Assessing the Failure or Success of the PPACA

Writing at Fiscal Times, John Wasik produces what to my eye is a pretty fair set of benchmarks for determining whether the PPACA has succeeded or failed:

To date, about half a million Americans have applied for insurance through the online marketplaces, although the government isn’t saying how many have been able to get through the ongoing technical problems to actually buy a plan. Yesterday, President Obama said he would concentrate on fixing the snafus.“The website has been too slow, people have been getting stuck during the application process,” Obama said on Monday. “And I think it’s fair to say that nobody is more frustrated by that than I am – precisely because the product is good, I want the cash registers to work. I want the checkout lines to be smooth. So I want people to be able to get this great product. And there’s no excuse for the problems, and these problems are getting fixed.”Let’s take the president at his word and assume the website problems get sorted out, and fairly soon. How will Americans know if Obamacare is a success or failure? Here are four benchmarks…

Here are his benchmarks:

  • Will the Government Exchanges Be Competitive with Private-Sector Prices?
  • Will Customer Service Be Adequate?
  • Will Out of Pocket Costs Be Reasonable?
  • Will Those Who Need It Most Get Covered?

Read the article for analysis and his preliminary assessments. I’d suggest an even more basic standard: by March 31, 2014 will more people have healthcare insurance than did on February 1, 2009?

None of these, of course, satisfy the benchmark I’d like to see addressed: is real per capita healthcare spending lower than it was on February 1, 2009? If real per capita healthcare spending continues to increase faster than income, it will sink the budgets of many state and local governments not to mention private companies and individuals.

12 comments… add one
  • TastyBits Link

    “Obamacare” is a political issue. As @michael reynolds has noted many times, the policy has no bearing on “Obamacare”. The success or failure will depend upon how many more people think it has failed, and this need not be based upon facts.

    If people think that the website is “Obamacare”, the website will be a significant factor in their decision. Presently, “Obamacare” is a failure.

    It is amazing how quickly one’s political future can change. Hubris has a way of catching up with you.

  • PD Shaw Link

    One benchmark will be whether it functions without need for additional legislation or appropriations from Congress. Cause I don’t see that happening.

  • jan Link

    The latest fly in the government website ointment is that the information being disbursed may be misleading, and ultimately inaccurate: Feature Often Lists The Wrong Price For Coverage

    Industry executives CBS News spoke with could not believe the government is providing these estimates, which they said were useless and could easily mislead consumers. They also said that the website repeatedly states the actual prices could be lower, but it makes no mention that they could be higher.

    Perhaps Michael should take note of this before he gets too excited about how much money he’s going to save.

    Other down-the-road developments, marking the failure or success of government-created healthcare, are laid out in the following WSJ piece, taking you beyond the computer malfunctions and into the more important and enduring realities of the unintended consequences these HC changes may create:Obamacare 2016: Happy Yet?

    the predicted shortage of 42,000 primary-care physicians and that of specialists (such as heart surgeons) was vastly underestimated. It didn’t take into account the ACA’s effect on doctors retiring early, refusing new patients or going into concierge medicine.

    The uninsured poor now have insurance, but they can’t find a doctor, so essentially the ACA was of no help.

    Steve, for instance, seems to refute notions that doctors will retire early, or there will be fewer individuals inclined to become doctors — possible negative repercussions of the PPACA, leading to a decrease in the quality of health care because of stretching an increasingly thin film of services across more people attempting to access it.

  • jan Link

    When you really put it all together, think how much fun a person can have signing up for the PPACA!

    First they can hang out by their computer screen for up to a day, just waiting to get through the maze. Then they can hand over all their personal information, on a site that is a ‘hacker’s dream,’ exposing themselves to identity theft. Then they finally access ‘Candy land,’ having the long-awaited ability to browse HC options and get quotes, that actually may prove to be wrong, by either their over/under estimations of premium costs.

  • Red Barchetta Link



  • Roy Lofquist Link

    “March 31, 2014 will more people have healthcare insurance than did on February 1, 2009?”

    How about 10 million fewer people with health insurance? The news are replete with stories about 300,000 here, 160,000 there policies being cancelled because they do not meet PPACA guidelines. What do you suppose will happen when the insurance companies are faced with 5 to 10 times the normal volume of applications? Maybe the same thing that happened when mortgage foreclosures quadrupled in volume. A real cluster conjugation on the way.

  • jan Link

    It’s getting to be as simple as who do you believe, when explanations are given as to the etiology and extend of this HC roll-out. The contractors, for instance, parroted by the government, are calling these problems “isolated.” However, the insurance industry has a whole other interpretation describing the array of glitches as widespread across the entire insurance industry!

  • How about 10 million fewer people with health insurance?

    I think that such a prediction is premature. Some of those whose insurance is cancelled will qualify for Medicaid under the new rules. Others will obtain insurance via the healthcare insurance exchanges. Still others will just go without insurance.

    If the first two possibilities come to pass, it’s also possible (even likely) that the cost of the PPACA right out of the gate will be substantially higher than originally projected.

    In summary, the total number of people insured could be lower, the same, or higher. There’s no way to tell. We’ll just need to wait and see.

    My off-hand conjecture is that on April 1, 2014 the scope of the problem of lack of healthcare insurance will be about the same as it was on February 1, 2009, healthcare will be substantially more expensive, and a bit more than five years will have been allowed to elapse without addressing the fundamental problem of cost.

    Note that if the PPACA achieves the goals set for it by the administration the percentage of people without healthcare insurance will decline from about 15% of the population to about 12%. Three stinking percent. That’s what I complained about when the law was enacted. All of this Sturm und Drang and five years to insure just 3%.

  • Roy Lofquist Link


    Looks like we have a date for April fool’s day. Dinner and a show? Or maybe franks and beans and a Dobie Gillis rerun?


Leave a Comment