OBAMACARE OCTOBER 25, 2013
Sorting out the commentary on Obamacare is a lot less important than sorting out Obamacare. But an interesting and potentially important debate has started in the last few days—one that gets at why the failures (so far) are so depressing and how (hopefully) the administration can fix them.
It all started a few days ago, when Joan Walsh of Salon wrote a column in which she criticized liberals for criticizing the administration and the website so quickly and forcefully. Her two examples: Ezra Klein of the Washington Post and Ryan Lizza of the New Yorker. Wrote Walsh:
Don’t get me wrong: The problems with Healthcare.gov are real, and disturbing, and must be fixed asap. (Think Progress has a dispassionate assessment here.) But excuse me if I believe the president knows that without my telling him. It’s like watching the 21st century version of the rise of the Democratic Leadership Council, and I feel the way I did back then: On the one hand, yes, it’s important for Democrats to acknowledge when government screws up, and to fix it.
On the other hand, when liberals rush conscientiously to do that, they only encourage the completely unbalanced and unhinged coverage of whatever the problem may be.
Klein responded on twitter, “Kind of shocked at this piece from @joanwalsh. My job is to cover Obamacare accurately, not instrumentally.” Later Walsh’s colleague Brian Beutler wrote his own piece at Salon:
Liberals are contributing to the ongoing public relations fiasco, but that’s a good thing for the law. If the only people making noise about Healthcare.gov were its avowed enemies, decision makers in the administration would be much more likely to create false bases for denying the extent of the challenges.
A few stipulations: I like all these writers and read them regularly. The media and political reaction to healthcare.gov has sometimes been disproportionate to the actual problems on the site—and ignorant of the very real successes, particularly among states running their own marketplaces. Republican hypocrisy about the problems is difficult to stomach, given that they not only wish the law to fail but also have (in some cases) tried to make failure more likely. And Walsh was not, to be clear, asking anybody to ignore healthcare.gov or misreport the facts. Her column was all about framing, tone, and emphasis.
But I think the emphasis so far has been more right than wrong. And one reason is that I'm a lot less sure Obama and his advisers understood the extent of problems "without my telling him," as Walsh put it. This is a familiar problem of the presidency—the infamous White House "bubble." Truth is, officials at the White House and maybe even at the upper levels of the Department of Health and Human Services did not grasp the extent of website problems before it launched. Administration officials have admitted as much already. And if you spoke to them in the aftermath, or even listened to their public comments, it’s clear the full realization hadn’t sunk—at least right away.
They would talk of glitches and delays, when in fact problems with the early stages affected most visitors and those same delays were masking other, deeper design flaws that have come to light only recently. As late as Thursday, on a conference call for reporters, HHS officials were describing problems as largely a function of traffic. Nobody I know believes that. A lot of this was spin, obviously. But given recent history, making sure officials understand the extent of problems is very much a first order priority for anybody writing about the situation, if only to make sure officials realize the big challenge ahead.
Another reason for liberals to make a fuss about these problems is that liberals are the ones who believe in government. That’s not an easy claim to make and defend these days. If polls are right, faith in government to accomplish little things, let alone big things, remains near historic lows—and a far cry from the peaks of the 1950 and 1960s, when government was sending millions of veterans to college, building the interstate highway system, and capably managing a new social welfare state. Episodes like these first few weeks of Obamacare online make it harder. By highlighting the flaws of healthcare.gov, liberals show that they, too, expect government to work—that subpar performance is no more acceptable in the public sector than it would be in the private sector. That’s something the skeptics need to hear, as Obama himself knows. A cornerstone of Obama-ism is that government can be an instrument of good—and that you build faith in it by delivering real, if incremental, progress, so that skeptics are willing to give it more opportunities in the future.
Of course, the criticism can go too far. It feels like every software and web developer in America is sure that he or she knows exactly what is wrong with heatlhcare.gov (and, by extension, that he or she could have done a better job of designing it). Few people appreciate the complexity of the task the government faced, or the political constraints. Those of us in the media can also get carried away. The other day I appeared on the public radio show "On Point." The host, Tom Ashbrook, asked me if I thought the online introduction of Obamacare had been a "fiasco." I said yes. It wasn’t much different from Klein’s characterization—a “disaster”—that landed atop the Drudge Report and reverberated in the right-wing press. But, upon thinking about it, both verdicts are wrong or, at least, premature.
If the problems don't get better—if the system is not running reasonably well by late November or early December—Obamacare will have some serious and potentially lasting problems. People need to sign up for insurance by the middle of December if they want January coverage, and for many people current coverage is lapsing at the end of the year. If it comes to that, the administration will need to find workarounds and develop “break-the-glass plans,” absolutely none of which are easy or without their own drawbacks.
But what was true before October 1 is true now. The administration has time to get things right—a few weeks, at least. Tough coverage, even from its friends, makes that success more likely.
Update: Just to be clear about something, in case the item above leaves any doubt, I'm a big believer in health care reform—as a moral imperative and a rational response to an economic crisis. Most of you know that. But I also believe the first job of all journalists, even opinion journalists, is to convey information truthfully. Sometimes that means reporting inconvenient facts, or even harsh ones, no matter what the effects on politics or policy.