Supporters and opponents of the Affordable Care Act, or Obamacare, can agree on at least one point: The health care website’s rollout was a fiasco.

But incompetent administration is not the only cause of Obamacare’s rocky debut.

Too much complexity is the real culprit. One need only look at the length of the bill to see the problem: The legislation that created the Affordable Care Act is over 900 pages long. That is 900 pages of new requirements added to the already vast and sprawling American health care system.

The website’s technological problems stem directly from Obamacare’s complexity. For example, in order to determine whether an Affordable Care Act enrollee qualifies for a government subsidy, the health care website must retrieve and process data from an astounding variety of far-flung federal and state agencies, ranging from the Social Security Administration to the Department of Homeland Security.

It is no wonder then that the Obama administration has sent an urgent appeal for help to Silicon Valley. Rube Goldberg’s mousetrap looks simple compared to the Affordable Care Act. Who knows what other problems the law’s complexity will give rise to in the future? We have only scratched the surface of what lies within the act’s 900 pages.

Obamacare is not an aberration. Other recent high profile laws have been tripped up by their own complexity. For example, supporters of the Dodd-Frank Wall Street Reform and Consumer Protection Act of 2010 argued that the law would protect the nation’s financial system by preventing banks from growing dangerously large.

But the extraordinary complexity of the act’s regulations — that bill is 848 pages long — has defeated its intended purpose. Small and medium-sized financial institutions lack the resources to hire the lawyers and specialists necessary to interpret the bewildering forest of regulations created by Dodd-Frank. Many community banks may go out of business or curtail their lending as a direct result of the law’s complex regulations.

Meanwhile, the skyrocketing cost of regulatory compliance has given large financial institutions a competitive advantage in the marketplace because they can afford the army of lawyers needed to decipher Dodd-Frank. The reform measure thus has the paradoxical effect of encouraging further consolidation of the banking sector, a result directly contrary to the law’s intent.

We have been down this road before. Decades ago, the United States military learned the hard way that complexity often backfires. On the eve of World War II, the B-17 bomber represented a major technological innovation. But because the cockpit was so complex, the plane suffered from an extraordinarily high accident rate. This was despite the fact that the military assigned its best pilots to the aircraft.

In time, the military realized that simplifying operations is essential to maximizing performance. Today, the acronym “KISS” — which stands for “Keep It Simple, Stupid” — informs everything that our armed forces do. The United States military’s unparalleled battlefield success stems directly from its focus on practicality and common sense.

The problem of excessive complexity is not limited to government. In two acclaimed books, the prominent Boston surgeon Atul Gawande warned that the growing complexity of modern medical treatments has become a major source of doctor error.

Similarly, in the business world, excessively complex operations undermine managers’ ability to run their companies in an efficient and effective manner. As the Nebraska billionaire Warren Buffett likes to say, “Never invest in a business you cannot understand.”

But change is coming. An IBM survey of senior corporate officers found that more than 80 percent of them view simplifying internal business operations as a top priority. Similarly, Gawande’s writing has inspired soul-searching across the medical profession.

Most noteworthy of all, Professor Cass Sunstein, a former Obama administration official, published a book earlier this year in which he persuasively contends that an emphasis on clearer laws and simpler regulatory schemes will lead to better policy results.

As for Obamacare, it is certainly possible that in the weeks ahead the administration will fix the health care website’s problems. But even so, the Affordable Care Act’s long-term policy ramifications remain an open question.

Whatever lies ahead for Obamacare’s implementation, one lesson seems clear: In the public and the private sectors alike, decision-makers should think long and hard before adding a new layer of complexity to a world that is already profoundly complex.


Anthony Gaughan is an associate professor of law at Drake University