The Bishop and the Butterfly: Murder, Politics, and the End of the Jazz Age
    Michael Maiello's picture

    Obamacare's Website Benghazi'd His Birth Certificate

    By Michael Maiello on Wed, 10/23/2013 - 12:11pm | Politics

    This morning I was not feeling 100% and so I skipped the very cool calisthenics class I like to take on Wednesdays for the more tender embrace of the elliptical machine.  Unfortunately, this meant that I did my silly walk while facing CNN with the sound off but closed captioning on.  It is very funny to watch report after report, rendered by CNN's botched, real time closed captioning, about how Kathleen Sebelius should resign her cabinet post because the Obamacare website hasn't worked.

    That the website has not worked is bad.  That's true.  Obviously, it can be fixed, but appearances are important.  Obviously, arguments like "they can't even make a web site, what makes you think they can run the health care system?" are childish and stupid, but they will be made.

    That a mainstream news organization is taking seriously suggestions that Sebelius should resign is just evidence that our media has lost all sense of proportion.  Sometimes, Facebook goes down.  Sometimes, Google crashes.  Twitter even has a famous "Fail Whale."  Executives do not resign when these things happen.  Problems are fixed and life goes on.

    Further, CNN's Sanjay Gupta wanted to know what the President knew and when he knew it.  Okay, nitwit, he's the President.  He probably shouldn't have thought a lick about the website until it became a problem.  He should also probably not be thinking about it now, except to order that it be fixed.

    Obamacare failing is not the same as the website failing.  Obamacare fails if more people do not ultimately get access to health care.  Obamacare fails if medical bankruptcies are not prevented.  If doctors flee the country or all the private hospitals close, we have a problem.  This is a website.  It is a glitch.  It should not have happened, but it did, and it can be fixed.

    Of course, Obama is not allowed for anything to go wrong, ever.  This is fast becoming the domestic Benghazi.  The Benghazi story, by the way, is incredibly simple.  Why was the diplomatic corps not more heavily guarded in a dangerous city?  Because such security might have impeded the face-to-face diplomatic work that the team wanted to conduct.  Why was the public at first misinformed about why the attacks happened?  Because it took awhile to put everything together.  That's it.  Use some judgment and it's a simple story of something that we wish hadn't happened but that happened.

    More silliness.  I'm never skipping class again.

    Topics: 
    Politics

    Comments

    Great Post, cool title.

    I saw snippets of that last night while channel surfing on what was a night of wall to wall "bad website" coverage.

    Gupta's demeanor was disgraceful.  Follows the pattern of Dr. Drew, a previously well regarded therapist now joining the ranks of Nancy Grace and Judge Judy----wait a minute, that does Judge Judy a disservice.

    So the effing website is the worst thing since, well, .... brings to mind somethings which were worse given that the Chief Executive had the Con (Navy term for chief officer on the Bridge)

    Things which might have been worse than a screwed up Obamacare website:

    No effing plan---none, nothing, for the aftermath of the overthrow of Sadam Hussein. I think no damn plan at all for the reconstruction of a country we tore apart equates to a plan which is a off kilter but fixable.

    While we are at it, wasn 't George Bush's organization of FEMA before Katrina just grand? Really, what fabulous administrative skills.

    CNN, the channel of impaired pundits. They are simply trying to attract Fox viewers.

     


    by Oxy Mora on Wed, 10/23/2013 - 12:33pm

    Yes, never skip class again, and if you do, you should use the PreCore Stride machine I love that when I don't get to ride!

    Oh and also.. nice blog!


    by tmccarthy0 on Wed, 10/23/2013 - 3:47pm

    Oh everybody knows that Barry was born in Benghazi for chrissakes!

    And everybody knows that Benghazi only has death certificates; no birth certificates.

    I must award you the Dayly Line of the Day for this here Dagblog Site however given to all of you from all of me for this gem:

    Obamacare failing is not the same as the website failing.  Obamacare fails if more people do not ultimately get access to health care.  Obamacare fails if medical bankruptcies are not prevented.  If doctors flee the country or all the private hospitals close, we have a problem.  This is a website.  It is a glitch.  It should not have happened, but it did, and it can be fixed.

     
    Kentucky of all places is being lauded as far as implementation of the ACA and we shall hear more from other states like Minnesota. I mean, Minnesota already implemented its own health care system last year. I signed up and I keep getting notices that nothing changes my situation with regard to ACA.  I send them a check for UCARE every month as I have for the last 11 months.
     
    I am really pissed at the companies who were given the contracts with regard to the damn computer sites but that will be cleared up shortly and some of those contractors are going to have to pay for their negligence.

     


    by Richard Day on Wed, 10/23/2013 - 4:35pm

    After I ranted this morning I read, and this seems plausible, that one of the big problems with the government site is that it has to interface with the private insurance companies, since they are the service providers.  Fine, they should have planned that out since that is Obamacare but I can't help but think that Medicare for All or some other form of single payer would have been technologically, and not just logically, easier to pull off.


    by Michael Maiello on Wed, 10/23/2013 - 5:05pm

    I don't need to plague you with this but of all people, Dennis Kucinich who became a laughingstock on SNL proposed a graduated Medicare remedy. And I think that in ten years? Medicare and Medicaid will prevail.

    http://en.wikipedia.org/wiki/Dennis_Kucinich

    Dennis wished that in a couple years those over 60 received Medicare and then years down the line the 55 year olds would receive Medicare....etc.

    Representative Kucinich had the best plan! I mean if this idea had been implemented in 2009, we would be a quarter of the way there and Medicaid could have taken care of the rest as they say.

     

    In the end, maybe the conservatives know this is how it is going to end. 

    I just recall that five foot nothing girl of 20 years of age I wrote about recently with two babies should receive some relief!


    by Richard Day on Wed, 10/23/2013 - 5:32pm

    And Obamacare fails if those states that are balking at joining continue to balk.  Or if the Right (and some on the Left) can convince young people that it's not worth bothering with.  Or if people give it a failing grade before it even begins.  Sort of like Medicare in 1966.  Some failure, huh?


    by Ramona on Wed, 10/23/2013 - 6:20pm

    It was short sighted of a state like Florida to refuse Medicaid expansion, because it will backfire for the Republican Party at the state and local level.  It has really speeded up the movement to the left in Florida.  People need and want access to health care.  More people will be at the polls in 2014 then 2010 to vote because they know they will have to fight for it with their vote.


    by trkingmomoe on Wed, 10/23/2013 - 7:11pm

    Good post. Anyone sick of watching Sanjay Gupta or other highly paid news celebrities in the TV News pantheon, just turn it off or watch TV Land reruns. TV News is a waste of time, electricity and likely dangerous to your health. Didn't Fox News Dr. Keith Ablow say it can cause dementia?

    You may learn more from the NYT comment section. Among the 500 or so comments a couple days ago on 'healthcare.gov' were some from software engineers who said the 500 million or so lines of code were 10 times more than the usual major bank website.

    Plus, healthcare.gov had to link up with 55 or so other systems run by insurers or government databases. They said a site like this should be beta tested for 6 months or more to iron out bugs.  If it is 'fixed' by November 1 or even 15, it will be nothing short of a miracle. Apparently the option is there to sign up with a paper application, or extend the sign-up period?


    by NCD on Wed, 10/23/2013 - 6:44pm

    Very simply "Benghazi" was a tip of the spear CIA mission which sadly went awry. Clearly, the despicable conservatives are trying to conflate the website failures with obamacare in general. It's cheap its tawdry, it's the modern american right.

    by Grung_e_Gene (not verified) on Wed, 10/23/2013 - 6:44pm

    Birth certificate forgotten when replaced with the fast and furious scandal, replaced with the Benghazi scancal, replaced by the Election theft scandal, replaced by the NSA scandal, replaced with the IRS scandal, replaced with the Obamacare scandal.  Nothing solved, just covered up with more scandals.  Scandals get worse to cover up previous scandals.  Anything to distract us from Obama's impeachable CRIMES!  If our legislature had an ounce of guts, they'd face up to the ridicule and Racist media campaigns by the Soros/Saudi/Mafia/union controlled media and IMPEACH Obama NOW! 


    by Anonymous (not verified) on Thu, 10/24/2013 - 6:08am

    Darrell, go for it.  Prob'ly drive your Party's approvals into the teens.


    by Oxy Mora on Thu, 10/24/2013 - 9:45am

    Do you think Fox pays him per word to troll or more simply by incoherent paragraph?


    by tmccarthy0 on Thu, 10/24/2013 - 6:44pm

    GET A BRAIN MORANS! The Kenyan Usurper's Greatest Impeachabel Crime - LOOSING THE DECIDER'S GORYIUS IRAQ WAR!!!


    by NCD on Thu, 10/24/2013 - 3:10pm

    Still, even you have to admire Obama's ability to unite Jewish Soros with Muslim Saudis and the Catholic Mafia!


    by Verified Atheist on Thu, 10/24/2013 - 12:46pm

    You should go over to MyFiredoglake and try to form a coalition; they are always talking impeachment of the one they call Obomba in-bed-with-the-oligarchy, and seem to be able to find a scandal per week as well.


    by artappraiser on Thu, 10/24/2013 - 5:41pm

    I'd rather have my fingernails ripped out with fiery tongs while being waterboarded.  Good thing I'm still free to ignore them.


    by Ramona on Thu, 10/24/2013 - 7:51pm

    Ignore them? You should encourage them. I think the republicans in the house should impeach Obama. Personally, I think impeachment over the fraudulent birth certificate he released is the way to go, since that's a felony.

    If the house impeaches him and the senate doesn't why I'm sure the republicans will win the senate in 2014. Yeah, that's exactly what will happen. Please do it, republicans. Stand up for your principles.


    by ocean-kat on Fri, 10/25/2013 - 1:25am

    Firedoglake is your enemy. Greenwald & Assange are your enemies. Republicans are your enemies. Guess you'll settle down with a few good establishment types to see you through.

    No one ever got fired for choosing IBM voting the Democratic party line. Just waiting for that new Grand Bargain II where they auction off Social Security to save it, being the deficit adults & all.


    by Anonymous pp (not verified) on Fri, 10/25/2013 - 2:18am

    Oh come on, get real. If there are people over at firedoglake that are calling for the impeachment of Obama they're morons. That's what this little subthread is about. They're not quite the enemy, they're to stupid to raise to the level.


    by ocean-kat on Fri, 10/25/2013 - 3:25am

    FiredogLake has dozens of active bloggers.

    A quick search found 3 posters demanding impeachment 2 & 3 years ago, with commenters calling them dumbshits, and none since. There may be others in comments, but I haven't noticed it to be even a substantive trend. Trashing a whole contributor-focused site over and over based on a tiny minority view is putrid. Should Dagblog's reputation be based on what Peracles wrote about the Civil War 2 years ago? Quinn who's been gone for a long time?

    Note: I don't go to FDL much anymore, and it does have its problems, but much of the innate loathing I see goes back to the "FireBagger" epithets from the 2008 anti-Hillary position. I wouldn't care much except the fallout being "those progressives can never be satisfied" with the "perfect is the enemy of the good" doctrine. So complaining about Gitmo, drones, surveillance, lack of single-payer, attempts to Grand Bargain cuts into Social Security, all make one a "FireBagger". Someone here used "anti-war" as a personal epithet the other day, and I was rather shocked - it used to be being anti-war was a fairly respected position of a significant segment of Democrats. Now we're expected to be "pro-war" and "tough on terror" with only a few caveats, having learned our security weaknesses & reality-check from 9/11.


    by Anonymous pp (not verified) on Fri, 10/25/2013 - 4:56am

    A funny Firebagger aside but, the whole attempt to define the term seems to come down to me and Overreach This! arguing on Urban Dictionary.

     

     

     


    by Michael Maiello on Fri, 10/25/2013 - 10:26am

    You're right, PP.  I haven't given FDL a chance lately.  I quit going there when Jane Hamsher was still struttin' her stuff.  (Whatever happened to Hamsher?)  I went there this morning and looked around.  To be fair, they're out there attacking the Republicans all over the place, but as hard as I looked, I couldn't find a single eensy teensy weensy favorable mention of the Obama administration or the Democrats in general.  Anywhere.

    It's okay.  It's their bag.  It's just not mine.

     

     


    by Ramona on Fri, 10/25/2013 - 1:18pm

    I quit listening  to or watching any of these talking heads long ago, it's bad for your health and they are deflecting the discussion away from the core problems. I do have sympathy for the people who are being forced to buy this defective product through a defective system. From the comments I have read here no one here is in the class of people who have to buy this "product" but that doesn't stop some from proclaiming how great it is, or will be sometime in the future, for those "others" who must buy it. One thing we can learn from this drama is that this is the best we can expect from the Ruling Class and now they will move their agenda to dismantle the remaining safety net and force people to accept this corporate alternative which benefits no one but them.


    by Peter (not verified) on Thu, 10/24/2013 - 4:41pm

    You are wrong, I'd guess there are several here who "have" to get health insurance through the ACA. There's at least one. There are also probably some who have children or relatives who are now covered up to age 26 due to Obamacare. Might also be some here or relatives with pre-existing conditions that can get health care after years without.

    I have numerous criticisms of Obamacare from the left. Flawed as it is it is significantly better than the nothing that preceded it.


    by ocean-kat on Thu, 10/24/2013 - 5:04pm

    Technically, class has nothing to do with it.  If you get health insurance through your employer, you do not use the exchanges.  Were I to lose my job or find myself re-employed as an independent contractor (this happens to all sorts of people) then I would use the exchanges.  I would use the exchanges even if I made more money as a contractor than I do as a staff employee.


    by Michael Maiello on Thu, 10/24/2013 - 9:23pm

    Technically you're right. But I'm fairly certain there's a strong correlation with class.


    by ocean-kat on Thu, 10/24/2013 - 11:50pm

    Obamacare failing is not the same as the website failing

    The website failing is making it impossible to judge anything factual about results of Obamacare, because no one knows what people will actually get out of it beyond the pre-existing thing and coverage of college students (which everyone has known about for a long time,) giving its attackers more time to attack. Politically,and in P.R. terms, it's not a minor snafu.

    The answer that people should apply by phone is not an answer, because the people assisting the phone-ins are running into the similar problems of getting the necessary verifications and data. Enrollment is seriously delayed and the rollout is therefore pretty much a disaster in P.R. terms.

    Obamacare fails if more people do not ultimately get access to health care.  Obamacare fails if medical bankruptcies are not prevented.

    I have read in respectable non-right-wing sources like the NYTimes that in the states where there is not expansion of Medicaid, which are not minor in number, many will not ultimately get access to health care, and that where people purchase plans with strict in-network rules, medical bankruptcies may not be prevented. And that in rural areas, there may be other major problems with cost as well. This kind of information will continue to affect judgment of Obamacare as long as website problems stymie enrollment and man-on-the-street examples of happy campers who managed to enroll successfully are still rare.

    And website problems will almost certainly stymie enrollment among all those healthy young people who have no patience for internet sites that don't work, and whom the administration have said they absolutely need to enroll.

    Everyone I know that plans to use an exchange, actually needs to use an exchange because their current policy is being cancelled as of Dec. 31, is now planning to wait until the last minute to do so in order to avoid time-consuming hassles for no reason. If  there aren't sufficient website improvements by early December, there is going to be a lot of screaming from the people who absolutely need to enroll by Dec. 15 because insurance companies have already cancelled their policies (and are only offering very expensive replacements outside of the exchanges if they are offering any at all.)

    Rollout so far does not bode well is all I am sayin'. It's depressing, sad and disappointing, and even somewhat scary, and it seems to me that those who are saying "this is no big deal" don't seem to understand that because they might not have any skin in the game. I don't see any reason to sugarcoat this if you have skin in the game, only if you believe the sugarcoating thing will help somehow in the political wrestling arena.


    by artappraiser on Thu, 10/24/2013 - 5:35pm

    I don't think the incredibly bad roll out is a disaster yet. They still have some time to turn it around and then we'll see how well it works. But that window is closing. The big advertising push begins Thanksgiving. They better have it up and running then.


    by ocean-kat on Thu, 10/24/2013 - 6:28pm

    If I were using this to set up my family's insurance for 2014, I'd be livid, too.  I'm not minimizing the struggles of real people.  But the media is.  They're making it about whether or not Sebelius steps down. CNN seems far more concerned with that than with, say, whether or not the government will cover people if they have a gap in coverage because they can't enroll in a timely fashion.


    by Michael Maiello on Thu, 10/24/2013 - 9:28pm

    He did it, Mom! No, he did! Ok maybe there really are gremlins. This sez they've already extended the deadline:

    Obama under fire as contractors shift blame over healthcare website errors

    Congressional committee left frustrated with lack of answers after contractors repeatedly deny their software is to blame for glitches

    By Dan Roberts in Washington, theguardian.com, 24 Oct. 2013

    Contractors involved in the rollout of the exchanges that form a key part of the Affordable Care Act heaped fresh pressure on the White House on Thursday, refusing to take responsibility for glitches with the healthcare.gov website that have threatened to derail President Obama's flagship domestic policy.

    Testifying before the House energy and commerce committee during the first congressional hearings into the debacle, four contractors repeatedly denied their software was to blame and turned the spotlight instead on the government agency in charge of overseeing the complex system.

    More than 50 different companies, five government departments and 36 states were involved in building the website, which is designed to help millions of uninsured Americans find affordable coverage from private insurers.

    But extensive bugs and delays in the registration and enrolment process have now forced the government to postpone a February 15 deadline for purchasing coverage, allowing an extra six weeks before fines are levied on those without insurance [....]


    by artappraiser on Thu, 10/24/2013 - 6:55pm

    this looks to me a very big mistake:

    The closest admission of failure came from Andrew Slavitt of Maryland-based contractor QSSI, who revealed that systems to check identity were flooded with 178,000 requests on the first day that healthcare.gov was live, after a last-minute government decision to make people create accounts on the site before they could compare insurance products.

    The media and people in general should be allowed to get quotes for a theoretical person! I don't get the need for limiting it to actual registrants with actual verified ID's, incomes and tax returns! Can anyone think of a reason? Limiting it like that makes the system tailor made for conspiracy theorizing....

    There is an important concept of an open public market involved! If information on the things sold on a market is limited, there's always trouble. People should be able to find out what other people might pay, not just themselves!


    by artappraiser on Thu, 10/24/2013 - 7:04pm

    "Wh sources" in one article I read claim it was politics. They didn't want people to see numbers without subsidies. They thought it would turn too many people off and depress enrollment. And also give opposition talking points.

    The question in my mind at the time was why couldn't they just let people toss in unverified information and give them a number with subsidies included. Verification would only be needed for actual sign up.


    by ocean-kat on Thu, 10/24/2013 - 7:09pm

    I had the same puzzlement. I must admit that what I ended up thinking about was the Obama administration tradition of being non-transparent and/or secretive because of political considerations and then that bites them in the ass.

    I would like to point out that extending the deadline (if The Guardian has that correct) for enrollment does diddly squat for the many who already have notices that their insurance is void and null as of Jan. 1. Someone would have to order the insurance companies to do the same, and they've already made adjustments to their systems, to end those systems on Dec. 31 and to move on to others.


    by artappraiser on Thu, 10/24/2013 - 7:36pm

    I think the reason for implementing a system that requires the user to sign up for an account was to 1. Limit the number of users to those who actually need insurance; 2. Collect accurate demographic information about the numbers of uninsured working people and their families. They need clear numbers to justify future permanent funding sources for the program.

    edited to add: It also allows the system to produce quality information for the user. I hope they get those kinks worked out soon.

     


    by tmccarthy0 on Fri, 10/25/2013 - 9:48am

    I really don't like that at all. It's not an open market where everyone can see what everyone is paying. Don't know about you, but that's not the way I shop for anything.

    It's sorta like when you had to be a registered representative to trade on the stock market, or worse, like the private art market where prices are closely held and only those in the know are privy to what's really going on.

    One of the major problems with our health care system is that nobody can figure out what's being paid for anything without major major work, effort, skill and being tough and ornery and not giving up.

    I don't think that making what people pay for insurance a secret held by the government until they decide to publish some figures is going to help the situation that much.

    It's not a good sign that journalists point to the Kaiser Foundation so far rather than the government itself to figure out what people might pay for insurance under Obamacare. Making it hard to figure out what someone other than just oneself is going to pay is just more of the same we've been dealing with all along. In the past you got quotes from insurance companies and you had no way of comparing with what anyone else was paying, no way to know whether you were getting a fair deal. And now we have exactly the same thing, with a couple more rules we know they are supposed to play under. But we can't be sure they are even following those because: we can't compare.


    by artappraiser on Fri, 10/25/2013 - 5:49pm

    I agree with this... if it's an exchange, it should have transparent pricing.


    by Michael Maiello on Fri, 10/25/2013 - 8:07pm

    AHA! It is encouraging to know that they didn't do it on purpose:

    In fact, Mr. Chao said, federal officials blocked the “anonymous shopping” function because it had failed tests.

    “It failed so miserably” that consumers could not use it, Mr. Chao said.

    from

    Officials Say They Don’t Know Cost of Health Website Fixes
    By Robert Pear and Eric Lipton, New York Times, Nov. 13, 2013

    They really did intend an open market! Maybe someday we'll still get one.

    That said, I am very disheartened by this:

    Todd Park, Mr. Obama’s chief technology adviser; Henry Chao, the chief digital architect of the website; and Steven VanRoekel, the chief information officer for the federal government, could not answer questions about the cost of repairing the site, which has been plagued with scores of software and hardware problems since it opened on Oct. 1.

    They don't worry their pretty heads about what things cost, eh? Well then, what has this whole health reform thing been about....?

    Edit to add: why do we have to wait until inquisition by GOP congress for the Obama administration to quit speaking with forked tongues on Obamacare? Once again, every day there's something new on Obamacare rollout where I find transparency lacking from the I-promise-transparency president's administration. They seem always to be playing the "keep a lid on this game":

    “There was such an environment of don’t do anything that can get bad press,” the insurance industry source said. “That is why nothing was being shared out of CMS. We would share stuff with them. The general viewpoint was — don’t do anything to get any bad press whatsoever. They didn’t create an environment where that would be OK.”

    And the result is often that they end up with worse press than that which they were trying to avoid. It's the coverup-worse-than-the-crime thing, stupids.


    by artappraiser on Wed, 11/13/2013 - 2:04pm

    I am finding the shopping process to be pretty sucky on the NY State exchange so far as to creating wise shopping and a real market. We're not talking healthcare.gov here, we're talking the sites that are supposed to be working as envisioned. The situation is pretty much summed up by the quote from the Gay Men's Health Crisis lady (and official navigator) here:

    Without easier access to information, "we're concerned that people may be attracted to plans with low premiums and not have much drug coverage at all," said Kimberly Beer, director of advocacy for the Arthritis Foundation, one of many advocacy groups that have been trying to advise patients shopping on the exchanges and having difficulty obtaining drug-cost details.

    "Right now, the problem is not getting access to care—it's getting access to information," said Alexandra Remmel, a longtime AIDS counselor at the Gay Men's Health Crisis in New York and an official navigator on the state's exchange.

    from

    Drug-Cost Surprises Lurk Inside New Health Plans
    By Melinda Beck, Wall Street Journal, Dec. 4/5, 2013

    Granted, it was never easy to figure out what health insurance covered. But I had great hopes that what "Obamacare" was going to do was to make those choices clear! Those hopes are pretty well dashed now. The situation is basically buying a pig in a poke and then learning by experience whether you made a wise decision or not. My main point all along was: the "reform" intent of ACA depends on it being an open fair market with all parties knowledgeable about all the facts. It's clear to me now that it's not going to be that. You're going to either be lucky or need special knowledge to fare well in the system, and it will continue to feed middlemen and navigators who sell that knowledge. It will also rely heavily on word-of-mouth, i.e., people will hear from a neighbor about their coverage and how it's working out for them at a decent cost, sounding much better than what they've got, and they will switch during the next open period.

    An efficient market? Doesn't look like it's going to be that for quite some time, if ever. Looks more like the current Wall Street situation, if I do say so myself. Inside information & professional advice will be important as to who gets the best, most appropriate coverage for their situation and income.


    by artappraiser on Thu, 12/05/2013 - 2:35pm

    It still is a private health insurance system.

    Buying health insurance is unlike any other purchase in many ways. There are many trade-offs one has to consider that will necessarily change by what happens to you in the future. One day you're not a diabetic; the next day you are.

    The site could use a "trade off calculator" that would show people how to evaluate the ENTIRE impact of a given plan: premiums v copays v percentage paid v drug coverage, etc.


    by Peter Schwartz on Thu, 12/05/2013 - 3:57pm

    I'm confused by your need to access the federal site AA, you are in New York. New York State has it's own exchange, it's own website, everything. It will tell you your subsidy, everything. The federal site doesn't serve you, you are not in a state that ins't running an exchange.

    You are a prime example as to why there should be limits on people just surfing the federal site. You must have a need, which means you have to be in a state that lacks and exchange program. Limiting the number of users to users who are qualified helps not strain a new system.

    I guess I just don't understand you need to access the federal site, or set up an account at all, given your residency.

    Same goes for you Maiello.


    by tmccarthy0 on Sat, 10/26/2013 - 4:17pm

    Its not just about AA or Maiello's "need" to access the federal site. Numerous articles from all sides of the political spectrum claim that forcing all users to register an account before being able to get information created a bottle neck and was one of the main reasons for the bad roll out.


    by ocean-kat on Sat, 10/26/2013 - 4:38pm

    And I would argue it's worse than that, it keeps the system and the market less open and lacking trust.

    Let's give an example. I already know they fucked up the software royally. So I don't trust them 100% to fix it right. So when I apply how can I trust the software to give me the right options? If everyone can only get a single set of options based on their verified data. You can't even test it with a theoretical to make sure it's right. All you can do is search the news for comparisons from people quoted in news articles who said they got this Silver plan for this much because they have this income and this many dependents.

    It's a real shame that people still have to go to Kaiser Foundation to play around with options and that the results may not be right. That the government system doesn't allow that for people. It thought that was the idea-- a fair market bazaar. This is not a fair market or an open market, this is "these are the options your government has decided you should get based on the data we have on you-take them or leave them." All because of that stupid registration requirement decision.


    by artappraiser on Sat, 10/26/2013 - 5:41pm

    Here is a related comment I noticed on a thread @ the NYTimes:

        Amy A.
        Heartland

    I've been in healthcare for more than thirty years, and I want this to work. The patchwork quilt of a free market program, managed by feds, would not have been my choice but I am more geared toward a single payor system. What is so danged complicated in all this is that there is probably no way the feds could have predicted that so many states like my own Hoosier state would not take the medicare expansion.

    I live ONE mile from Kentucky across the Ohio, where things are running very smoothly. Just for fun I ran my numbers on the Kaiser calculator (I have insurance) and there was a five thousand dollar per year difference. That is amazing to me. Looks like we have some things to work out.

    My thought on how we got here.
    http://raven.amyabbottwrites.com/2013/10/25/how-we-got-here-american-hea...

        Oct. 25, 2013 at 3:09 p.m

    and here is another one on the same thread on topic of Michael's thread that I very much agree with:

        Glenn
        DC

    I don't think we can say that just because the republicans downplayed a poor launch of a program it is ok for the democrats to do the same thing.

    The fact is that in the years since Medicare part d launched we should have learned how to launch a website that handles a new program.

    We should have high expectations for professionalism and we should set high stanards for performance. And we should absolutely not just accept that with a new system there will be problems and we have to be patient for it to work right. We are better than that.

    In this case we stuck to a launch date that we were not ready for based on political considerations - not based on delivering a quality product to the public. that was a wrong decision and we should demand better from our government no matter which party is in power

        Oct. 25, 2013 at 5:38 p.m.


    by artappraiser on Sat, 10/26/2013 - 6:50pm

    Years ago, in my financial services days, I worked on  big survey of 529 college savings plans.  These are, for the most part, state programs run under federal law.  Though, unlike Obamacare, you technically can set up a 529 out of state, there are excellent reasons, in almost all cases, not to.

    Still, the work my partner and I did, which wound up trolling federal resources to make state by state comparisons that no actual user would ever really have had to make did reveal inequities.  There are good reasons for journalists and watchdogs to be able to create an accurate national survey, using federal resources.


    by Michael Maiello on Sat, 10/26/2013 - 5:00pm

    Thank you for responding on my points, Michael. It's helpful for me because it verifies for me that what I am upset about is not my imagination.

    Personally, I think this is more than a glitch, it's a major problem, for me it's a "what the heck are they thinking?! maybe I was wrong about Obamacare having potential!". I think this could really hurt the success of the system if they continue to insist on it. Sure, lots of people with pre-existing and without insurance previously are happy to get something, anything, right now. And I am not bashing that. But that is definitely not the key to Obamacare becoming full instituted and popular! It's got to work for people who are not desperate. And it's got to start a process of an open market with clear prices and clear subsidies for health insurance, so people know how to financially plan. Not some mysterious secretive system that no one can explain or analyze, like a Google algorithm.

    Furthermore, I sort of resent that some people are still letting the Tea Party frame the discussion! I'm sorry, but I don't care about the politics here. This is too important. We have to move on to this being the law of the land and what may be right with it and what needs fixing. Sorry, but I am not going to laud Obamacare if I see things wrong with it. Time to let go of the political fight, this is too important for people's lives.


    by artappraiser on Sat, 10/26/2013 - 5:58pm

    clear subsidies

     

    Because the paperwork errors to which I have previously alluded have conspired to bring me under medicare (notwithstanding I am 19...) I have not made any sort of in depth investigation of the actual operation of the subsidy function of O'care.

     

    That said, a poster on Firedoglake who had actually delved (through necessity) into the scaled subsidy schedule reports that the promised help is really pretty skimpy, and will do very little to bring financial relief to any but the borderline working poor who are just over the medicaid line--the true middle class are in for a shearing as they are forced to buy overpriced insurance with shitty coverage.

     

    The fault, of course, lies in the failure to provide a public option, which was always the only true guarantee against the ongoing grind down that our neo liberal preznit touts as universal health care reform. 


    by jollyroger on Sat, 10/26/2013 - 7:08pm

    the failure to provide a public option

    Well, what do you mean by a public option? Medicare buy-in was what got killed in Congress, and current Medicare fee-for-service is far from cheap (not to mention it's at the heart of a lot of expensive unnecessary medical treatment.)

    The current unsubsidized price for Medicare Part A (hospitalization costs) alone for those eligible to buy into it is $441 per month. (That's with the $1,184 deductible everybody has to pay.) Then Part B for everything else besides drugs is $104.90 subsidized but can go up to $335.70 depending upon income:

    http://www.medicare.gov/your-medicare-costs/costs-at-a-glance/costs-at-g...

    so suffice it to say the gummint considers Part B is worth at least $336 per month.

    So you're talking at least $700-$800 a month valuation on Medicare coverage, plus more if you throw in Part D, with significant deductibles and co-pays. Putting in some healthy young bodies into the pool would reduce it how much?

    Maggie Mahar just wrote an essay that says the profits of the health insurance companies in the exchange are on a real tight leash.

    As to subsidies, we have to keep in mind that the middle class often ends up paying one way or another. The government could give you a subsidy and take it back in raised income taxes. What they do with Medicare is make you pay in advance for your "subsidy" over your working lifetime in FICA taxes, so that's not really a useful comparable.

    The real answer to the problem is to stop paying 17% of GDP for health care without getting quality. We have to get a better handle on who's paying what for what and why. (And what Medicare pays for is a big big part of that, in its current fee-for-service form it's the biggest feeder of the medical industrial complex.)

    That's why I am all het up about transparent markets regarding everything concerned. If we're going to try this consumer-oriented thing (and who knows, in the end, over many years, that could work out better than other country's systems, all of which are facing rapidly spiraling costs and aren't sure of what to do about it, so I am willing to be open-minded about this) we can't continue to be buying pigs in a poke. It's real real important to make it as simple as possible for people to know what they are getting when they buy insurance, at least not more complicated than setting up and maintaining a I.R.A.  Who knows, maybe the "wisdom of the crowd" could work in finding a solution better than the kind of forced cutting other countries are doing to their systems, but that requires clearly understanding what they are buying.


    by artappraiser on Sat, 10/26/2013 - 11:16pm

    Well, if I were picking the "public option" I would option the VA, which I believe currently runs at about 6k/pp annually.

     

    That said, the public option bruited at the outset of the HCR battle would presumable have embodied a sliding scale/means testing front end, via which the current Medicare Part B premium would have been ameliorated, and I suppose something would have been added for the Part A coverage.

     

    It might or might not have been the simplest approach, viz. making Medicare buy in available as an option to the other insurance coverage on offer.


    by jollyroger on Sun, 10/27/2013 - 12:37pm

    First, all the state sites depend on the Federal sites for some of the verifications. So even if you can register on the site, you run into not actually being able to finalize anything.

    Second, I have to help relatives in other states with sign up. They include one without its own system and without Medicaid expansion.

    Third, most importantly, as I said before, I don't like ANY system that doesn't allow you to get price quotes for something without giving real access to important personal data. That's not a real open market. And especially one that has to do with our health care system. Everyone should be able to get theoretical prices for various theoretical variables! Maybe they want to move or stop smoking or expect earn a lot more in six months or get a job with health insurance within the next year. Or trying to decide whether to have another kid or not. Or a thousand other possible variables. It's called smart buying and financial planning. The exchanges should not limit you to the plans available to your personal situation as of your last tax filing, that is what they all do now because of that stupid decision.

    Even without that, the system wasn't ready for primetime. They shouldn't have introduced it until it was. It made it so much easier to disparage it. And they should have delayed long ago, with enough warning to delay those cancellation orders everyone got from their insurance companies.

    Edit to add: as Emma notes, there is simply not enough information to make a wise buying decision about even the plans that are offered. What they have set up is a system for people who are so desperate for health coverage that they will just grab something, anything. That is not the way to fix our health care system.

     


    by artappraiser on Sat, 10/26/2013 - 6:03pm

    As he said in his post, Maeillo has insurance from an employer, so actually he doesn't need to access any site, state or federal, but as he is a journalist with financial expertise, I would very much like it if he were able to access any of the websites, state or federal, to the point where he can get quotes for various possiblities! That's what an open public market is!

    They have created a captive, closed market so far with this system. And I think that's a very bad mistake. I think that should be changed pronto. Make the verification happen when you are ready to buy, and let everyone plug in variables to see theoreticals until then.

    And get more data on the actual plans so people aren't buying a pig in a poke, which will just hurt the Obamacare reputation later when everyone finds out that this or that isn't covered! Not having clear detailed info. when they make the purchase makes for unhappy customers when they start using!

    You do not have to be logged into Amazon.com with your verified credit card in order to read about all the products they have and their prices! Nor do you have to be logged in to find out about special discounts Amazon will give you for certain registrations, memberships and qualifications.


    by artappraiser on Sat, 10/26/2013 - 5:28pm

    Another thing that occurs to me... say you're buying on the exchange because you are self employed by either choice or circumstance.  It might well be that if you can do your job from anywhere or, in he case of more closely situated states in the northeast, from one of 4-5 states, that you might want to comparison shop because the prices might factor into where you choose to live.


    by Michael Maiello on Sat, 10/26/2013 - 11:24pm

    Also, network or other options can be more important as price in this "market" to some. That's the thing, it's not always price that is the main determinant, it's not a "fair market" that way. People are already known to move homes and jobs just to get access to certain kinds of care and specialization. Such as a group of practitioners known for a more environmental or wholistic approach.

    Also as genetic testing for inherited disease develops further, this could also be a greater consideration for many. (I.E., I want access to Sloan-Kettering or the equivalent, and I will move there to have it.)

    I believe one thing we are about to learn rather quickly from Obamacare is whether people will more happily tolerate managed care now rather than free-for-all fee-for-service once they know the cost difference, or they will still demand total freedom (including the freedom to lose their health through expensive iatrogenic illness-even Presidents can fall for that--and to fall for pharmaceutical marketing,) enough to pay a premium.

    Another thing that intrigues me and I don't know the answer to is whether the Medicaid expansion means higher payments to providers than what has been in many cases so rock bottom that many providers of any quality refuse to participate. In which case, happy word of mouth on Medicaid would mean people of higher incomes clamoring to be allowed to join. And you know what that could lead to....socialized medicine, gasp.

    I can't stress enough how much I think clearly understandable choices are important to success now that we are going to go this route. The future of medicine, not just health insurance, is in the choices people will make. Especially if more employers end up bailing out and letting insurance up to the individuals more and more.


    by artappraiser on Sun, 10/27/2013 - 1:03am

    On the fee for service freedom -- I think everybody encounters multiple health issues where the average doesn't work out for them.  The doctor says, "Usually, this pill will fix this but with you it doesn't.  Sometimes this other pill works, let's try it.  Or, maybe this test will tell us something, I wouldn't normally order it but in this case..."  If this fixes your problem, you are going to say, "I have a great doctor."  Only if it doesn't will we worry about overselling, overtreatment, etc.  But not every situation is going to be average.  We need the freedom.


    by Michael Maiello on Sun, 10/27/2013 - 9:35am

    I just visited Healthcare.gov to check it out. Far and away its biggest problem is how uninformative it is. Where is the information about co-pays, out-of-pocket and other limitations?

    Obamasurance will be far and away the biggest group plans ever. Why are individual rate calculations even necessary? Sure any subsidies will have to be but that is a separate issue. Why do individuals even have to choose an insurance company when they all offer the same plans? Why can't  HHS just assign individuals to insurers in their areas based on some reasonable formula that encourages competition among them to provide the best prices and services?

    And why does it let some of them get away with charging tobacco users up to a 50% higher (punitive) premium when extra taxes on tobacco products are already imposed to pay for the supposed extra health care required, at least that was the justification used for them. Using the extra taxes to pay the insurance premiums would make far better sense than giving it to a bunch of anti-smoking advocacy groups to buy disgusting media ads.

     


    by EmmaZahn on Fri, 10/25/2013 - 1:06pm

    CMS has just basically been fired and the website management is being done by a private company; I put it on my news thread so I can the story later more easily if I need to:

    http://dagblog.com/link/obamacare-website-could-stay-broken-while-17610#...

    Your questions are all good, Emma. Ain't got no answers. I haven't tried it myself like you have; it was: why bother until it's real. Especially since the requirements are so strenuous.  God forbid you log in once and then it doesn't recognize you again because it thinks you are still logged in and it's protecting you from yourself.

    I am trying to remain positive but I really really am feeling bad juju along the lines of your questions and many others that I have seen. Utmost in disturbing is the one complaint I've read several times: that for those lucky few who have been able to consummate a purchase, they have not been able to have a clue on whether their current doctor(s) or provider(s) will be in any of the many limited provider plans, that they felt they were just buying a pig in a poke. Where the prez's promise of "if you like your doctor, you can keep your doctor" has basically been broken, even worse, you don't have much of a clue what providers you will be getting at all "in network" and what the real penalties will be if you go out of network.

    And yes, one can see there are real big questions going to be raised on lots of unclear particulars, the smoker penalty is one that is serious and all up in the air about how they are going to prove someone is a smoker/was a smoker, etc. Some life/health insurance in the past required urinalysis. How is it going to work with Obamacare policies? If a smoker lies as all the ones who have any brains will, what are they going to do, refuse coverage later when they find out? (And why do Medicaid people get to smoke without penalty?) What about E-cigarette usage?


    by artappraiser on Fri, 10/25/2013 - 5:37pm

    P.S. I can foresee already that there is great opportunity for someone to set up websites where people share "what's the real deal?" in the exchanges.

    Edit to add: Though I have no idea how helpful or transparent Romneycare's website in Massachusetts was, I just read somewhere about how long it took for it to take hold, how slow initial sign up built. It sounded very much like word-of-mouth might have to do with that, people telling other people what plans worked for them.


    by artappraiser on Fri, 10/25/2013 - 6:27pm

    I did not register because I doubt I will sign up since I qualify for Medicare next year and I have some concern that if I get in for the first few months, how will I get out when Medicare kicks in. There was nothing on that at either site.

    There is just not enough information available to make a decision without committing in some way. I have enough experience with screwed up computer conversions to be wary.

    I also have more than a little experience signing up employees for heath care using paper, mountains of it, booklets, enrollment forms, rate sheets, special information flyers, acceptable doctors and clinics, etc. All that should be available onlne as pdfs for each of the five plans. But no, as usual IT has to reinvent the wheel instead of checking out how armies of office wives handled it when every piece was physical. 

     


    by EmmaZahn on Fri, 10/25/2013 - 7:14pm

    Here's something I found interesting on the adversely affected under Obamacare in California; it does not appear to be right-wing agitprop, the info. is verified by a Public Health academic I think if the same starts happening elsewhere when more people start trying to sign up, there is going to be a lot more anti-Obamacare screaming. I can see the planning reasoning in no longer offering high deductible catastrophic plans--it's the old HMO theory to encourage people in to treat minor things before they become major expensive things--but most small business types and free lance types are loathe to give that kind of control to others much less being forced to pay for it. The thing that occurred to me reading it was this: Obamacare planners might not have expected so many health insurance cos. to just totally close down offering plans outside of the exchanges. And what they are ending up with is people who are used to particular providers and doctors having them taken away from them, and be forced to enter a more managed plan without the choice of out-of-pocket hiring of favored providers that they were used to, and, furthermore, if in the upper middle class, having to spend more on it to boot:

    Some Californians Being Dropped by Health Insurance Companies
    Half a million Californians with catastrophic plans are losing their insurance plans because they don't comply with the Affordable Care Act
    By Whit Johnson and Daisy Lin, NBC Los Angeles, Oct 10, 2013

    [....] His insurer, Healthnet, also dropped thousands because it was joining Covered California, and his plan won't be available.

    Divito's monthly premium was $188 a month, with a $7,000 deductible for him and his wife.

    Under Covered California, the lowest premium for him would be $335, but his deductible would be lower by $2,000. Gerald Kominski, Director of the UCLA Fielding School of Public Health, said that the law has essentially increased the requirements that insurers provide more.

    "So the best estimate that we have is that a half million people who are currently insured might be paying more premiums or higher premiums next year because the policies that they have today, those lower cost high deductible skinny benefit policies are not going to be allowed next year on the marketplace," Kominski said [.....]
     

     


    by artappraiser on Sat, 10/26/2013 - 6:39pm

    OK,  yay! finally, some skinny on what's going on with insurance being offered outside the exchanges, what are the new rules with that and what is the game, will be helpful for some of those people with cancelled policies who don't like what they get on the exchange that they are allowed to use; thank you to the NYTimes. And, as the article notes, if you are ineligible for a subsidy or eligible for only a minor one, there is no reason to limit yourself to an exchange:

    Health Insurance Options Aren’t Limited to Government Exchanges
    By ANN CARRNS, Your Money Advisor/New York Times, October 25, 2013

    WITH so much attention being paid to the troubled debut of the Obama administration’s health insurance exchanges, another alternative has largely gone unnoticed: unless you live in Washington, D.C., or Vermont, you can also buy insurance outside the exchanges — by going directly to insurance brokers, agents or company Web sites.

    In general, health policies effective Jan. 1, whether sold on the exchanges or off, must comply with the Affordable Care Act [....]

    Whether or not the policies you will find off the exchange are a better deal for you than the on-exchange plans isn’t clear yet, and will vary by market. “I don’t think we have a good sense of that,” said Robert Zirkelbach, spokesman for America’s Health Insurance Plans, an industry group. But, he added, it makes sense to check.

    Another possible reason for shopping off the exchanges is if the networks offered by the plans you find there don’t include your own doctor or hospital, said Sara R. Collins, a health policy expert at the Commonwealth Fund. In some cases, insurers are seeking to control costs by narrowing the networks of plans offered on the exchanges [....]

    And it looks like EHealthinsurance.com is going to try to do what Obamacare promised it was going to offer but seems to have changed its mind--an open marketplace--including the subsidy info. if and when the government fixes their glitches:

    [....] Web-based brokers, like eHealth, are supposed to be able to help consumers enroll in subsidy-eligible plans by connecting to the federal marketplace to verify the consumer’s income, under government guidelines issued last spring. But that isn’t happening yet at eHealth, in part because the company is still testing its system, said a spokesman, Nate Purpura.

    However, the site offers more than a thousand plans from 60 insurance companies that you can buy if you aren’t looking for subsidies [....]

     


    by artappraiser on Sat, 10/26/2013 - 7:41pm

    In the same situation as those Californians, but is still a supporter:

    ‘We’re all in this together.’
    Subsidies won't lower premiums for author, but she supports law that finally delivers affordable coverage to millions less fortunate
     By Louise Norris, HealthInsurance.org, Oct. 5, 2013

    That's an extremely helpful site, BTW; I'm real glad I came upon it.

     


    by artappraiser on Sat, 10/26/2013 - 11:53pm

    Ezra Klein very much disagrees:

    Sorry liberals, Obamacare’s problems go much deeper than the Web site

    (Oct. 25, WaPo)

    And it's important for everyone else writing on this to read what he thinks, I think. (And it's not because he agrees with all my own thoughts on this, except for the point about it being time to stop letting GOP politics affect the discourse.)


    by artappraiser on Sun, 10/27/2013 - 12:05pm

    Really trying to figure out what AA is complaining about...

    In particular...a free market being one in which you know what the other guy is paying. Really? I just walked into a new house that had already been bought, but which the builder was showing to show off his craft. I asked, "How much did the buyer pay for the house?" She quoted me not THAT price, but the price EYE would have to pay to buy this house. In short, I have no idea what that couple paid and won't until it finally shows up in the county records.

    Maybe I'm not thinking straight here, but we almost never know what the other guy is paying. That's why he gets to niggle us at the cocktail party about how much he paid while we paid much more...for X.

    The transparency we need as shoppers is knowing how much Anthem is going to charge me for X v how much Cigna is going to charge me. What AA has to pay is irrelevant. The competition lies in Anthem competing with Cigna for my business.

    And not every plan can be the same because there are age differences and regional differences in pricing. Over and above subsidies.

    That said, I know all sorts of people who plugged in dummy data into their state exchanges (which seem to be working better) and got answers. But why would you want to plug in dummy data when you need to know what you are going to pay, not what some hypothetical you is going to pay.

    Anyway, AA, maybe I'm just not understanding you...

    When the program opened, I typed in "Join Obamacare" into Google. It sent me to the VA site. I typed in a few bits of information, and it spit out about 60 different plans and the top 10 plans for me (in its estimation). Deductibles, co-pays were all clear. It had neat little videos that explained technical terms. It also gave me a list of the doctors who would accept my insurance.

    In short, it seemed like my choices were very clear.

    What's hard about that?


    by Peter Schwartz on Sun, 10/27/2013 - 3:19pm

    I think that knowing what the other guy is paying can be quite important and virtually nobody in business makes acquisition or sales decisions without such data.  In the stock market you generally know what every other investor will be expected to pay for a given stock.  If a special arrangement has been made for one buyer to get a discount, you can generally figure out the how and why.

    When companies are acquired, they look for comparable sales as a main metric in picking a valuation.  In short, what the other guy is expected to pay is vital for a fair and open market.  Otherwise you just get nothing but the greater fool principle in action in every transaction.


    by Michael Maiello on Sun, 10/27/2013 - 7:36pm

    This is true for some kinds of products...products that you or I could buy.

    So, there's a public price for a stock which you or I would have to pay. Whether you pay it or I pay it makes no difference. (This leaves aside questions about whether all information is already priced into a stock. Information we might not both have.)

    But in a situation like this, how would you look for "comparables"? The critical differences are not in the product, but in you and me, and how different products respond to those differences.

    Or let's put it this way: It doesn't matter what a fair price for a house is on the other side of the street from where I live. I don't live there. My house has to compete with houses on my side of the street.

    It doesn't matter if Joe Shmoe pays less for insurance than I do--I'm not him.

    All that said...having reread AA's original comment...I DO think it's important for the press to be able to run hypotheticals. And the companies on the exchanges should, too. To give people an idea of what they might have to pay.

    But still, when it comes down to my applying, my particulars are what count. Health conditions don't count any longer, but other variables, I think, do.


    by Peter Schwartz on Sun, 10/27/2013 - 8:43pm

    Two classic situations where you do not know what the other guy paid would be airline tickets and hotel rooms.  Somebody might get exactly the same service you do for hundreds more or less than you paid.  We accept this and maybe we should.  But we also have very good reason to want to know everything we can, right?  Are we booking too early, for fear or missing out?  Are we using the wrong intermediary to make the purchase?  Are we just not asking the right questions about how to get a better deal?

    As for a home purchase, this is all surely relevant.  At some point you have to pick what street you want to live on, in what neighborhood, in what city or in what state.  If you work in New York, Boston, Philadelphia or Chicago, to pick a few examples, you might very easily be able to commute from out of state.  Maybe the health care options available will factor into where you decide to live.  People need this information in order to make the best decisions.


    by Michael Maiello on Sun, 10/27/2013 - 8:52pm

    These are good points. I'm agreeing now with AA (I think) that hypotheticals and broad market data about what 61 year old men in VA are paying for health insurance would be a good idea.

    But in a lot of cases, you're using broad information that isn't going to be congruent with the particulars of your situation.

    You can run home comparables in a neighborhood. You can know that homes in this neighborhood are more expensive than homes in that neighborhood. And you can find a range of prices.

    But it's also hard to find two homes that are exactly comparable especially when you're looking at a limited pool of homes for sale or that have recently sold. They each have different features that will factor into the price.

    Your insurance example is less good, IMO. It's hard enough to sell my house as is. I'm not going to pick up and move to X for a better price on health insurance. No one is. It's probably way down on anyone's list of why they choose to live in, say, Manhattan.

    I will say, though, if a male neighbor of mine in approximately my situation paid a lot less for health insurance than I did, I'd want to know why. But I'm not going to find that out by punching in a bunch of variables on the Web site. What would I punch in?

    I'm going to find that out by asking him at a cocktail party. "Hey, what did you pay on the exchange? Oh really, I wonder why...etc."


    by Peter Schwartz on Sun, 10/27/2013 - 9:30pm

    One of the biggest problems with buying health insurance is that you rarely know what will be covered...how much coverage you'll actually need...because all those questions can only be answered by the future and what happens to you.

    People are complaining because their insurance is being canceled. And it's being canceled because it's not deemed to be "good enough."

    Folks say they "liked" their old plan--but what does that really mean? Most people don't really "use" their plan, so if the premiums are low enough and it feels like they have "enough" coverage to protect them against some number of unknown and unknowable future events, they like their plan.

    But that's totally different from, say, liking your car or your house which you use every day and know well. Insurance is something that sort of "runs in the background" as they say in the computer biz until you need it, and then it pops and goes to work.

    Well or not well...it's generally a surprise.

    Obamacare designers seem to have made the judgment that most people are under-insured. I think they're right. But it's hard to argue that with people who "like" their insurance but have never really put it to the test. Never really used it.


    by Peter Schwartz on Sun, 10/27/2013 - 3:26pm

    The newsstand issue of Consumer Reports offers some advice on how to navigate the ACA process. I'm as dismayed as anyone to read that the rollout has been fraught with snafus, but remembering what a cobbled-together piece of legislation it was, I didn't really expect that it would be a smooth introduction.


    by Donal on Mon, 10/28/2013 - 10:31am

    One of the reasons Kentuckycare is working well (from NYT article here):

    people can check whether they qualify for Medicaid or subsidies without creating an account, a requirement that caused huge bottlenecks on the federal exchange.

    I am not going to let this point go: creating a fair market requires everybody being able to access all the applicable data. They have to be able to shop for all different kinds of scenarios in order to understand the market and in order for the market to have market tendencies (doh.) Otherwise, you end up back where we were, people buying pigs in a poke and having to trust that someone else is making the right decision for you (i.e., I trust Madoff, don't you?)


    by artappraiser on Tue, 11/05/2013 - 1:55pm