Sorry, but Obamacare is not President Obama's 'Iraq war'

http://www.theguardian.com/commentisfree/2013/oct/23/obamacare-website-glitches-not-iraq-war

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Someone actually went there: as the problems with Healthcare.gov moved into the vacuum created by the end of the government shutdown, National Review reporter Jonathan Strong Tweeted, "is Obamacare President Obama's Iraq war?" One can understand why Strong found the logic seductive. The Bush presidency was defined by the Iraq war; Obama has made the Affordable Care Act the centerpiece of his legacy. The Iraq war was a hideous, years-long fiasco, costing hundreds of thousands of lives and billions of dollars and the weeks-old strangled roll-out of the ACA insurance marketplace exchanges has … ok, wait. Here is how the ACA exchanges are not like the Iraq war (or the Bush mismanagement of the Hurricane Katrina aftermath), in one chart:

why you shouldnt compare obamacare to katrina or iraq, in one chart. cc: all pundits pic.twitter.com/wcRANjeaa5

— Oliver Willis (@owillis) October 22, 2013

As offensive as Strong's analogy is to, well, anyone, it's perhaps more instructive than he intended: imagine if the ACA had the kind of blindly optimistic bipartisan support enjoyed by the Iraq War. Imagine if the Obama administration had been able to embed reporters in among enthusiastic and over-prepared participants. Imagine if the ACA's explosions had painted pretty colors in the night sky. Instead, the ACA is the polar opposite of the Iraq war, not just in terms of aim (saving lives versus taking them), but in terms of a model for political cooperation and press coverage. The ACA created ruthless, even suicidal political opposition: if the Democrats had responded to even the rumors of disaster at the beginning of the Iraq war (and we were warned) the way that the GOP has dug its heels in on Obamacare – shut the government down until Bush admitted defeat and withdrew – then the chart of how many deaths each had caused might not look quite as tragic. Though it would still look pretty tragic. Looking at press coverage, you might think it's hard to even begin a comparison because the healthcare rollout itself had hardly begun. But that's actually what the two events have in common: just as we were quick to declare the Iraq War a success based on a shiny beginning and short-term successes, so has the mainstream press decided that the ACA is a failure based on a set of stubbornly dysfunctional websites. Preference for anecdotal evidence is at the heart of both premature judgments. The Obama administration's failure to embed reporters among the populations that stand to benefit the most from the insurance exchanges doesn't, after all, mean that reporters aren't falling for the same kind of "if I see it, it must be representative" delusions that characterized Iraq war reporting. It's just that in this case, they're visiting a website and not Fallujah. And if their bias is to find the project a failure rather than a success, it's because there's no drama in a successful but tedious process. First-person accounts of reporters trying to use the exchanges litter my newsfeed, some historically sympathetic to the Obama administration and some not: Ryan Lizza, Josh Barro, Josh Marshall, Sally Kohn. A glance at Fox News yields another batch of dissatisfied customers, even though many of them became dissatisfied around 8 November 2008 and can't really be properly called "customers": a Salon columnist followed-up with a panel of Sean Hannity ACA would-be eyewitnesses and found that none of them represented their experience fairly; one family wasn't even planning on using the exchanges. Perhaps you think I shouldn't equate the reports of journalists with those of the more obviously cherry-picked Fox News Obamacare opponents (although, it should be noted that Sally Kohn not only had a positive review of the site but was able to shop for a plan). Here's how they're all alike: none of them have much in common with those the exchanges were designed to serve. The paradox of the ACA and the exchanges is that the ACA is the largest change in federal policy a generation. But the exchanges are designed to serve a tiny subset of the American people: 7%, to be exact. That's about 18 million people – the number of Americans who neither covered by Medicare or Medicaid, don't have employer-based health insurance, or are otherwise exempt from the mandatory minimum coverage. About half that number of people visited Healthcare.gov in the first four days it was open for business. What's more, Healthcare.gov – the federal site that's gotten the most attention, and had the most problems – wasn't even supposed to be the main portal into buying coverage. The overloading of that site is due almost entirely to the intransigence of Republican state legislators who punted on the development of their own exchanges. Reporters who giddily write up their personal trials in signing up on Healthcare.gov are representative in one very real way: most of the other people visiting Healthcare.gov are also not seriously in the market for health insurance. A Pew poll found that only 29% of the visitors to the federal portal were actually uninsured, and only 32% were in fact shopping for coverage. Pew also found that most of those who had visited the site did not think the "exchanges overall" were working very well – just 37% said they were. Questioned about their personal interactions with the site, however, 56% said the site was "easy to use". Maybe I'm reading too much into that 20% swing: Maybe people were telling Pew the site was "easy to use" even if they failed to actually procure coverage, but it sure seems like a significant number of respondents were willing to discount their own experience and instead go with what they've been hearing and reading on the news. I don't think, or I don't want to believe, this cognitive dissonance can be sustained. One of the reasons the Bush administration was able to prosecute the Iraq war long after those in the thick of it knew it was a disaster was that so few members of the public actually had direct contact with the tragedy. (We have effectively outsourced the ugliest parts of our foreign policy – and drone strikes have allowed us to automate them.) The tragedy of the American healthcare system, for better and worse, can't be covered (or covered up) in the same way. It may be that the ACA dies under its own weight. It may be that the online exchanges never work, that young people refuse to enroll, that giant Uncle Sam figures invade our private parts and death panels begin to convene. But when and if those things happen, people will know because it will happen to them; the reporters that are bemoaning the program launch are not canaries in the coal mine, they're just whistling in the dark.

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