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The Obama Method, or, How to Complicate Everything

There is the hard way to get something done and then there is the most difficult way possible, otherwise known as the Obama administration method.

In fairness, introducing insurance exchanges to millions of previously uninsured people was always bound to be difficult, regardless of how much time was given for the rollout and, really, under any circumstance at all. At this point, however, it appears that while the administration should have been working on the HealthCare.gov website, they were instead getting sauced on a heady cocktail of inattention and incompetence, making the website’s rollout a more difficult exercise than it needed to be. For example, dozens of contractors were signed to the project without clear performance terms, while the agency in charge of coordinating the entire operation was hog-tied by politics and bureaucracy. So far it seems that the administration’s disinterest in methodically executing their signature piece of legislation has proven to be the new law’s greatest liability.

Still, it is important to keep this spectacular bureaucratic face-plant in perspective: today, Social Security is the closest the nation has come to the sacrosanct in American politics. George W. Bush, for example, could invade several countries, but his attempt to privatize Social Security was a nonstarter. However, this devotion to old age insurance wasn’t always a given.

Before Social Security was introduced in the 1930s, Americans’ pay was not reported to the government, and neither workers nor employers had unique identifiers. What’s more, the rollout of the Social Security wage reporting system in 1938 did not go smoothly. Many employers were not properly reporting either the name or the number of their employees. According to the Social Security Administration:

An early crisis took form as the “John Doe” problem. Many employers reported earnings without providing a worker’s name or [Social Security Number]. The first report from the Bureau of Internal Revenue did not contain SSNs for about 12 percent of the wage items—and this rapidly increased in subsequent reports. The BOAI dubbed reports without SSNs “John Does.” The Bureau quickly established procedures to contact employers for the identification information, and the “John Doe” rate decreased substantially, to 2.5 percent as early as 1939. A series of articles by Drew Pearson, a muckraking journalist of the period, repeatedly raised alarms about the John Doe problem and eroded some public confidence in the program. However, by the time the Pearson articles were published, SSA figures showed that John Does were less than 1 percent of total wage reports, suggesting the articles reflected political differences rather than administrative inefficiency. Nevertheless, the Bureau would continue to receive incorrect names or SSNs on employer wage reports, and determining the correct identification information—and educating employers about the importance of supplying correct information—remained a large task into the 1950s.

Where can one find the chronicle of this bureaucratic fiasco? On the Social Security Administration’s own website, filed under the picturesque title “Challenges Yesterday and Today.” Barring an unforeseeable catastrophe, it is unlikely that this difficult website launch will occupy a more central place in American political history than the Social Security Administration’s inability to figure out which paycheck belonged to which person.

Then again, who knows? Unlike Social Security, Obamacare and HealthCare.gov grew out of a conservative proposal introduced by the conservative Heritage Foundation and inspired by Massachusetts’s not entirely successful health care initiative, popularly referred to as Romneycare after the Republican governor who championed the law. Social Security, on the other hand, was an offshoot of old age pensioner insurance, which had been used successfully in the United Kingdom since 1909 and was championed by America’s favorite Brit, Winston Churchill. The OAP’s American cousin was the “Wisconsin Idea,” the intellectual and practical blueprint for government-run, mandatory old age insurance.

The truth is Obamacare will succeed or it won’t, and its success will have nothing to do with the usability of a website slapped together at the last minute. Rather, the policy will gain traction if the basic idea—private health care bought and sold in the marketplace—proves to be a good one.

After providing federal and state health care websites with a truly astonishing amount of information, I suspect the relative simplicity of a system like, say, Great Britain’s National Health Service will seem alluring. In that country, a new resident is simply required to give name, age, gender, and a National Insurance Number to receive health care services.

Whether the law is a good one will have nothing whatsoever to do with the usability of computer systems, but whether the decision to eschew a single-payer option in favor of a complex, unruly computer-based system was the correct one.

Image: All thirty-five possible hexominoes, created on September 12, 2008, R. A. Nonenmacher / Wikicommons