This morning, Paul Krugman introduced me to a new word.

“The fact remains that Obamacare is an immense kludge — a clumsy, ugly structure that more or less deals with a problem, but in an inefficient way…. As Steven Teles of Johns Hopkins University put it, we’ve become a ‘kludgeocracy.'”

Entranced by the associative power of the word — klutz and sludge mashed together in a bureaucratic muddle — I thought it had to be a new coinage.  But no, as the computer-literate among you will know, it already exists (and is even better as an adjective:  kludgey).

Here’s how Teles himself explained it in his analysis for the New America Foundation :

The dictionary tells us that a kludge is “an ill-assorted collection of parts assembled to fulfill a particular purpose…a clumsy but temporarily effective solution to a particular fault or problem.” The term comes out of the world of computer programming, where a kludge is an inelegant patch put in place to be backward compatible with the rest of a system. When you add up enough kludges, you get a very complicated program, one that is hard to understand and subject to crashes. In other words, Windows.

“Clumsy but temporarily effective” also describes much of American public policy. For any particular problem, we have arrived at the most gerry-rigged, opaque and complicated response. From the mind-numbing complexity of the health care system (which has only gotten more complicated, if also more just, after the passage of Obamacare), our Byzantine system of funding higher education, and our bewildering federal-state system of governing everything from the welfare state to environmental regulation, America has chosen more indirect and incoherent policy mechanisms than any comparable country.

This kludginess, as Krugman points out, is not inevitable.  In health care, it’s the result of the Republican ideological assault on the very idea of single-payer insurance:  i.e. Medicare.  The Republican ideology “is fundamentally hostile to the notion of the government helping people, and tries to make whatever help is given as limited and indirect as possible, restricting its scope and running it through private corporations.  And that ideology, at a fundamental level — more fundamental, even, than vested interests — is why Obamacare ended up being a big kludge.”

And it’s why the distinctly un-kludgey decal on the rear window of my car is this:

Medicare for all

4 Responses

  1. It is impossible to fix the healthcare system while doing nothing to change what is wrong with it. The change in the last generation from non-profit to profit seeking institutions and the mass marketing of medications are all things we need to lose if we wish to make it affordable. So, the ACA , which is mostly an effort to get everyone to pitch in to pay for unbillable hospital care, is really a joke. It is not affordable for many people who have variable income which is not easily verified.

    We need to move to a single payer system (medicare for all). We need to bargain with the bandits who set the prices for medications.

  2. Hurrah for bring up the absurdity of those anti-Affordable Health Care Act dolts. Our nation is #1 in healthcare costs in the world but #26 in longevity. So how does that all work out, Republicans?

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