging in the typical magical thinking of democrats.  It is far too late for Mr. Obama to rescue "Obamacare." He needed to be paying attention and taking action last year and the year before.  Setting up the exchanges looks like it will follow the same schedule as closing Guantanamo.  

Marianne Campbell
Marianne Campbell

easy. I have been a consumer of all three. its not a cadillac federal employee plan, but those plans are more than adequate. extended background checks on recipients of these programs would go a long way;)

Marianne Campbell
Marianne Campbell

no kidding. I have said since the beginning that we dont need obamacare. nj already has family care/medicaid hmos. they could have raised the income eligibility requirements. the fed already offers a tax deduction for the self employed individual health insurance policy holders. the tax deduction could have been raised and expanded to include the non self employed.

ekpyros
ekpyros

Nice try, Klein. The problem is the bill itself -- and you're trying to cover your ass for backing it, now that it's shaping up to be the disaster that every sentient being knew it would be, back when you were slobbering over Obama. And to suggest that it's the Heritage Foundation's idea, so conservatives are somehow complicit, is pathetic rhetoric; not one Republican voted for the bill, and the Heritage Foundation railed against it. At least have the guts to own your mistake.

Andy Pratt
Andy Pratt

Yeah, Mars still seems appealing by comparison, and Saturn.

Elaine N Lala
Elaine N Lala

Bush spent 4 trillion dollars to arrest Saddam and to elect Karzai

Musa Polat
Musa Polat

I have a simple question for those who are defending President Obama. Where did the Billions of dollars for the implementation of the AFA go? They've had 4 years, with funding, to set up the system and knew that some States would not participate. I would expect that it would be easier to set up exchanges in 15 States than it would be for 50 States. Basically the administration has failed to perform the necessary tasks in order to meet a known deadline for implementation. While this may or may not be the President's direct fault, it is his chosen Cabinet members and administration that have not performed their required duties, therefore it is his responsibility as President

docwhocuts
docwhocuts

avoiding disasters overseas?

how insulting can a know nothing progressive be?

doddle
doddle

america is a complete mess thanks to obama

kpolgrasecoward
kpolgrasecoward

Hey jonathan.. it was the Clinton administration that hyped the idea of WMD.  Bush was criticized by both Hillary, Kerry, & Reid for not acting quickly enough before the War.  I know.. never let the facts get in the way of good propaganda

JonathanSwift
JonathanSwift

"Certainly, the Republicans who have stood in the way of these exchanges — their own idea, by the way, born in the conservative Heritage Foundation — deserve a great deal of 'credit' for the debacle." THAT really says it all, doesn't it?" Yet the author implies that the chief problem here is the Obama administration. Let's look at another look at the salient quote within the quote, "...their (GOP leaders) own idea, by the way, born in the conservative Heritage Foundation — deserve a great deal of 'credit' for the debacle." One of the many reasons the AHA has some unpalatable aspects to it is the fact that GOP leaders added amendments to poison the effectiveness of the AHA---just in case their campaign of misinformation failed and the AHA became the law of the land. Now, they have the gall to say "I told you so!" Nice try, Mr. Klein, but you-do-know that at least some of us read beyond the misleading title of your misinformation piece, right?

flamecct
flamecct

I have a simple question for those who are defending President Obama.  Where did the Billions of dollars for the implementation of the AFA go?

They've had 4 years, with funding, to set up the system and knew that some States would not participate.  I would expect that it would be easier to set up exchanges in 15 States than it would be for 50 States.  Basically the administration has failed to perform the necessary tasks in order to meet a known deadline for implementation.  While this may or may not be the President's direct fault, it is his chosen Cabinet members and administration that have not performed their required duties, therefore it is his responsibility as President.

kpolgrasecoward
kpolgrasecoward

Nailed it on the head, Roberto.. Does not matter because Shirley does not care

RobertoAlvarez
RobertoAlvarez

Shirley - you are entitled to your own opinion, but not your own facts.  

The facts are that Medicare is not at all "run efficiently" - the facts are that it has been a terribly expensive and inefficient means of providing healthcare to those insured, not to mention the vast amounts of fraud and waste inherent in the system.  

The same is true of Social Security.   Once again... the facts are that if anyone begins saving and investing $2,000 each year from the time they are 20, until they reach retirement age, and the funds are invested in the S&P 500 ETF, the funds with earnings will grow to about $1.5 to $2.0 million in retirement funds owned by that individual.  That's at an investment rate of return of 8-10% per year, which is the historical average of the S&P 500 over all years.  And... that person then will be able to live, quite comfortably, on just the earnings each year of about $200,000, without touching the principal... so that when they die... they will be able to pass the principal on to their heirs (children).  

Now... compare that to the paltry $250,000 you may receive in SS benefits over your lifetime... if you're lucky enough to live 20 years in retirements... and... when you die... your heirs receive... what... that's right "zip, zero, nada."  

As far as the VA health system is concerned... they have the worst Dr's and Nurses in all of healthcare... and they kill far more vets than they heal, as the result of incredible incompetence.  The best Dr's and Nurses are in private practice as a result of the incentives provided by the best healthcare system on earth... or... what was until ObamaCare.  

No... Shirely... your facts are simply wrong!


JackBrumbelow
JackBrumbelow

and? Is this not typical of this administration?  Somewhat like "The Gang That Couldn't Shoot Straight"?


collioure
collioure

Here's some perspective on this issue

http://news.investors.com/ibd-editorials/041113-651603-obama-administration-tries-to-blame-gop-for-obamacare-failures.htm

Frankly, given how this legislation was developed - on one side of the aisle with no input either desired or accepted from the other side, and given the enormity of the task undertaken, the coming train wreck should not be a surprise.

We were told at the time that in the past all major legislation (e.g., Civil Rights Act) had been bipartisan, that in fact it needed to be bipartisan. So blaming the loyal opposition is hardly credible at this late date.

RobertoAlvarez
RobertoAlvarez

Shirley - you are entitled to your own opinion, but not your own facts.  

The facts are that Medicare is not at all "run efficiently" - the facts are that it has been a terribly expensive and inefficient means of providing healthcare to those insured, not to mention the vast amounts of fraud and waste inherent in the system.  

The same is true of Social Security.   Once again... the facts are that if anyone begins saving and investing $2,000 each year from the time they are 20, until they reach retirement age, and the funds are invested in the S&P 500 ETF, the funds with earnings will grow to about $1.5 to $2.0 million in retirement funds owned by that individual.  That's at an investment rate of return of 8-10% per year, which is the historical average of the S&P 500 over all years.  And... that person then will be able to live, quite comfortably, on just the earnings each year of about $200,000, without touching the principal... so that when they die... they will be able to pass the principal on to their heirs (children).  

Now... compare that to the paltry $250,000 you may receive in SS benefits over your lifetime... if you're lucky enough to live 20 years in retirements... and... when you die... your heirs receive... what... that's right "zip, zero, nada."  

As far as the VA health system is concerned... they have the worst Dr's and Nurses in all of healthcare... and they kill far more vets than they heal, as the result of incredible incompetence.  The best Dr's and Nurses are in private practice as a result of the incentives provided by the best healthcare system on earth... or... what was until ObamaCare.  

No... Shirely... your facts are simply wrong!

PaulSerrano
PaulSerrano

The fact is Joe, that the GOP has done EVERYTHING it could to PREVENT the national economy from recovering, vis a vi the debt ceiling hijacking, and stopping Obama's jobs bill from passing purely to help Romney, etc, not to mention the obvious fact that GOP governors held back implementation of the ACA for the same reason, and are continuing to stonewall funds for implementation - it's NOT Obama's fault that the GOP leaders at the state level seem only to happy to stand in the way of a government play which would actually HELP individuals and business lower their health care costs JUST so they can stick it to Obama.. this is the GOP's phyrric victory play they've been running since Obama was inaugurated in '08, and it will continue as long as their's a GOP majority at the state level and in the House...  common sense and civic duty mean NOTHING to the GOP these days..

PaulSerrano
PaulSerrano

the simple reason it's not happening is that for purely political reasons, the GOP governors are DRAAAGGGIINNNG their feet, despite the fact that individuals health costs will go down as will the overall costs of implementation; it's called cutting off your nose to spite your face, and Obama's biggest mistake was naively believing they cared more about effective government than political posturing...

NooneOfan
NooneOfan

@BobGarrettRadio They waited so long that the time ran out. Ok, blame Obama for giving them an option, which they fumbled themselves!

NooneOfan
NooneOfan

@BobGarrettRadio I like Joe, but he doesn't explain that PBO gave GOP Governors the option to come up with alternatives,but they have NONE!

JonathanSwift
JonathanSwift

@flamecct I'd liked to know where the billions---as in tens of billions (if not hundreds of billions)---went regarding the no-bid contractors in Iraq? I would also like to know why President Bush and VP Cheney have not been investigated for possible war crimes against the Iraqi people (over 100,000 innocent Iraqi civilians were killed, after all) and treason (4,500 American soldiers and tens of thousands of American soldiers needlessly lost their lives in Iraq, due to fictitious WMD) for their deliberate manipulation of intelligence reports---ignoring the vast majority of reports that DID NOT INDICATE THE PRESENCE OF WMD---in favor of the testimony of ONE dubious source of information who, of course, was later found to be lying, which conned the US Congress to authorize war, and the American people to support it? By the way, the article already indicates the primary reason that the AHA has problems---our GOP leaders added amendments to poison the effectiveness of the AHA. Then, after it was made the law of the land, have fought tooth-and-nail to prevent its successful implementation, not only at the federal level, but at the state level, as well. You DO remember the red states attempting to legally challenge the AHA---and the SCOTUS slapping them down, right? Yet, here you are, still trying to blame the Obama administration.     

collioure
collioure

@PaulSerrano

You sound like a guy who just made it through high school because enough teachers believed you when you said time and again that you had forgotten your homework.

NB: Obama has never offered a "jobs bill." His stimulus bills mostly funneled money to his supporters working in state and local governments. Harry Reid never even brought the second one to a vote.

Obama doesn't care about the economy or massive unemployment. He hardly ever talks about either.

As for Obamacare 33 governors have decided not to set up insurance exchanges. That means that 2 of 3 don't see such as in their state's interest. On some implementation points hold-outs have signed on at the last minute. Not on this one.

Please grow up and offer us some adult answers next time.

Thank you.

dkeays
dkeays

@PaulSerrano to some degree, a separation of powers is what the founders wanted.

TimMullins
TimMullins

@PaulSerrano Please, let us at least be honest here. Where were you when 'Jimmy Carter's own party carefully shot him in both feet for not following the party line? And guess who they were? One prominent Democrat at the time, Senator Scoop Jackson had some choice things to say about the actions of his associates.

 In your rush to defend Obama, you failed to check the point. How do you get bickering politicians to support something you want passed if you are POTUS? This particular job skill is called leadership, and it is definitely a requirement for the position of president. And it just happens to be something that Obama lacks.

 As president you will face opposition. This is how the system is designed to work. When Reagan first took office, he faced a stone wall of it,, so hated were his ideas by the Democrats. What did he do? Just take it straight to the people via television. This is why he was called the Great Communicator. He addressed the public directly with everything he stood for while he was president. Pity that Obama hasn't thought of doing the same thing. It's a pity he doesn't even try to make his ideas known to the public. And considering recent revelations, it's small wonder he keeps them quiet.

collioure
collioure

@PaulSerrano

Oh, pulllllleeeeeze. Grow up!

These infantile partisan assertions are getting stale.

BobGarrettRadio
BobGarrettRadio

@NooneOfan If you read the piece, there is much more criticism than what you present as the GOP's fault.

BobGarrettRadio
BobGarrettRadio

@NooneOfan It seems like you knee jerk react by blaming GOP for everything. Obama is culpable too, he's the President!

darth_schmoo
darth_schmoo

@collioure:  If you want to call "bribing the states to not fire millions of teachers, health care workers, and police officers" (officers who, by the way, mostly vote Republican) in an effort to prevent the losses of millions of jobs "funnel[ing] money to his supporters working in state and local governments," go right ahead.  We see right through you.

And hell yes, Obama has offered jobs bills.  The stimulus was a jobs bill.  This --> http://en.wikipedia.org/wiki/American_Jobs_Act was a jobs bill.

Your hatred for Obama does not entitle you to your own facts.

darth_schmoo
darth_schmoo

@dkeays: To some degree.  To this degree?  No.  They assumed that the members of the three branches would understand that the separation of powers required compromise.

What they did not expect was the rise of a party whose entire goal was to make sure the government never did anything, whose goals were perfectly compatible with total, systemic gridlock.

darth_schmoo
darth_schmoo

@collioure: While your infantile partisan assertions continue to bless and illuminate our minds?

NooneOfan
NooneOfan

@BobGarrettRadio I read the piece and know all about it. He can criticize, but it is extremely tough work and obstruction does not help

NooneOfan
NooneOfan

@BobGarrettRadio What? The has been trying to repeal, weaken, defund the ACA from onset!They are afraid we might end up liking it

collioure
collioure

You make bad assumptions in your responses to me.

Hate?  Try disappointment because he never tried to be the President he promised to be.

Partisan?  I don't have a party.

The Stimulus bill was porky, silently funneling money to his supporters working in government while promoted as entirely something else.  As a result it didn't stimulate anything!  The other bills that never got anywhere, even in his own Senate, were at times called jobs bills, but they were just more pork.

Pick your own adjective to describe someone who amidst a horrible recession spends his last $800 billion on himself if you will.  Mine is SELFISH.

Instead of blaming the Republicans for Obama's failures, you would do well to look at his many failures - and we haven't even gotten to the train wreck of Obamacare.  Indeed throughout history those who promised to make the poorer better off at the expense of the rich only succeeded in making everyone poorer.  This Pied Piper is no different so far.

dkeays
dkeays

@darth_schmoo@collioure The stimulus bill was hyped as recovery of lost business and jobs, but I never saw any positive results. If you want to imitate the recovery of the depression then pray for another WW2- but I think I'll pass. So far this administration has proven itself very capable when it comes to thwarting natural recovery and extending the pain and agony for years- FDR would be proud.

dkeays
dkeays

@darth_schmoo@dkeaysIIRC, they did want one branch to be able to interfere with the government if another branch was getting out-of-hand. The government isn't the "end to all means". Life will go on even if government pauses. The government only exists to serve the people and must be stopped when it no longer serving the people.

Maybe the current admin can be said to "no longer serve the people" or maybe not, but the people have a right to interfere with government as necessary (that is what the American Revolution was).

I'll have to double check my sources (primarily biographies of Jefferson and Madison and their letters).

dkeays
dkeays

@darth_schmoo @collioure I don't think I've read him (or her) pointing to any one party as the final answer. What makes the posts in question "partisan", the fact that they disagree with the president? 

Another piece of evidence that your alliance with the established powers is clouding your judgement.

collioure
collioure

I don't have a party.  I am not a partisan.  My posts don't play Republican vs Democrat.

We have one President.  I hope he achieves important objectives.  So far he isn't doing that.  He prefers to play politics and try things only his way.

Obamacare is all his way - a very partisan bill.  If he had sought a bipartisan effort to extend health care to all Americans, he would have the support of both parties during this implementation.  Most everyone would have an interest in a good outcome.

NooneOfan
NooneOfan

@BobGarrettRadio What are you talking about? Miners aren't Gov workers and the mines are privately owned by people who threaten the workers

BobGarrettRadio
BobGarrettRadio

.@NooneOfan It is extremely tough work that isn't getting done because it's government and they're not good at doing things.

NooneOfan
NooneOfan

@BobGarrettRadio I bet you don't even know what is in the bill.Do you know that Ins.Co. Have made your healthcare decisions since 1989?

BobGarrettRadio
BobGarrettRadio

@NooneOfan We appreciate the sentiment, but we know it's doomed to fail because it's a bunch of gov't b.s.