Otherwise, premiums shoot up and up, pushing others out of the system -- a death spiral that can continue year after year.
"At what point," she asks, "do we admit that the system just isn't working well enough, roll it back and delay the whole thing for a year?" She suggests that if the system can't enroll 50 percent of its users by November 1, such a hugely drastic step would be in order.
That sounds like a nightmare of the first order -- for individuals, for insurers, for employers and for the Obama administration. A far worse nightmare than when Congress in 1989 repealed the Medicare prescription drug plan it passed the year before because of widespread dissatisfaction.
Of course it's possible this nightmare will not happen. Things will get ironed out somehow.
But if they don't, who's responsible? First, a president who is not much interested in how government works on the ground. As a community organizer he never did get all the asbestos removed from the Altgeld housing project.
Politico reports that his "universal heath care" promise was first made when his press secretary and speechwriter needed a rousing ending to a 2007 campaign speech to a liberal group.
Second, lawmakers and administrators who assume that, in an Information Age, all you have to do is to assign a task to an IT team and they will perform it. Cross your fingers, and it gets done.
Third, government IT procurement rules are kludgy. Apple didn't bid on this. The IT work went to insider firms that specialize in jumping through the hoops and ladders of government procurement rules.
Unfortunately, the consequences of a meltdown are enormous when a system is supposed to be used by everybody. If a private firm's software fails, it can go bankrupt. No one else much cares.
But if Obamacare's software crashes, the consequences will be catastrophic -- for the nation and for the Democratic Party.