Health Care Reform Part III: The Implementation.

Today's good news: Henry Chao (CIO at CMS) testified today that the HealthCare.gov website is 60% dev complete.
The bad news: One of the system components not yet done is the billing component

Uh, how can you call a website an e-commerce portal if you don't have a functional billing system? The level of incompetence on display is mind boggling and yet you people pretend it will all be sorted out by Nov 30th! Yeah right.

When do heads start to roll?

 

New meme? I'll just give it a day or two before it falls apart.

 

Do you not get CSPAN?

 

I was referring to your previous post. But for the newer one I have a link:

http://www.newrepublic.com/article/...care-part-d-comparing-two-health-care-reforms

No historical analogy is perfect. But if you want an analogue to the calamitous rollout of healthcare.gov, it’s not the federal response to Hurricane Katrina in 2005. It’s Medicare Part D, the prescription drug program for seniors that the Bush Administration introduced in January 2006.

On Monday, writing in the Washington Post, Ezra Klein reminded everybody of the history: The program’s first few weeks were chaotic, with seniors unable to get their drugs because enrollment into their chosen plans hadn’t worked. Even Republicans called it a disaster. But the Bush Administration fixed the problems and, eventually, it became popular. Today millions of seniors use it to pay for their prescriptions. Nobody talks of modifying the program, let alone repealing it. It’s part of the policy landscape.

Even this analogy, though, has its limits. The most important difference between Medicare Part D and Obamacare has nothing to do with information technology—and everything to do with policy trade-offs. The Bush Administration and its allies weren’t particularly concerned about budget deficits, though they frequently talked about them. And it showed in their drug benefit proposal, which called for spending hundreds of billions dollars in perpetuity—and no new revenues or cuts to offset the new spending. When a government actuary warned that the program would cost even more than the administration projected, the Bush Administration famously tried to squelch the finding. The actuarial projections turned out to be wrong, but the law is still increasing deficits by hundreds of billions of dollars in the next decade alone.

Aaaand /quote

 

So you are not prepared to cite a few examples... I understand.

 

Examples of what? Every person that has been portrayed as a "victim" of Obamacare by the media has later been found not to be one. Why should this case be different?

If it is about the "failure" of healthcare.gov, I posted a link showing you why it is not. Given enough time, it will be a success (within its own limited scope, you know not comparing it with Falcare(tm)) and will imprive the american healthcare system. It might even open the door for a true reform in a not so distant future.

 

You are one of the last people on this forum who should call people out for not using data.

 

As someone who's worked in (mostly private sector) IT for many years - the billing part of any system is always the last thing to worry about getting working. Often, as the group before the billing system in telecom, we'd hold data for quite a while before even releasing it to billing if they couldn't handle it yet.

It's not that unusual for that to be done last, stop getting your panties in a bunch.

 

Here's an interesting chart.



Why does the US have so few physicians per 1000 residents? Well, it's because doctors act as a cartel that serves to drive up their income.

Which gets back to a point I've made a few times...a very, very big reason that health care costs so much here is that in the old system, suppliers worked together (aka "conspired") to drive up their income, and there wasn't any pushback from those who pay for health care. Hopefully, under Obamacare, doctors can start making alot less money.

 

I still await a proposal from the Republicans. I assume from their lack of a proposal that their position is that the current system is a success.

Then you look at that chart and wonder, how on earth could anybody believe such nonsense?

 

We have a bunch of people working for insurance companies and pharmaxeuticals though.

 

Since American doctors are the most highly paid in the world, and a certain type of conservatives think that the law of supply and demand is something like gravity and an ironclad rule of life that cannot be altered by circumstances, I wonder how this chart is possible?

There's a particularly, ahem, Fishy poster who likes to mock my remark that health care isn't subject to normal laws of economics. By that I mean that a shortage of denim just means the price of denim will go up and some people will buy khakis instead of blue jeans. But in health care, an increase in the cost of something that's going to save your life is NOT going to lessen the purchase of that thing. You can substitute khakis for blue jeans but you can't substitute death for life.

But this chart makes the same point. The law of supply and demand is a crucial insight when you're 13 years old. But once you get past that, once you've attended the 3rd lecture of Econ 101, then you know there's more to it than that. In the real world, everyone is trying to create a cartel to extract rents. Few have the power to do so.

The doctors have that power. And so do Pharmaceutical companies, via patent law.

 

Will vfish and falc believe Krugman?

http://krugman.blogs.nytimes.com/2013/11/20/the-state-of-obamacare/

But at this point there’s enough information coming in to make semi-educated guesses — and it looks to me as if this thing is probably going to stumble through to the finish line. State-run enrollments are mostly going pretty well; Medicaid expansion is going very well (and it’s expanding even in states that have rejected the expansion, because more people are learning they’re eligible.) And healthcare.gov, while still pretty bad, is starting to look as if it will be good enough in a few weeks for large numbers of people to sign up, either through the exchanges or directly with insurers.

If all this is right, by the time open enrollment ends in March, millions of previously uninsured Americans will in fact have received coverage under the law, and reform will be irreversible. Obama personally may never recover his reputation; Democratic hopes of a wave election in 2014 are probably gone, although you never know. But anyone counting on Obamacare to collapse is probably making a very bad bet.

/quote

 

That's only the part of it. The bigger part, I suspect, is the inefficiency/stupidity that comes from overtesting, overtreating, having doctors do what nurses should be doing. Because insurance will pay and because of the ongoing fear of lawsuits if treatment isn't expensively overdone.

That and keeping dying people alive for 3 more weeks, so that they can be miserable at a cost of $100,000 that somebody else pays.

 

Bending the cost curve!!

http://talkingpointsmemo.com/dc/3-signs-that-obamacare-is-slowing-health-care-spending

I'm sure @Falc and @VFish are gonna say it's the recession. But are they right?

Well, first of all, the recession ended in 2009. Second of all, remember the "Medicare cuts" that the GOPs ran against in 2010? (The cuts were NOT to health care services, but to reimbursements, but that's just the truth rather than a campaign slogan.) And third of all

Basically, the ACA is a massive, massive public policy initiative. It's gonna take time before even the dead enders agree that it's good policy. These are just some data points on the "plus" side of the scale.

 

Recessions don't have much to do with health-care prices. I doubt that ACA before it was implemented did, either.

 

How about posting a link that actually explains what the Act did to bend the cost curve. The data given by this rubbish does not explain anything at all. Then again Dorothy, just tap your heels three times .....

 

As someone who's worked in (exclusively private sector) IT for many years - the billing part of any system is always up and running and tested before the system goes live.

For God's sake, this there no level of incompetence you won't accept?

 

Yes, a decrease in spending is a far cry from a decrease in costs. And remember, we were promised the average family would see a $2500 decrease in health care premiums.

 

Time is a luxury the bill doesn't have, it looks like the plan might implode on itself within a year. And just wait until all the chaos the law has invoked on the individual markets starts to creep into the employer based system... you can expect that fun to start mid 2014 (there is a good reason Obama was so quick to waive the employer mandates).

 

You are NEVER allowed to post anything resembling this again. You wouldn't recognize data if it bit you in the ass.

 

@superdave

Here's some good news for your home state... Blue Cross NC is going to raise rates 24% on the policies Obama is forcing them to revive from the dead just so the President can try and save political face. I'm sure that is going to go over well in Carolina.

 

Might help you and your friends here to actually analyze data instead of regurgitating meaningless numbers. Ever hear of cause and effect? Ever hear of connecting dots. Now tell us if that article has any?

 

No, I meant the White House report with full analysis was below the article and you are too dumb to read ignored it. There's no way you could say the things you've said after reading the report, so no, you cannot possibly have anything relevant to say.

 

http://www.charlotteobserver.com/2013/11/19/4480209/blue-cross-nc-to-raise-individual.html

This is what happens when you parrot talking points without reading the link that came with your newsfeed, or just relying on the NewsMax edited version

Kate Walker, for example, saw her monthly Blue Cross premium soar from $98 to $577 for a policy recommended as a replacement to her canceled plan. Walker, 64, said the increase was so steep she was planning to drop coverage altogether until she became eligible for Medicare in August.
Walker of Pittsboro and other Blue Cross customers will have the option of sticking to the plans they have, with price increases, or switching to a 2014 plan, depending on which benefits and costs work best for them.
Walker is keeping her plan, which will likely increase to about $115 a month.

The 2014 plans are generally more expensive because they offer more benefits and because insurers will not be allowed to turn away applicants with pre-existing conditions.
However, 2014 plans also come with federal subsidies for those whose household incomes fall within a range set by the federal government. Blue Cross officials estimate 40 percent of its customers would qualify for a subsidy to offset their costs...
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There are detractors quoted in the article, of course, but as usual, the situation not as simplistic as you would wish it to be.