With the Affordable Care Act (ACA) better known as Obamacare scheduled for implementation in two days Oct, 1, 2013 there are lots of news and opinion stories about it online. I will quote and link to many of them throughout the day. This makes for a looong article. If this interests you just keep scrolling.
Here Megam McArdle from Bloomberg writes that the ACA exchanges are an IT disaster that will not be ready to go Oct.1 and in fact will probably never work as proposed. The article is a well rounded look at both the politics and the practical issues that plague the law. Read the whole thing.
Related, more Megan: 11 Pieces of Obamacare Conventional Wisdom That Shouldn’t Be So Conventional
But of course ACA is not about IT, it is an all too human problem which elicited this response on Instapundit:
If Obamacare were merely an IT project I wouldn’t think twice about it. I would take it in a heartbeat over what Obamacare actually is.
Obamacare is not about the exchanges and I’m stunned that you would say that it is. Obamacare is a five-fold reentrenchment of the insane health care payment system that we have somehow allowed to evolve from its origins as a wretched socialist mistake made in the 1940s by the wretched socialist FDR administration attempting to put price caps on salaries.
Obamacare is a giant leap forward on the path of more bureaucracy, less choice, worse quality, and higher cost. It continues removing decisions from consumers and providers and placing them with third parties. It makes health care decisions even more contingent upon rulings by the IRS (THE IRS!!!) than they already were – and the fact that our health care financing system is largely overseen by our tax collection agency should be absurd on its face, and yet Obamacare doubles down on this absurdity.
If it were all about the exchanges I’d be ECSTATIC. Write the specs then take bids from Amazon and IBM and Raytheon and call it a day. It’d be full of problems but it would work eventually.
What we have instead will never work, even if the exchanges someday do. What we have instead will only serve to make things worse.
Obamacare online enrollment delay for small business
From CNN, another delay.
Online enrollment and other Web features for the Obamacare health marketplace for small businesses will be delayed for a month, officials said on Thursday.
Related: Instead of a live application, the federal government will post a PDF version on Tuesday. Applications will still be taken by phone, mail and fax.
Trader Joe’s To Drop Health Coverage For Part-Time Workers Under Obamacare
“There are several folks I work with who are there for the insurance as much as anything, mostly folks with young families,” she said. “I can say that when I opened and read the letter yesterday my reaction was pure panic, followed quickly by anger.”
Turns Out Obamacare Is Going to Limit Your Choices
Who could have seen this coming? Megan McArdle again at Bloomberg:
Prices on the insurance exchanges that will make their debut on Oct. 1 will, by broad consensus, mostly be higher than you were paying before but lower than some studies had projected. And why is it lower? The answer, it appears, is that state and federal regulators have been pushing insurers to hold the cost down. In some cases, insurers have simply pulled out of the market, as Aetna did when Maryland asked it to lower prices by 29 percent. In other cases, such as Kaiser Permanente in California, the companies have gone ahead offering high priced insurance that few people seem likely to buy. But it’s been clear for a while that most of the insurers who stayed on the exchanges, at least in states with aggressive pricing policies, have been keeping their costs down by restricting the number of authorized providers in the policies they offer on the exchange.
My Opinion: I have tried to present facts and/or the opinions of others and avoid blatant political statements. However as I write this the ACA issue has evolved into a squalid political winner take all bitch slap. Desperate to stop the implementation of a flawed law that the vast majority of Americans oppose the Republicans have passed a budget that excludes the ACA. What will the Democrats do? Compromise or force a government shutdown?
There is nothing good about a shut down. The fact it is becoming a real possibility just emphasizes how deep the issue is and how committed each side is to their vision. I hope they are committed to a vision based on core values. It often seems they are more interested in opposing the other side at all costs than in doing what is principled andright for the country.
Similarly way too many pundits are focused on the political ins and outs of who will get the blame or who is winning points and neglecting the actual issue; the governments takeover of medicine.
Update: The situation has become a classic prisoner’s dilemna where each side’s optimal choice is defection against the other resulting in the least favorable outcome for both.
Obama’s line is “the Republicans are unreasonable because they won’t compromise — and neither will I!”
Why should Congress get special exemption under Obamacare?
This one really frosts me:
Back in 2009, when Democrats were writing the massive new national health care scheme, Iowa Republican Sen. Chuck Grassley offered an amendment. Obamacare created exchanges through which millions of Americans would purchase “affordable” health coverage. Grassley’s amendment simply required lawmakers, staff, and some in the executive branch to get their insurance through the exchanges, too.
To every Republican’s amazement, Democrats accepted the amendment…
…That has caused Democratic panic as the formal arrival of Obamacare nears. Right now, all lawmakers and staff are entitled to enjoy generously-subsidized coverage under the Federal Employees Health Benefits plan. Why give up that subsidy and go on the exchanges like any average American?
The American Medical Association (AMA) went along with the Federal government on so many healthcare rules and regulations they are now faced with a complete government take over. At the same time AMA membership has plunged to just over 20% of US physicians.
This has basically left the profession without and effective voice in Washington.
Needing to have a voice in Washington is one of the major problems that having too much government creates. Professional associations, (in fact all businesses) cannot devote themselves to improving patient care but must become political actors. This will only get worse with government control, soon every disease will have its own lobbying group and treatment decisions will be made by congressional committees.
The ADA still represents the vast majority of US dentists, however there seems to be a tendency for organizations to tilt toward government control. It may be that the types of people who seek leadership of a large organization believe in central control or it may be the natural tendency to go-along to get-along. Whatever the reason rank and file dentists need to encourage the ADA to keep us out of this mess.
…the American Medical Association – the professional group that has purported to represent physicians in the U.S. for over a century – managed to foolishly get itself caught in the crossfire of the “Obamacare” war over the past few years.
Obtaining simple hospitalization policies to cover for catastrophic situations became impossible as everyone was required to cover procedures they did not want or need. Of course, the finger was pointed at the insurance companies for the soaring costs and not the politicians.
Update Sept 30: