The roll out of ObamaCare (aka, ACA) has been gloriously incompetent. Websites that don't work, near zero testing of said websites after spending $600 million on just one of them and so on. I'm even told that they haven't even started writing the payments system yet. But there's yet one more story that has me shrieking with laughter:
While the Affordable Care Act requires health insurers in the territories to accept all shoppers no matter how sick, it does not mandate that all territorial residents buy plans nor does it provide subsidies to make coverage more affordable–as it does in the 50 states and the District of Columbia.
To explain a little here. The ACA says that anyone can buy an insurance policy, even to cover a disease that everyone knows they already have. It also says that the insurer can't vary the price of that policy based upon what is known: they can only charge something around and about what everyone else is paying. This, on its own, would kill any insurance market stone dead because the very sick would be charged the same amount as everyone else, meaning that only the very sick would insure themselves as the price would be so vast. So, to solve this there is the mandate: you must buy insurance or pay a fine. This is meant to make sure that younger and healthier people buy insurance and so all policies are cheaper.
Hmm, OK, it's a bit Heath Robinson but that's the way they designed it. Except, unbelievably, the policy wonks who toiled away on this vast bill made a very simple error. That mandate rule applies only to the 50 States and DC. And not to the other, non-state, territories of the US. Various Pacific islands, Puerto Rico and so on. Where, inevitably, the insurance systems are going rapidly bust.
This is the thing about Adam Smith's man of plan. The world is more complex than a plan allows it to be: which is how we get all those very bright people in Washington DC devising a plan that has such a glorious and gaping hole in it.
Oopsie. Next time someone proposes that the government step in to fix something, remember how badly they got this wrong.
Quite. As with the military maxim that plans never survive first contact with the enemy. So it is that complex plans about governance never survive first contact with reality.