dagblog - Comments for "Obamacare's Website Benghazi'd His Birth Certificate"

It still is a private health

Peter Schwartz — Thu, 05 Dec 2013 20:57:36 +0000

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.

I am finding the shopping

artappraiser — Thu, 05 Dec 2013 19:35:34 +0000

In reply to I agree with this... if it's

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.

AHA! It is encouraging to

artappraiser — Wed, 13 Nov 2013 19:04:30 +0000

In reply to I agree with this... if it's

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.

One of the reasons

artappraiser — Tue, 05 Nov 2013 18:55:16 +0000

In reply to Obamacare's Website Benghazi'd His Birth Certificate

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?)

The newsstand issue of

Donal — Mon, 28 Oct 2013 14:31:06 +0000

In reply to Obamacare's Website Benghazi'd His Birth Certificate

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.

These are good points. I'm

Peter Schwartz — Mon, 28 Oct 2013 01:30:13 +0000

In reply to Two classic situations where

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."

Two classic situations where

Michael Maiello — Mon, 28 Oct 2013 00:52:34 +0000

In reply to This is true for some kinds

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.

This is true for some kinds

Peter Schwartz — Mon, 28 Oct 2013 00:43:54 +0000

In reply to I think that knowing what the

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.

I think that knowing what the

Michael Maiello — Sun, 27 Oct 2013 23:36:55 +0000

In reply to Really trying to figure out

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.

One of the biggest problems

Peter Schwartz — Sun, 27 Oct 2013 19:26:12 +0000

In reply to Obamacare's Website Benghazi'd His Birth Certificate

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.