The Obama administration's struggle with debugging the HealthCare.gov website is causing critics to ask whether ObamaCare is "Obama's Iraq War," and to dismiss Obama's signature policy achievement a "quagmire."
Media coverage is becoming increasingly hysterical, meaning some historical perspective is in order. Many large-scale government programs that are now embedded in American society also began with rough rollouts that are now mostly forgotten.
Here are five programs that are humming along today, despite their rocky beginnings:
1. Social Security
In the program's early days, many employers failed to include worker names and their new Social Security numbers in their earnings report, leaving the government without the basic information needed to calculate benefits and cut checks. Syndicated columnist Drew Pearson turned the "John Doe" problem into a crusade, writing about the snafu once a week for two months and stoking panic that the government would be unable to pay out the promised benefits to millions. But new procedures were established to follow up with delinquent employers, and within a year the number of John Does was slashed. Today, the crisis is dismissed as a blip, while Social Security historians view the effort to build a nationwide social insurance system from scratch before the age of computers as "Herculean" and "amazing."
Last week, historian and Bloomberg columnist Stephen Mihm chronicled the myriad problems that beset the 1966 Medicare rollout. More than 700,000 eligible seniors initially refused to sign up because they mistakenly believed it meant giving up Social Security. Some Southern cities were left without any participating hospitals because the Medicare law required hospitals to comply with the new Civil Rights Act, yet many in the South remained segregated. It was more commonplace at the time for doctors to bill patients directly, and excessively long waits for Medicare reimbursement checks frustrated seniors. But as Mihm notes, "The government and the private insurers worked out most of the kinks, and by the late 1960s the system was working reasonably well."
3. Medicare's Prescription Drug Benefit
It wasn't all that long ago that another presidential health-care initiative ran into an online buzzsaw. In 2005, the Bush administration rolled out its new Medicare Part D program, providing seniors coverage for prescription drugs. But the debut was bedeviled by website problems. The Washington Post noted at the time that the launch was delayed twice over the course of a month. Then on the day it actually launched, "visitors to the site could not access it for most of the first two hours. When it finally did come up around 5 p.m., it operated awfully slowly." The glitches continued throughout the open enrollment period, but as Jack Hoadley of the Georgetown Health Policy Institute reminded us in a blog post this month, "The program added both phone lines and customer service representatives and implemented other upgrades over the weeks. The website — both its functionality and the accuracy of its information — was the source of ongoing frustration for its users, but it did get better over time. By the end of open enrollment in May 2006, over 16 million successfully enrolled for drug benefits in Part D.... And today, Part D enjoys widespread popularity."
4. The Peace Corps
President John F. Kennedy established the Peace Corps by executive order shortly after taking office in 1961. Skeptics worried that the program would be overrun with immature draft-dodgers. And that concern was seemingly confirmed when one of the first volunteers mistakenly dropped a postcard before it could be mailed, telling her stateside boyfriend that her host country of Nigeria suffered from widespread "squalor and absolutely primitive living conditions." A horrified Nigerian student discovered the postcard, made copies, and distributed it widely. It sparked an international incident. Riots ensued, and the volunteer had to be sent home "cloak and dagger" for her safety. Still Kennedy forged ahead, shrugging off the setback by joking to a new batch of volunteers, "Keep in touch, but not by postcard!" And two years later, the Christian Science Monitor reported that foreign governments were "so pleased with [the Peace Corps'] work they have called again and again for more.... Although the 'postcard incident' in Nigeria seemed to confirm some fears that the program might do more harm than good, that has been far from the case."
5. The income tax
It was 100 years ago this month that President Woodrow Wilson first enacted the progressive income tax that finances much of our government today. Now, few Americans would claim to be fans of our current tax system — but many of them are fans of what the income tax system helps pay for. In the early days of the rollout, however, plenty of people were sent over the edge because of the forms' perceived complexity. As tax historian Joseph Thorndike noted, one lawyer made headlines in 1915 by saying of the paperwork, "It is so complicated that it is utterly impossible to understand its meaning save by consulting a palmist." A 1915 New York Times headline characterized the forms as "Income Tax Riddles."
Now, some may say the tax forms have only gotten worse over the last 100 years. But by and large, the public has accepted the nature of tax forms as a governing necessity, and no politician has gotten very far in the past century campaigning against the progressive income tax. As Thorndike noted in Barron's, "The income tax has survived because it does two things reasonably well: It raises money, and it satisfies popular notions of economic fairness."
The lesson? History suggests that glitches get fixed and forgotten, people get acclimated to new programs, and policies rise and fall on their merits. If past is prologue, ObamaCare will be judged on the quality of the coverage, not on the first incarnation of the website.
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