#28 – OBAMACARE VERSUS GOVERNMENT DISRUPTIONS – A RISK ANALYSIS – CAPERS JONES

Capers Jones pixINTRODUCTION
For almost two weeks the country (the United States) and the press have been mesmerized by the partial shut down of the Federal government and by the threat that the U.S. will default on its financial obligations due to failure to raise the debt limit.

These problems are due to conflicts between the Republicans and the Democrats on spending versus taxes, and more recently on the pros and cons of the Affordable Health Care act commonly known as ‘Obamacare.’

Both Obamacare and the government shut down have risks associated with them.  From the external viewpoint of an independent voter whose work involves risk analysis, neither side appears to have done a careful examination of any of the risks from either Obamacare itself or from the shutdown of the government.

Politics everywhere is all about risk.  This short paper suggests that shutting down the US government is a self-defeating activity and not effective in reducing the risks of Obamacare.

OBAMACARE RISKS
Obamacare has a number of serious problems that I believe will cause harm to U.S. citizens.  And, these risks have not been considered in the development and deployment of President Obama’s pivotal public policy.  Among these risks are:

  1. Increasing the number of insured without increasing physicians, nurses, or dentists.
  2. Increasing wait periods for elective surgery; long waits to see physicians.
  3. Higher insurance costs for the young and healthy to pay for the old and sick.
  4. Shifting  jobs from permanent to part-time to avoid health insurance costs.
  5. Hospitals cutting back on expensive services with low reimbursements.
  6. Physicians refusing new patients due to over loads.
  7. Decline in hospital care due to overwork by nursing staff.
  8. Excessive overtime and fatigue for nurses.
  9. Probable loss of medical personnel due to onerous clauses and reduced payments.
  10. Fining those who do not buy insurance – very unpopular and of questionable legality.

There are other risks besides these 10, but they are enough to show that Obamacare is not a carefully crafted piece of legislation.

OPTIMAL STRATEGY TO CONFRONT OBAMACARE RISKS
The optimal strategy for dealing with the Obamacare risks by the Republicans should have been the following:

  1. Perform a careful risk analysis of all features of Obamacare.
  2. Publish a factual itemized risk analysis that cautions voters and congress of the problems.
  3. Monitor the results of Obamacare and collect valid empirical data of results.
  4. Use the pre-Obamacare warnings and solid empirical data to repeal or amend bad features.
  5. Receive praise for being far-sighted and attract thousands of new voters.

This strategy would not have closed the Federal government, would not have put the debt ceiling in doubt, and would not have diverted attention from high government costs and Obamacare problems to the trauma of the government shutdown.

RISK FROM THE GOVERNMENT SHUTDOWN
It was Republican folly to try and stop Obamacare by subverting Congress and attaching irrelevant clauses to defund or cancel Obamacare to bills that have nothing whatsoever to do with health care.

From the day the U.S. government shut down local papers, news radio, and the national news services essentially stopped covering Obamacare and switched 100% to the spectacle of the government shutdown and the approaching debt ceiling.

The ineffective strategy of the Republicans in trying to block Obamacare before it goes into effect makes the Republicans look arrogant, selfish, and incompetent.   It makes all of their leaders and especially John Boehner appear callous about the harm being done to workers and to the economy.  It makes the tea-party fringe group appear to be totally callous about lost jobs, disruption of veteran benefits, closure of national parks, and all of the other collateral damages.

Worse, from the point of view of an independent voter (like myself) whose work involves risk analysis, the Republicans don’t even understand some of the more serious risks and have failed to point them out.

It is obvious that increasing patient loads without increasing physicians will make it harder for new patients to get accepted by doctors and will cause delays in many elective medical procedures.  But so far the Republicans have been silent on this issue as have the Democrats.

ADDRESSING OBAMACARE RISKS WITHOUT THE RISKS OF GOVERNMENT SHUTDOWNS AND DEFAULTS
The optimal risk strategy for the Republicans would not be to stop Obamacare by closing the government and threatening the debt ceiling and other unrelated bills.   The best strategy would have been to warn voters of the Obamacare problems and then repeal or amend the harmful Obamacare features when they occur. 

This strategy would not make the Republicans look dumb and would have had supporters among Democrats, since the harmful Obamacare features would hurt their voters too.  This strategy would have increased the popularity of Republicans instead of lowering their popularity, which is what has actually happened due to the government shutdown.

As it is the approval rating of Congress has dropped to 5% (yes, single digits); a majority of U.S. voters blame the Republicans for the mess Congress is in, and many Republicans will face increasingly severe challenges in the next election cycle with their opponents using the government shut down as an election weapon.

Risk analysis of both Obamacare and government closure indicate that the government closure is ineffective in reducing Obamacare risks.  Instead the ill-conceived Republican strategy diverts press and voter attention to the looming problems of the government shutdown and the risks of not raising the debt ceiling.  The actual risks from Obamacare have dropped out of the news.

Instead of trying to stop Obamacare from occurring, the Republicans should have welcomed it because it will cause a great many serious problems.  If the Republicans had merely published a solid risk analysis of these problems they would soon become very popular and could gain enough support to repeal or amend the worst Obmacare features.

Neither the Republicans nor the Democrats seem very sophisticated in risk analysis, but the Republicans have been alarmingly incompetent.  In fact the Republican actions have diverted attention away from Obamacare and away from high government spending levels.  What the Republicans have done is to focus press and voter attention purely on the Republican threats to the economy.

Neither side appears to care very much about the displaced workers.  In fact as of October of 2013 the Congress of the United States appears to have the lowest approval rating of any body of elected officials in the world.  This low approval rating is justified due to sheer incompetence.

Both sides blame the other for the problems.  In fact both sides are to blame.  But in the dispute about closing the government and the debt ceiling, the true risks of Obamacare have dropped out of sight and neither the Republicans nor the Democrats seem to know what they are.   The Republican policy has  caused new problems and has not eliminated any of the existing problems with Obamcare.

Bio:

Capers Jones is today’s preeminent software quality expert.  President Obama’s biggest mistake with his healthcare bill was not to consult with Capers on his website.  The Republican’s biggest mistake was not consulting with Capers on public policy strategy and political risks.

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