Citizenship Fraud

An old boss of mine used to comment that a primary task of auditors was to find bruises and turn them into cancers.  He could have substituted “the press corps” for “auditors” in that statement and been more correct.  I’ve been reluctant to join the vultures, mostly politicians or wearing press badges, picking at the carcass of Obamacare.com, but sometimes the urge to speak truth just can’t be set aside.  President Obama himself is being accused by some who should know better of fraudulent misrepresentation of the legislation, which is completely aside from the real issues involved.   For political reporters, accusations of misrepresented legislation are much easier copy to write than analyses of inept implementation, but accusations should be left to the politicians.  And second, I’m tired of hearing apologies from the White House for the wrong things, which serve mightily to assist the press in their muddling. 

As a matter of personal history, I’ve been in on a number of mad scrambles to make computer systems work in accordance with legislative deadlines, so I know the territory.  That you’ve mostly never heard of them simply testifies to the fact they were accomplished on or before schedule; you only heard about the legislation, which is how things are supposed to work.  But the important fact was that whether or not the systems were ready on schedule would not have affected whether the legislation was good policy or not. A lot were decent policy, but one effort I coordinated, elimination of the Social Security minimum benefit during the Reagan Administration, I personally thought was lousy as policy; we got it ready on schedule anyway.  Again, that’s how things are supposed to work.

The Obamacare.com implementation has been inept, mostly because some mid level bureaucrats were not knowledgeable about how to set up complex implementations on tight time frames (using 47 contracting firms is ridiculous!) and other upper level bureaucrats were lax about monitoring or interpreting the impediments to upward flows of information in their organizations.  And the White House suffered the common second term propensity to think that, just because the upper level bureaucrats are “our guys”, everything is going to work out fine. But the real issues there also include an outdated and ineffective organizational structure that contributes to mismanagement and contracting policies that have veered so far in the direction of promoting competition that efficient operations are verging on impossible, and those issues have mostly gone untouched.  And both structural and contracting policy issues are the product of congressional emphases over several administrations on reducing the number of employees counted in the budget; government is reduced in name only by use of contractors as for-profit agents, actually raising costs, to perform tasks far more effectively managed as an internal operation.  So there’s enough blame to spread everywhere.  Apologies are due, but they should be coming from all directions.

Meanwhile though, just the White House keeps apologizing.  President Obama accepts blame for having said ObamaCare “would not force anyone to change their doctor” when that, in fact, is absolutely correct.  For it to be incorrect is to include in ObamaCare the vast array of insurance companies which have steadfastly fought against government regulation of their premium rates and it is to hold ObamaCare responsible for the high prices charged by, again unregulated, medical service, prescription and equipment providers.  It is correct only in the sense that poor people who have been captive to the insurance-in-name-only companies are now being charged rates they cannot afford for real coverage, by the insurance companies and not the government.  Many of these, though not all, are people struggling at or near the poverty level who feel unable to afford better coverage than the pitiful amount they have received up to now. 

What has happened is that the insurance companies have been forced to cancel super-cheap semi-fraudulent policies that did not even cover the cost of going to a hospital.  Irresponsible individuals not poor, who have been purchasing them expecting they’ll never be used or that they will in an emergency rely on public hospital emergency rooms at public expense, are facing the need to pay a higher premium, and rightly so; they have, whether willing to admit it or not, been perpetrating a genteel fraud on their fellow citizens.  The government itself is not forcing anyone to change their provider of choice.  They are bringing a spotlight to bear on the seediest part of the health insurance industry, and that is one of the better features of the legislation.   Upgrading standards of what constitutes adequate health coverage has been a goal from the beginning, and eliminating this practice is a vital part of that upgrade.  For that, thanks, not apologies, are in order.

A valid policy issue is how better to handle the issue of transitioning individuals to adequate coverage.  The fundamental problem is how to care for those who are ill strictly, as at present, on a for-profit basis.  Other nations with health systems rated far better than ours have achieved good health care by insisting it be on a not-for-profit basis.  As I’ve noted before, extending ObamaCare to a Medicare-like system with a flat premium rate for all would be a major step forward in that direction.

I call it a fraud on other citizens when you knowingly pass on to them costs for which you rightly are responsible and deny basic needs to others simply to increase your own prosperity.  The real need for apology  is by the wealthy, individuals and businesses, who expect the fellow citizens who work for them to live in or near poverty, while at the same time the employer prospers by paying wages below the poverty level and fights against the very health coverage they shed crocodile tears about, passing on its costs to others.  A case in point is the current situation where Wal-Mart fights tooth-and-nail against increasing the minimum wage up to the poverty level while at the same time providing baskets for public donations to help its employees in need.  Being a good citizen of either community or country should not include preying on the poverty of others.