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  • A rolling catastrophe

    Posted by Michael Kennedy on November 4th, 2013 (All posts by )

    Obamacare debuted on October 1. It is now November 4 and the mess is worse. I have been posting about it, here, and here, and here, and even here.

    The political left is trying very hard as can be seen here.

    keep-your-plan-flowchart

    It’s kind of complicated so I will summarize. You are screwed !

    There are accusations that insurance companies are using this to drop high risk subscribers. Maybe that is true but it is the consequence of ignorant people designing Obamacare. Did these guys ever set up a new business ? As Casey Stengel once said to the Mets , “”Can’t anybody here play this game?”

    I guess not.

    The New York Times has done what it can.

    We are also told that “in all the furor, people forget how terrible many of the soon-to-be-abandoned policies were. Some had deductibles as high as $10,000 or $25,000 and required large co-pays after that, and some didn’t cover hospital care.” Never mind that we have seen cancellations of insurance policies with deductibles much lower, and customers forced to purchase replacement policies with higher deductibles, and with premium increases of 100%, if not higher.

    Then there is this argument.

    Why can’t people opt out of mental health coverage if there is not a reasonable chance that they will need that coverage? Why can’t they get mental health coverage when it is needed? After all, pre-existing conditions can no longer be denied, so in the event that mental health coverage is needed down the line, it can be obtained and the insurance companies cannot deny people who already have pre-existing mental health conditions. The Times assures us that over-coverage–and the high premiums that come with it–is “one price of moving toward universal coverage with comprehensive benefits.” They don’t explain why having unnecessary coverage is a step towards social justice, but as we saw from the beginning of this intelligence-insulting, repulsively dishonest op-ed, the New York Times is less about explaining, and more about covering up a disastrous rollout with disastrous policy consequences for the country.

    Peggy Noonan, who has frustrated me with her obtuseness at times, gets it now.

    Politically where are we right now, at this moment?

    We have a huge piece of U.S. economic and social change that debuted a month ago as a program. The program dealt with something personal, even intimate: your health, the care of your body, the medicines you choose to take or procedures you get. It was hugely controversial from day one. It took all the political oxygen from the room. It failed to garner even one vote from the opposition when it was passed. It gave rise to a significant opposition movement, the town hall uprisings, which later produced the tea party. It caused unrest. In fact, it seemed not to answer a problem but cause it. I called ObamaCare, at the time of its passage, a catastrophic victory—one won at too great cost, with too much political bloodshed, and at the end what would you get? Barren terrain. A thing not worth fighting for.

    So the program debuts and it’s a resounding, famous, fantastical flop. The first weeks of the news coverage are about how the websites don’t work, can you believe we paid for this, do you believe they had more than three years and produced this public joke of a program, this embarrassment?

    She assumed that it wasn’t worth it if it worked !

    The problem now is not the delivery system of the program, it’s the program itself. Not the computer screen but what’s inside the program. This is something you can’t get the IT guy in to fix.

    They said if you liked your insurance you could keep your insurance—but that’s not true. It was never true! They said if you liked your doctor you could keep your doctor—but that’s not true. It was never true! They said they would cover everyone who needed it, and instead people who had coverage are losing it—millions of them! They said they would make insurance less expensive—but it’s more expensive! Premium shock, deductible shock. They said don’t worry, your health information will be secure, but instead the whole setup looks like a hacker’s holiday. Bad guys are apparently already going for your private information.

    This is the worst that could be imagined.

    ObamaCare is a practical, policy and political disaster, a parlay of poisonous P’s.

    And it is unbelievable – simply unbelievable – that the administration is so proud, so childish, so ideological, so ignorant and so uncaring about the bill’s victims that they refuse to stop, delay, go back, redraw and ease the trauma.

    Two closing notes. In my lifetime the good word liberal was discarded by the Democratic Party. Over the decades they’d run it into the ground and changed it from a plus to a minus. Liberal came to suggest a whole world of bad ideas—soft on crime, eager for gun confiscation, big taxing. So the past 20 years Democrats tried to change their label, and in the Obama era it was finally definitively changed. They were now progressives.

    Well, the biggest piece of progressive legislation in our lifetimes—not just costly but intrusive, abusive, and marked by a command-and-control mentality—is ObamaCare.

    What happens now ? Richard Fernandez has some comments.

    WASHINGTON — President Obama was assured that the healthcare insurance website was ready to launch on Oct. 1, even as private contractors and some administration officials knew the site had failed in early testing, a senior White House adviser said Sunday.

    Obama aide Dan Pfeiffer said the president repeatedly asked about the healthcare.gov website, a key piece of his 2010 healthcare overhaul legislation, and was told it would meet his expectations.

    Along with the president, Pfeiffer hyped the website in the weeks before the troubled launch, promising it would “be a consumer experience unmatched by anything in government, but also in the private sector.”

    The system had been in free fall for three years, but nobody wanted to listen. “Three years ago, a trusted Obama health care adviser warned the White House it was losing control of Obamacare. A memo obtained by CBS News said strong leadership was missing and the law’s successful implementation was in jeopardy. The warnings were specific and dire — and ignored.”

    David Cutler, who worked on the Obama 2008 campaign and was a valued outside health care consultant wrote this blunt memo to top White House economic adviser Larry Summers in May 2010: “I do not believe the relevant members of the administration understand the president’s vision or have the capability to carry it out.”

    Cutler wrote no one was in charge who had any experience in complex business start-ups. He also worried basic regulations, technology and policy coordination would fail.

    The employer mandate is set to go into effect next October, one month before the 2014 election. Pfeiffer, of course, is the brilliant Obama adviser who attacked a cancer victim critical of the Obamacare debacle. Joe the Plumber must understand how she feels. Pfeiffer was absolutely correct about the “experience.”

    Now what ? I honestly don’t know. It feels a bit like France in 1940. Now what do we do? This is how an unfolding disaster in public policy feels. Peggy Noonan again:

    Maybe they [ the GOP ] could even call in some people from the White House and Congress, the ones who helped write and interpret this famous law that you had to pass before you could know what was in it, and ask: “Did you ever meet a normal human? Did you understand what you were doing when you produced this thing?”

    Maybe they could even ask the president: “In your entire life, from community organizer to lawyer to politician, did you ever buy an insurance policy? Were you always on your wife’s plan, or immediately put on a plush government plan? Did you ever have to do anything like what you’re telling the people of your country to do?”

     

    20 Responses to “A rolling catastrophe”

    1. Michael Hiteshew Says:

      The problem now is not the delivery system of the program, it’s the program itself. Not the computer screen but what’s inside the program. This is something you can’t get the IT guy in to fix.

      The scary thing is that this catastrophic mess is the debut. This is the unveiling on the showroom floor, search lights in the sky, red carpets, breathless reporting. And nothing works! Can you imagine how bad things are going to get when no one is watching? They threw half a billion dollars at the website! Do you see what a bottomless money pit that portends this will be? And now they pretend they’re going to run the healthcare system effectively?

      These people haven’t got the first clue what they’re doing. No idea.

    2. djf Says:

      “These people haven’t got the first clue what they’re doing. No idea.”

      That may be, but neither does the Republican Party, which could have warned people about this impending disaster as long ago as the 2010 election (by which I mean, telling people that they were going to lose their policies and be forced to buy more expensive ones) but instead just repeated the same stale Regeanite themes over and over again.

    3. dearieme Says:

      I used to say that I’d give no advice to Americans on the healthcare business, except “Don’t copy the NHS”. Now, withpleasing symmetry, I can advise NHS reformers “Don’t copy Obamacare”.

    4. Death 6 Says:

      The charge that the GOP failed to warn people that they would likely loose their policies, doctors, choice and be forced to pay more in both taxes and direct medical costs is, to put it bluntly, BS. Folks like Paul, King, Cruz and Rubio among a host of others warned specifically and forcefully about these specific issues and were shouted down by the progressives of both parties and most of the media.

      When the POTUS repeats with such conviction and wide spread support that these specific statements of consequence are simply false and partisan political obstructionism on behalf of powerful healthcare corporations seeking to stop universal affordable quality healthcare for all Americans, such direr warnings are generally drowned out or largely discounted. Apparently their warnings had some transitory net effect based on the 2010 election results. Why are we surprised now by these inconvenient effects? Because the media and the administration kept repeating the same declarative sound bites as required to deflect any doubts. Barry’s motto should be, “Who you going to believe, your lying eyes or me?”

      Before you dis the GOP for this, try reading the congressional debates on the 40 plus votes to repeal the ACA. Go back and watch some of the speeches of many, many GOP candidates during both the 2010 and 2012 campaigns. Truth doesn’t always win out on simple merit. Now find us one known democrat who spoke the truth. Besides Fox News, give us one national media outlet who probed the details and honestly tried to evaluate these issues and alternate proposals.

      I hear nothing but crickets.

      And don’t even try to tell me they haven’t or didn’t early on propose viable alternatives to reform the healthcare system. Of course if something is screwed up, the only solution the progressives want to consider is more government involvement and control. Tort reform, medical saving accounts, cross state borders plan shopping and in general reducing government regulation of health insurance never got an honest hearing, but they were all proposed and none of those ideas got seriously considered or incorporated into ACA.

      Mike

    5. Bill Brandt Says:

      As my father says all designed by politicians.

      And to make the claim that there were a lot of “bad policies that needed to go” indicates a basic ignorance of market economics by the left.

      Someone was buying those bad policies or they wouldn’t have been around in the first place.

    6. tyouth Says:

      Bill, I reckon you’re too kind. The plan, IMO, was (to some large extent) pay-off for supporters of 0 and the voting left. It’s more a wealth transfer akin to Obama Phones, writ large. While I’ll not rule out a humanitarian aspect, the order of the day is to maintain and increase an un-American-unconservative voting population.

      Immigration policies by 0 and Co. are similarly designed to maintain and increase that segment of people who will tend to vote his way. (Doesn’t hurt that some large corp. donors are lobbying for it either of course.)

    7. PenGun Says:

      Who knows, you may have been gamed. ;)

      Looking at the situation and it’s huge mass of rent takers, your insurance and other medical companies, the large disparity between your and other first world countries’ costs, one can only conclude that the rent takers are taking you to the cleaners.

      Changing this situation in the USA will not be easy and perhaps a more subtle approach is required. ;)

    8. MikeK Says:

      PenGun, turmoil is not the best approach to reform. The French tried that in 1793 and ended up with Napoleon. The Beveridge Report of 1942 was delivered to an England that had little in the way of healthcare for the poor. If you want a picture of English healthcare in the prewar era, read a couple of AJ Cronin’s novels.

      The German reforms were part of a huge social security initiative by Bismark in the 1880s.

      The French system that is in force at present, was planned by the Free French in exile in what I consider an amazing stroke of confidence. The Germans destroyed the prewar French medical institutions.

      The Scandinavian systems were developed after the Protestant Reformation when the state took over the role of the church in caring for the poor.

      The US had a pretty good system of big city hospitals that served the poor. I was there when Medicaid was enacted and it was designed to destroy that system, much as Obamacare is intended to destroy private insurance. Medicaid would not pay for the care of a patient in a county hospital. It insisted on “private care” so Medicaid mills appeared . I knew a guy who quit his residency to start one. The poor had to have the appearance of “mainstream care” even though that was less competent. Cargo cult medicine.

      The result was worse care for the poor and a decline in the big city hospitals that prevented them from modernizing in time for the flood of illegals that were to come.

      Notice, I am treating you as though you were a serious participant in a discussion and not a troll.

    9. Bill Brandt Says:

      Tyouth – I certainly see your point – I was just saying that the comments by these Democrats that certain policies deserved to die because of Obamacare indicated a basic ignorance of how markets work.

      Of course one could also say that it isn’t ignorance but more design (and probably the latter)

    10. tyouth Says:

      My bad Bill I was stuck thinking about policy makers. You were referring to apologists in general.

    11. Joe Wooten Says:

      MikeK,

      Medicaid destroyed the county hospitals all over the nation. In Texas, almost every county either had a small hospital they either ran or subsidized to provide medical care for the indigent. Most babies were delivered locally, most minor surgeries were done there and the big stuff was reserved for the big hospitals in Dallas/Ft. Worth, Houston, Amarillo, Lubbock, Midland/Odessa, San Antonio, Austin, or El Paso. Now damn near all of them are gone as Medicaid refused to pay them in the name of efficiency.

    12. Death 6 Says:

      PenGun is correct about one thing (!), there was and is massive rent taking. He apparently needs some help with figuring out how this occurred. The growth of state and federal intrusion into medicine and healthcare did result in rent taking as well as moral hazard, inefficiencies and reduced production as it always does (capture theory of regulation). Of course his implied “subtle approach” a la doubling down by nationalizing simply compounds all the issues and centralizes all the rents in the political class.

      Mike

    13. MikeK Says:

      Venezuela has seen its health care system collapse.

      Obamacare is using the same logic that Medicaid used in 1965. The county hospitals were not “mainstream” so they had to go. Everybody had to have the same level of care, even if those doctors treating Medicaid patients were marginal. I knew many of them. I remember black women coming to the GYN clinic in the late 60s for a workup. We would do so and recommend a hysterectomy for their fibroids (which they called “fireballs.”) They would say, “Thank you. I knew I could trust you boys at the County. I can go to south central hospital (or whatever) and have a semi-private room, so I will have Dr Brown do the surgery.” We didn’t say a word. Mot of the time, they were OK but we saw some weird stuff come back after.

      I will say it was a bonanza for black physicians (and now for Latino physicians) as the County was no longer a competitor. I was told by older physicians in Los Angeles that the County Hospital, the s modern hospital in the world at the time (1930s), was a serious competitor and was vilified by many of them to patients, not because it was poor care, but because it was good care. Many of them were attending physicians at it. Of course, they weren’t paid for that

      Now, Obamacare supporters say those private plans were “junk.” Or that United Health Care, the largest US insurer, “can’t compete in California,” where they have withdrawn. I don’t think this is malice, just incompetence. That idiot Congressman the other day described Obamacare as “Capitalism.” He would know the free market if it bit him.

    14. MikeK Says:

      The comments page keeps dropping letters. “Most of the time… “The most modern hospital …” “He wouldn’t know the free…”

    15. Jonathan Says:

      Could it be your keyboard? I’m not having any problems entering long comments.

    16. Michael Kennedy Says:

      Maybe my keyboard which is getting old.

      Today, Taranto has an update called The worst is yet to come.

      There is every reason to doubt the exchange can be made functional in the next 24 days. One reason is that much of the coverage and commentary tends to minimize the seriousness of the challenge by describing the nonfunctional system as a “website.” What’s not working isn’t just the website–the online user interface–but the complicated system that lies behind it. To say HHS needs to fix the “website” is like saying your car needs repairs to its steering wheel and accelerator when in fact the whole engine is junk.

      An expert assessment comes from Robert Charette, a technology risk-management consultant, in an interview with Willie Jones of IEEE Spectrum (IEEE is the Institute of Electrical and Electronics Engineers):

      How confident should we be in Sebelius’ assurances?

      Charette: Not very. They’re talking about dozens and dozens of items on their punch list—both in terms of functionality and performance issues. They’ve got just over 30 days to get through the list. Let’s just say that there are 30 items on it. What do you think is the actual probability of getting through testing them, making sure that the system works end to end and that there are no security holes all in a single month? How do you expect to get that done, knowing that every time you make a fix, there’s a high probability that you’re going to introduce an error somewhere else?

      Read the rest. This is going to be ugly. It may be the worst thing to hit Democrats since the Civil War.

      It would be very surprising if there isn’t some type of breach, either at the federal or state level, by this time next year. If you can breach some of these high security defense department or intelligence systems, what’s the probability that the Obamacare website is not going to be breached? That likelihood approaches zero if it isn’t zero.

      Identity theft will be the next big story.

    17. setbit Says:

      Jonathan,

      Could it be your keyboard?

      I have a similar but even more annoying problem. I keep typing insightful, funny comments, but when I come back later, they have been changed into boring, off-topic rants full of flawed logic and grammatical errors.

      I have replaced my keyboard, with no improvement.

      I am hoping this is a problem with WordPress. Could you update to a newer revision to see if that fixes the problem?

    18. Jonathan Says:

      Setbit,

      Ixnay on the OrdpressWay. Try replacing the dilithium crystals in your computer instead.

    19. Anonymous Says:

      Djf said:
      # djf Says:
      November 5th, 2013 at 3:43 am

      “These people haven’t got the first clue what they’re doing. No idea.”

      That may be, but neither does the Republican Party, which could have warned people about this impending disaster as long ago as the 2010 election (by which I mean, telling people that they were going to lose their policies and be forced to buy more expensive ones) but instead just repeated the same stale Regeanite themes over and over again.

      Take a gander at this:
      http://www.google.com/url?q=http://www.youtube.com/watch%3Fv%3DPczF-aYzAHg&sa=U&ei=0el8UqiOJ86NkAfjtYDwCg&ved=0CCkQtwIwBA&usg=AFQjCNEUhALwzndS-mpMJJaGGv_PicJEZQ

      Senator Mike Enzi R-wyo noted and predicted exactly what Obama promised would NOT happen. Back in 2010.

      Google for “Mike Enzi 2010 speech”…

      Too bad the “Mainstream” media chose not to report it, just as they now throw so many stories that would reflect poorly on the administration into the dustbin.
      tom

    20. Grurray Says:

      Three Guys Built a Better Healthcare.gov

      http://www.theatlanticwire.com/technology/2013/11/three-guys-built-better-healthcaregov/71195/

      Works pretty well