President Obama has staked his political reputation on the Affordable Care Act – designed to bring health care to millions of uninsured Americans. He pushed it through Congress on the most acrimonious of split votes, with not a single Republican voting in its favour. Had Romney won last year, Obamacare would have been consigned to the legislative dustbin. Its durability – and the president’s legacy– depends on getting off to a good start and becoming an entrenched part of US entitlements by the time power next changes. Yet the public debut of Obamacare has been a disaster, making our government’s local difficulties over universal credit look trivial in comparison. First, people who want to register are finding it very, very hard. Health and Human Services Secretary Kathleen Sibelius found herself testifying to Congress that the website was slow but functioning – alongside a split screen saying the site was down. The IT systems required to administer Obamacare take in six central government departments, state governments and vast swathes of the healthcare sector, from practitioners to private hospitals. The complex co-ordination problems inherent in such a system are now manifesting themselves as a major customer service failure. Second, not enough of […]

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