Commentary Magazine


ObamaCare and the Law of Unintended Consequences

I wanted to add to Seth’s fine post on the new study, published in the journal Science, that found that people who gained health-care coverage through Medicaid used the emergency room 40 percent more than those who were uninsured–exactly the opposite of what President Obama promised when selling his health-care plan. (Over at Forbes, Michael Cannon lists some of Mr. Obama’s shattered promises related to this matter.) 

It might be worth calling attention, then, to a paper by the 20th century sociologist Robert K. Merton, who in 1936 published an essay in American Sociological Review, titled, “The Unanticipated Consequences of Purposive Social Action.” (Merton helped popularize the theory of unintended consequences.)

In citing some of the major factors of unexpected consequences, Merton listed ignorance and error. About the latter, he wrote the following:

Error may also be involved in instances where the actor attends to only one or some of the pertinent aspects of the situation which influence the outcome of the action. This may range from the case of simple neglect (lack of systematic thoroughness in examining the situation) to pathological obsession where there is a determined refusal or inability to consider certain elements of the problem… In cases of wish-fulfillment, emotional involvements lead to distortion of the objective situation and of the probably future course of events; such action predicated upon “imaginary” conditions must inevitably evoke unexpected consequences.

What the mix was of ignorance and error (or perhaps knowing deceit, as was the case in Mr. Obama’s promise that people could keep their health-care plan if they wanted to “period, end of story”) is impossible to know. But this much we can say: The Obama years, and ObamaCare in particular, are turning into one giant national seminar when it comes to the failures of progressivism, the dangers of technocratic arrogance, and the inability of liberals (or anyone else for that matter) to finely manage and orchestrate an untidy and complicated world. 

One of the virtues of conservatism is its appreciation for the complexity of human society and some degree of modesty in what we can achieve. I suspect that after the Obama era, the American people will more fully appreciate that virtue than before it.