Obama has placed himself and his party in what now looks like a zero-sum bind, forcing a choice between inflicting the painful consequences of Obamacare on the electorate now or 11 months from now.
Politicians invariably choose to put off problems when they can. That means most of next year will be taken up by the administration’s struggle to protect the crown jewel of the president’s tenure without letting the roof collapse on his party.
The increasingly complex and technical character of the health care system – complexity which voters recognize, and about which they make implicit and explicit inferences – is what has turned the disastrous rollout of the HealthCare.gov portal into a ever escalating political crisis. This crisis has in turn generated a pervasive fear that the services provided under the Affordable Care Act, once they are finally in place, will themselves be subject to fatal technical glitches.
An effective health care delivery system that employs an open exchange among 50 states is likely to take years if not decades to complete. It will require that personal and confidential information not be compromised. A nationwide plan that works in the open market will require a vast hardware infrastructure, enough to consist of whole city blocks. Google and Amazon have taken over a decade to successfully deploy such hardware.