Skip to main content

Obamacare Health Insurance Exchanges Crash and Burn. Tweaks and Glitches

A few days ago, lawmakers sealed a deal to reopen the government and to relax the debt limit.  This was no O’Henry story with a surprise ending.  This was the outcome that all of us knew was forthcoming.  The GOP not only had no cards to play, but their empty hand was known to all.  It’s very hard to bluff when your cards are face up and you don’t even have a pair of deuces.   Obamacare was the GOP target that quickly became a phantom.  It disappeared.  Afterwards, there was nothing for them to shoot at except each other.

GOP vs Dems

A perusal of my posts nestled in the Health Care Reform Quality category will demonstrate my skepticism and hostility against Obamacare, which is an interim step toward something even worse.   But, the law was legally enacted, approved by voters in the last general election and was upheld by the U.S. Supreme Court. 
That such a monumental program was passed in a unipartisan manner is wrong, but is not illegal.  The roll out of the exchanges has been so abysmal that even Robert Gibbs, former Obama spokesman, has sounded more like a Tea Partier when commenting on the failed implementation. 

Even the Huffington Post, hardly a Tea Party outlet, trashes the exchange roll out. 

While Obamians may try to gloss over this colossal failure, amply documented in the media, by using words like ‘tweaks’ and ‘glitches’, the rest of us are not so easily hypnotized.   They are desperate to lure young healthy folk into the exchanges to pay for older Americans with health issues.  Those young indestructible Americans in their 20s, will pay a premium, particularly as they must pay for mandated insurance benefits that they may not want or need.   The penalty next year for those who opt out of the exchanges is $95, which young folks may choose over coverage.

And, if young folks do sign up, they will likely choose the low premium and high deductible option.  So, they will face high out of pocket costs for medical care and would be covered only for a catastrophic event that is unlikely to happen.  Will young people in these exchange plans become Obama cheerleaders?   I doubt it. 

Remember the president promising that if we wanted to keep our own doctor that we could?  Each week we read about another large company that is getting out of the medical insurance business and pushing folks onto the gleaming exchanges.    Once planted there, will they have free choice?  If their deductible is now $5,000, might this curtail their freedom to choose?  What if their doctor isn't on the plan?  The web site makes it nearly impossible for folks to determine if their doctor is on the plan.  This adds some adventure to the process.  And, it might be fun to meet a new doctor.  Another glitch?

The failed roll out is not an aberrational event.  It’s a symptom of system that is clumsy, controlling, expansive and broken. 

Let's stop the spinning.  When something is a disaster, then call it by its true name.   We’ve just seen how the legislative branch has served the nation over the past few weeks.  Would you call this a glitch?  Does Congress just need a tweak or two?   Let’s describe them in terms that pass the honesty test.  They are a group of self-promoting, petty and conniving partisans who spurn the public trust as they pursue their own personal ambitions while demonizing the opposition. 

Since the new agreement funds the government through January 15th and extends the debt limit through February 7th, we’ll be spectating once again the Congressional Theater of the Absurd in a few short months.

Last week, Congress’s approval rating has dropped to 5%.   My question to my learned readers is who are these 5%? 




Comments

  1. The members of Congress are actually doing their jobs well. They are paid actors, putting on a horror movie for the American people to watch.

    ReplyDelete

Post a Comment

Popular posts from this blog

Why Most Doctors Choose Employment

Increasingly, physicians today are employed and most of them willingly so.  The advantages of this employment model, which I will highlight below, appeal to the current and emerging generations of physicians and medical professionals.  In addition, the alternatives to direct employment are scarce, although they do exist.  Private practice gastroenterology practices in Cleveland, for example, are increasingly rare sightings.  Another practice model is gaining ground rapidly on the medical landscape.   Private equity (PE) firms have   been purchasing medical practices who are in need of capital and management oversight.   PE can provide services efficiently as they may be serving multiple practices and have economies of scale.   While these physicians technically have authority over all medical decisions, the PE partners can exert behavioral influences on physicians which can be ethically problematic. For example, if the PE folks reduce non-medical overhead, this may very directly affe

Should Doctors Wear White Coats?

Many professions can be easily identified by their uniforms or state of dress. Consider how easy it is for us to identify a policeman, a judge, a baseball player, a housekeeper, a chef, or a soldier.  There must be a reason why so many professions require a uniform.  Presumably, it is to create team spirit among colleagues and to communicate a message to the clientele.  It certainly doesn’t enhance professional performance.  For instance, do we think if a judge ditches the robe and is wearing jeans and a T-shirt, that he or she cannot issue sage rulings?  If members of a baseball team showed up dressed in comfortable street clothes, would they commit more errors or achieve fewer hits?  The medical profession for most of its existence has had its own uniform.   Male doctors donned a shirt and tie and all doctors wore the iconic white coat.   The stated reason was that this created an aura of professionalism that inspired confidence in patients and their families.   Indeed, even today

Electronic Medical Records vs Physicians: Not a Fair Fight!

Each work day, I enter the chamber of horrors also known as the electronic medical record (EMR).  I’ve endured several versions of this torture over the years, monstrosities that were designed more to appeal to the needs of billers and coders than physicians. Make sense? I will admit that my current EMR, called Epic, is more physician-friendly than prior competitors, but it remains a formidable adversary.  And it’s not a fair fight.  You might be a great chess player, but odds are that you will not vanquish a computer adversary armed with artificial intelligence. I have a competitive advantage over many other physician contestants in the battle of Man vs Machine.   I can type well and can do so while maintaining eye contact with the patient.   You must think I am a magician or a savant.   While this may be true, the birth of my advanced digital skills started decades ago.   (As an aside, digital competence is essential for gastroenterologists.) During college, I worked as a secretary