Obamacare’s complexity is really driven by the complexity of our present health care system—and the preferences of the American people
In a fantastic piece Megan McArdle exhorted journalists, who need both expert knowledge and insider connections to do their job, to nonetheless represent their non-expert, outsider readers. Taking Grubergate as her ostensible peg, she listed various Affordable Care Act complexities that are meant to hide what’s really going on. For example, we have the Cadillac tax, rather than just limits on the tax subsidy to employer-provided insurance.
But McArdle goes wrong when she claims that deliberate attempts to obscure are the main drivers of Obamacare’s complexity:
“Obamacare was designed—as many laws now are—to exploit [ordinary people’s] lack of understanding. It is huge and complex for a reason, and that reason is that this complexity is an effective thicket in which to hide what you are doing.”
The desire to obscure, though real, is only responsible for a tiny share of Obamacare’s complexity. The dominant cause is the complexity of our pre-ACA health care system. The second main cause is giving Americans what they want from health care—like the lowest possible cost to government. That’s really the opposite of what McArdle claims.