A few months ago, America’s national Tea Party organization emphatically cited Massachusetts’ web based health exchange as evidence that the Affordable Care Act (aka Obama Care) would be a disaster. It noted that the Bay State’s online exchange (like the federal government’s own healthcare.gov site) was not functioning effectively, and proclaimed that Obama Care itself was “an absolute mess in Massachusetts.”
Then, last week, the Commonwealth decided that its health exchange was “too broken to fix,” and decided to purchase the “off the shelf” hCentive software system that is now being used in Colorado, Kentucky, and New York. All three states are currently experiencing favorable results with hCentive.
Some information technology professionals may interpret Massachusetts’ inability to develop its own software as a failure of the Affordable Care Act. Others, however, may interpret the emergence of an “off the shelf” (i.e. “plug and play”) software solution as an indicator of the health law’s strength.
After all, Colorado, Kentucky, and New York are as demographically, economically, and geographically diverse as any trio of states. If a single “off the shelf” software package can work in these three states, it is likely that the same solution (or very similar ones) can work in any state.
That may explain why Oregon also decided to abandon its proprietary state-built health care web site recently; they opted to join the federal government’s healthcare.gov system. And Maryland recently decided to ditch its malfunctioning site and adopt Connecticut’s system.
So what’s going on here? If you tend to perceive the proverbial glass as “half empty,” you might be tempted to interpret these events as indicators of a health care market in chaos.
But if you prefer to perceive the glass as “half full,” you might instead interpret these maneuvers as the mechanisms of a capitalist free market. Customers are abandoning weak information technology products and are replacing them with strong alternatives, resulting in a health care insurance market that is stabilizing and strengthening accordingly.
In certain ways, the Affordable Care Act intrudes on the free market principles of traditional capitalism. In other ways, it embraces these principles. Did the designers of the Act balance these two conflicting impulses effectively?