11/22/2013 03:34 pm ET Updated Jan 25, 2014

Obamacare: The Question We Really Should Be Asking

I remember how difficult it was to pass Medicare back in the sixties (see also). Now many consider this a basic government service meeting the needs of hundreds of thousands of citizens. The fact that Obama got any kind of healthcare billed passed when Lyndon Johnson couldn't, Jack Kennedy couldn't and Bill Clinton couldn't is really something. Hillary Clinton put together a task force of the smartest people in the world and they got nowhere but Obama got something done. That, in itself, is an accomplishment.

There's a troubling aspect to the Affordable Care Act that no one seems to be talking about (aside from the fact that some people think the ACA and Obamacare are two different things...). We have a habit in this country of assuming the profit-making entities can deliver a service better than the government and it's become something of a religion in the last few decades. The idea, I suppose, is that you're going to get a more efficient process if it's done through the private sector. Maybe some think that it's even going to save money. But, you have to consider the profit-making factor and the desire for profit never goes down. It never even really levels off. Both the consumer and the government are held hostage to corporations that want to make more and more money for providing basic, necessary services. In fact, privatization and government contracts take market forces out of the equation when a mandated government service is provided by corporations.

Just look at the deals states are cutting with for-profit prisons - guaranteed occupancy levels. That means they're promising to pay for services even if crime levels go down and we have fewer prisoners. Not much incentive to cut crime there. So, the question we really should be asking is: just how will this play out in Obamacare?

Instead, the discussion - if you want to call it a discussion - is about how the badly the ACA launch has done. That's news and boy do the anti-government types love it. To them, it's proof-positive that government can't work. But let's be fair: these things almost never work right out of the box. Could they have done a bit more testing of the software - yes, and it's hard to believe that with all of the computer expertise in this country they couldn't have gotten some advice on this. Still, do the initial glitches mean that the ACA is a complete bust? No. So let's hope we can get beyond these surface issues and address the real potential problems of corporations providing government-mandated services.