You think ObamaCare is bad now?

   There's an old polygamy joke that goes like this:  

Question: What's the punishment for having more than one wife ?  

Answer :  Having more than one wife. 

     So also one might say the punishment for having big government is having... a big government to deal with. 

     We have all heard the horror stories of people doing business with those in government   How it's slow, unresponsive and lacking in concern and feeling.   Just look at how people fly thru the DMV at a snails pace.  People waiting in chairs for hours because it makes no difference to those working in the DMV if they serve 5 or 500 customers a day.   They will still have their jobs and their cushy retirement programs.  But now we have ObamaCare which is the "DMV on steroids" with millions of people waiting line rather than a few hundred.  The federal government's computers and computer networks and databases were never designed to work in the real world and in real time.  They were designed to be accessed by a few thousand government bureaucrats working on government computers.   It was never designed to be accessed by millions of people with a variety of computer interfaces outside the government networks who want answers NOW not in 1 to 3 days.  Some have argued that the IRS deals with large numbers of people so why can't ObamaCare ?  Simply because processing 1040s at your leisure ( you submit your data to the IRS and they get back to you at a later time) is completely different than processing requests real time.  

     I think ObamaCare is a gift to those who believe in small government as it shows us all how bad it really can be.  After all, most Americans do not deal with the federal government on a regular basis.  For most of us, April 15th is really the only time we interface with an agency of our beloved government.  But now, thanks to AHA millions of us will be getting a daily dose of government run healthcare and will see how bad it can get.  I think it to be hilarious that those who have never run a business let alone a website have taken on more they can handle as all it takes to bring the system down is one slow unresponsive database or network and crash goes the system. So often politicians tell us "We sent a man to the moon and back ... we can certainly do ______".   But it's one thing to cram 3 men in space capsule and hurl them 238,000 miles into space and back and it's another thing to handle 1/6 of the nations economy and handle millions of people with millions of differing health issues and needs.

     Of course we are now hearing the excuses from the media about how this is just version 1.0 and things will get better in 2.0 

Why I don't think it will get better

1) ObamaCare is a mess to start with:

ObamaCare Flow Chart

    With over 3000 pages and thousands of pages of regulations and exceptions yet to be added, it is the perfect example of something that was "designed by committee" by people who have never worked a day in their lives int he private sector.  In my company we call this "powerpoint engineering"  where all looks great from a Powerpoint presentation slide but the real devil is in the details of implementation.

2) ObamaCare is a moving target:

    Every day new regulations and exceptions are being added.  Who's not eligible and who is and for how much.  This becomes a programming nightmare for those doing the software development.  The main challenge of ObamaCare 2.0 won't be in fixing the user interface issues, instead it will be incorporating the AHA 5.3.1.2.a  changes that either someone in HHS or Congress has requested.  Going back to the NASA example, the main thing that allowed NASA to land a man on the moon was that the moon has a regular stationary orbit that obeys the laws of physics which does not change.   Government, industry, and the medical field are not.  Peoples needs change constantly.  The medical field is constantly evolving and improving.  Medical procedures that were not even thought of 10 years ago are common place today while methods used 10 years ago are now extinct.  Likewise the business and internet landscape morph as newer ways of communicating and paying for our services come about and business adapts to these changing needs.
   
     If history is any predictor of the future, we will see countless "glitches" to come.  Like a dog who pees on a tree to leave his mark over another dogs, so also bureaucrat after bureaucrat will come in want to "change" the system make their mark on it 

    .... only in this case WE ARE THE TREE.

3) Government systems were never designed to be efficient

     As I mentioned before, it's one thing for a system to be accessed by a government worker who has nothing better to do with their time that wait for a response (they get paid anyway) and it's another thing to have a system designed to be accessed by person who does.   

     ObamaCare is the first time in our countries history that we are witnessing the government try to "compete" (if you can call it that) with the private sector.   In their smugness our politicians have over-sold themselves with their "Yes we can!" chanting and now they must deliver on what they promised and so far many are very very unimpressed. 

4) Enrollment is the EASY part... delivering the goods is the HARD part

    In a famous episode of Seinfeld, Jerry lambasts a rental-car agency clerk who did not have a car for Jerry even though he had a "reservation".   He informs the agent, "Anyone can TAKE a reservation, its the KEEPING of the reservation that is the important part!".   

    Likewise , ask anyone who works in sales and they will tell you receiving the orders is the easy part, it's the delivery of the product that is difficult.  Given this, ObamaCare enrollment should have been the easy part for them and paying for it all even harder because you will have the system accessed by millions of workers from doctors offices, to hospitals and clinics around the country.  All of them trying to access the system for payment or to see if you are enrolled or not and whether or not they will pay for procedure X.   Now imagine, you standing in the doctor's office waiting for them to access your records... waiting ... waiting ... waiting.   It's one thing to tell a person at home on their computer to "Please try again later" and it's another to have them stand there for hours waiting for an answer.  If you think I am just trying to scare you, look at Canada.  A recent government study of their own healthcare system showed that the AVERAGE wait time to see a doctor was 17.7 weeks. That is almost 5 months!   Can you imagine you wake up one day and you have blurry vision or constant dizziness and you need to see a doctor but the soonest they can see you is in 4-5 months?   (also, that is an average wait time which means would could be waiting for 7-8 months in some cases).   That is what awaits us with ObamaCare in the future.

5) ObamaCare doesn't need to get better.... they just have to make the others suck more!

    The only way for government to compete with the private sector will be to constantly change the rules of the game and thus penalize their opponents in order to win.   This puts the government at unfair advantage over its "competitors".

     Take for example the mandate that insurers must take people with pre-existing conditions.  This allows people to hold off on paying for health insurance (they will still have to pay the penalty) until they need it.  But private insurers need these healthy customers to help pay for the less-healthy.   Without them, they will need to raise their rates to cover of cost of the ones who do.  This is liking bring your car on a flat-bed truck to the insurance company to buy insurance AFTER you've had an accident.   If insurers were forced to take you as a customer, no one would buy it until they needed it and all the insurers would go broke.

   Secondly, the government can force the private sector to pay for procedures and drugs that are too costly for them since they don't own a printing machine that prints 100 dollar bills like Congress does.  This leaves the private companies with no other choice other than to raise their rates to cover those costs as well.

    All of this will then force more and more people over to ObamaCare until all that is left is a single-payer system.  (kind of what they had in mind... don't you think?)  

6) The political class will not be using ObamaCare

    You may think that if we end up with a single-payer system, won't it be in Congress's best interest to make ObamaCare work too since they will be using it as well?   Answer: no.    This is because they have (and will always) exempt themselves from their own law.  They will be able to pay for their own healthcare without using the government system.  Watch and you will see the development of a large group of doctors and hospitals grow up around Washington DC to serve the political class directly.  They will get excellent healthcare while the rest of us will be standing in lines that would make a DMV worker blush.   For just like they see no reason to improve the TSA because they fly in their own government-run jets, they will have no incentive to improve the single-payer-healthcare system either.

7) Scam-ers and hackers will make it even worse.

   With every government program that doles out money, the scam-ers are bound to follow.   Medicare, for example, has been a bonanza for scam-ers to tap into and bilking the program for billions of dollars of fraud and abuse every year.   ObamaCare will undoubtedly eclipse Medicare fraud in little or no time at all.   A common way for them to do this is to submit bogus claims and abuse the new ObamaCare medical codes (there are thousands of them now) to get payment for services not performed.   Still others will milk the system by acting as ObamaCare advocates and surrogates.  These people will promise to help people "navigate" the complex world of federal healthcare only to leave the people in worse shape than they started.  They will prey upon the fears of the elderly and the uneducated and will con them out of their hard earned savings by claiming to have connections not available to the average person.   

    

    Finally, computer hackers looking for a new target will set their sites on ObamaCare to:

• Terrorize the system (for fun or for profit)
• Gain access to valuable information (SS#, Tax records, Medical Records, etc..)

     To keep ahead of this, the programmers will have to patch their software on a daily and maybe even hourly basis to close the various backdoor-entries and prevent:

• Trojan horses
• Invalid-code entries
• Worms 
• Viruses 
• Data-miners
• Password-loggers

    So if you still think that ObamaCare 1.0 will get better under 2.0 there is nothing more I can do for you other than to say "Good Luck!" and tell you to bring something to read when you go to the doctor's office .... you'll need it!