Meghan McArdle of Bloomberg and and James James Surowiecki of the New Yorker have dueling articles out on ObamaCare (here and here).

Both agree that ObamaCare got off on the wrong foot and is dogged by problems made at the beginning.

But that is about all that the have in common.

McArdle explains:

. . . I think that when it became clear how crippled the bill was going to be, the administration and its backers in Congress should have retreated to a more modest goal. Surowiecki, on the other hand, argues, “In fact, government hasn’t mucked around enough: if we want to make universal health insurance a reality, the government needs to do more, not less.”

Which of us is right? You’ll be unsurprised to hear that I think the answer is, “Me.” I’d like to explain why, and why I think that Surowiecki’s argument, though reasonable, ultimately fails.

It’s not that we disagree that European systems that look kinda like Obamacare work better than ours. They do. We differ because he thinks it’s possible for the U.S. to construct something like those European systems, “if there were a shift in the political mood and it were given a shot.” I don’t think that the shift he wants will ever occur, and even if it did, any “shot” we gave a European-style system would end up much like the “shot” we gave it in 2010, which is to say, a wide miss.

When Congress set out with the overly ambitious goal of reforming health care in one fell swoop, ObamaCare advocates faced a messy situation. The government operated four separate systems (Medicare, Medicaid/Schip, the VA and Tricare for families of those currently serving in the military). There was also a dilemma: everybody believed the system needed to be overhauled, and yet most people were happy with their own policies.

McArdle explains:

That created a political bind: No reform could pass if it seemed to shrink any of these major markets in any significant way. Expanding everything would cost a boatload of money and make taxpayers freak out, so the architects of Obamacare finessed this problem with a combination of:

  • Opaque rules.
  • Disingenuously optimistic promises such as, “If you like your plan you can keep it.”
  • Weak versions of unpopular measures needed to make the law work, such as paltry penalties for failing to buy health insurance.
  • Not touching the wildly inefficient profusion of programs.

All that stuff is what has left Obamacare where it is. The dishonesty was exposed. The weak versions of European measures failed to encourage the behavior changes needed to make the system work.

Theoretically, McArdle writes, ObamaCare could be reformed–but in reality, it probably would end up as bad after another try. One reason is loss aversion: people who benefit won't want to see change, and so various constituencies will have to be bought off with concessions and deals. It didn't work the first time, and it won't a second.

The Republicans have put forward some sensible plans for going another way on health care reform.

But with Hillary Clinton quite possibly in the White House, any attempt to get real reform would by complicated, as it has been since the launch of ObamaCare, by a president with a veto pen, who is committed to retaining as much of ObamaCare as possible before moving even further in the wrong direction.