Obamacare and the Three Errors

| October 29, 2013

hornetsnest

[made some minor edits and corrected a few typos]

A friend of mine, a staunch Obamacare supporter, made a comment the other day, saying in effect, “Since you Republicans are complaining about the lousy website launch, you must have already conceded the argument on healthcare reform itself.”

Well, no.

The current mess we find ourselves in, and will likely find ourselves in for years to come, is, I believe, due to three separate, distinct, and major logical fallacies or errors, each of which merely compounds the previous one.

Error The First: Doing anything is better than doing nothing.

In architecting a new program all the serious mistakes are made in the first day.

(Martin, 1988; cited in Maier & Rechtin, The Art of Systems Architecting)

This first error comes from something of a compound fallacious syllogism. Let’s start with an initial premise:

Premise 1: The situation with healthcare in the United States needs improvement.

This premise itself almost begs the question, since you can replace “healthcare” with just about any subject and still assert this a valid premise. For example, “the situation with bike lanes in the United States needs improvement.” Or, “the situation in the United States with online advertising needs improvement.” Since we do not live in a perfect world and a perfect society amongst perfect beings, virtually any such statement stands a chance of gaining some level of support. This begging-the-question is a strong argument for a limited, part-time legislature, on both the national and state level, since legislators with too much time on their hands will start looking around and saying, “Hey, the situation in [the United States/my state/my district] with [pick random topic] needs improvement, so let’s write some new laws!”

On the other hand, the increasing rise in healthcare costs, combined with the increasing rise in insurance payments and the difficulty for some people (myself included) in getting insurance as well, makes this a premise that one can readily grant, so let’s accept the premise for the time being.

Next, then the argument is extended to:

Premise 2: The government can do something about healthcare.

Conclusion 1: Therefore, the situation with healthcare in the United States needs government action.

Premise 2 is on shakier ground, since it is not inherently apparent that the government can do something useful or helpful about healthcare. This is, in fact, one of the fundamental differences between Left and Right/Libertarian, and this is where the argument really fractures. This is why the Left — consciously or not — almost always veers to a statist approach: if you just give us enough money and power, and let us choose the smartest people to do things, we can make everything better. We can legislate and spend our way to Utopia!

The Right and the Libertarians, by contrast, have grave doubts about the perfectibility of man as well as a solid grasp on the inherent corrupting effects of power and access to other people’s money. They tend to believe in complex adaptive systems rather than top-down control.

But let us grant, arguendo, a more specific Conclusion 1, which now becomes the first premise of our next argument:

Premise 3: The situation with healthcare in the United States can, in fact, benefit as a whole from the right government action.

The next step requires another premise which is often assumed by the Left because they believe that they simply Know Better and are Smarter and Wiser:

Premise 4: It is possible to determine and specify the right government action that will improve, as a whole, the situation with healthcare in the United States.

This is actually a very tricky assertion and based on lots and lots of unvoiced assumptions and beliefs, starting with whether we has humans can actually see all consequences of such actions. History says no; the historical record is full of unintended consequences, quite frequently unpleasant, deriving from well-intended government action, whether such action is promulgated by the Left or by the Right. Again, the whole “healthcare reform” initiative can founder on this premise alone. But again, arguendo, that Premise 4 is true, at least under some circumstances, we are presented with Conclusion 2:

Conclusion 2: Therefore, we should specify the right government action so as to improve, as a whole, the situation with healthcare in the United States.

That sound you hear is the ice of logic cracking beneath our feet. We have just inserted a moral imperative into a logical argument: because the government can do something, it should do something. Of course, politics is very much about the particular moral imperatives of a given viewpoint, so we’ll allow it. And to be honest, if we reach this point — if we truly believe we can specific the right government action that will improve, as a whole, healthcare in the United States — then I think there could well be bi- or tri-partisan consensus on such actions.

The problem, of course, is that the Democrats — the Obama Administration and the Democratic-controlled Congress — didn’t stop there. Instead of working with the Republicans for a set of small, carefully thought out, and low-impact steps, they went for the whole shebang. And their fundamental argument — often vocalized as such — instead was:

Premise 2: The government can do something about healthcare.

Premise 4b: Doing anything is better than doing nothing.

Conclusion 2b: Therefore, anything we choose to do is better than doing nothing.

Now, it’s a bit more complicated than that, because the “anything” that the Democrats chose to push through Congress — with no Republican participation — reflected (to the extent it was coherent at all) the statist tendencies found in the Left. One can, in fact, argue that many of the currently emerging unfortunate consequences of Obamacare were, in fact, fully envisioned and hoped for. But few Democrats want to go around saying, “But we wanted your premiums to go up and for you to lose your existing plans”, so they revert back to “But the current system was unsustainable, so we had to do something, and you can’t make omelettes without breaking a few eggs” or words to that extent. In effect the Democrats are arguing that their good intentions justify not just the means but the ends as well.

And that’s how we got Obamacare. Speaking of which…

Error the Second: A comprehensive “big-bang” solution is better than a cautious piecemeal solution.

 A complex system that works is found to have invariably evolved from a simple system that worked.

John Gall, Systemantics

My co-blogger and close friend Bruce Henderson puts it in pithier terms:

Henderson’s Law: Start out stupid, and work up from there.

Most of my professional career has focused around projects to develop information technology (IT) solutions to specific problems. During the early part of my career, I was an actual software engineer or software architect; for the latter half of my career, I have largely been involved in review large-scale IT projects that are in trouble or that failed, both as a consultant to existing projects and as a consulting/testifying expert in litigation over such projects. My 39 years of professional experience have taught me time and again the truth stated above.

Four years ago, when healthcare reform was still in the House of Representatives as HR 3200, I wrote a two-part post about the inherent problems with legislation in general and with HR 3200 in particular. All those same issues still apply — if anything, in spades — to the Affordable Care Act, so I’ll give the links (again) below. They anticipate both the explosion in text from the ACA (~950 pages) to the resulting regulations (~11,000 pages), and the apparent deliberate rewriting of regulations to force more people out of their current insurance plans:

HR 3200 from a systems design perspective (Part I)

HR 3200 from a systems design perspective (Part II)

Significantly, but not unexpectedly, this same fallacy applies to the public embodiment of the ACA, namely the Healthcare.gov website and all the back-end systems behind it. In other words, rather than take an iterative approach to the rollout of Healthcare.gov, the Obama Administration set a fixed deadline — October 1, 2013 — and went live with what they had, whether it was ready or not. And that leads to our third fallacy…

Error the Third: Intent can produce results contrary to reality

GLENDOWER
I can call spirits from the vasty deep.

HOTSPUR
Why, so can I, or so can any man;
But will they come when you do call for them?

Henry IV, Act 3, Scene 1

While many liberal commentators try to distinguish between the steadily unfolding IT (and, frankly, PR) disaster that Healthcare.gov is becoming, and the actual implementation and benefits (as they see them) of the Affordable Care Act, they are two peas in a pod, both reflective of the same hubris: that a massive, complex system can be envisioned, created, and commanded to work as hoped for rather than as reality dictates.  As noted in the second section (and the posts linked therein), reality is harsher and more immediate when it comes to information technology; the inherent flaws, and both intended and unintended consequences of Obamacare will take longer to unfold. But both derive from hubris and a stunning disconnect (in my opinion) from reality.

The silver lining in all this is that the problems with Healthcare.gov may, in fact, damage and postpone implementation of Obamacare sufficiently to minimize the damage. At the same time, the current unfolding of Obamacare may well lead to a GOP takeover of the Senate next fall and a chance to undo some of that damage. But that may be more wishful thinking on my part. (After all, I thought Romney was going to win in a landslide.) The truth may simply be that the healthcare system in the United States has been made permanently worse, thanks to the statist point of view of the Democratic leadership in this country and, frankly, the American people who voted them into office. And as that unfolds, the Democrats will simply cry again and again, “But our intentions were good, so that excuses everything! We had to fix the whole thing at once! Doing something was better than doing nothing!”

And they’ll be wrong on all three counts. ..bruce w..

 

P. S. Click here to see all my Obamacare posts.

 

 

 

 

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Category: 2014 Election, Creeping socialism, Economics, Healthcare Reform, Idiot bureaucrats, Idiot Congresspersons, Information Technology, Main, Obama Administration, Obamacare

About the Author ()

Webster is Principal and Founder at Bruce F. Webster & Associates, as well as an Adjunct Professor of Computer Science at Brigham Young University. He works with organizations to help them with troubled or failed information technology (IT) projects. He has also worked in several dozen legal cases as a consultant and as a testifying expert, both in the United States and Japan. He can be reached at bwebster@bfwa.com, or you can follow him on Twitter as @bfwebster.