Thursday, October 3, 2013

Hurricane Medicine



No, the title is not about weather or tropical storms. The current cyclone is in health reform, specifically the Affordable Care Act. I think we should stop calling it  ObamaCare.  Labelling any piece of legislation or policy ‘Obama…..” elicits strong reactions, either positive or negative and it triggers partisan political loyalties.

The swirl of controversy regarding the Affordable Care Act continues as it is approaching a category 3 intensity.  The storm has made landfall with it’s outer bands on shore.  The eye of the storm remains offshore tracking along parallel to the beaches, and it is currently stationery pounding health care and the economy with uncertainty.  Should we board up the windows and evacuate or continue to battle with sandbags and a storm shelter.

The Affordable Care Act infrastructure is not complete in many states.  HBX amounts to a health information technology portal (clearing house).  No one installs a new computer system without ‘bugs’.  The platforms may have worked well in the “alpha” rollout. This week we are in the ‘beta’  test.  Betas are never stable and anyone receiving an invitation to use new software is   always warned that it may be subject to unexpectd ‘bugs’.

Our government in it’s proclivity to prove the Affordable Care Act has opened the first act with an unproven system.  This could be a fatal error.

Standard operating procedures for high tech new venture is a competitive process before the contracts are awarded. This project involved over 300 million Americans.

The Air Force gives out contracts for aircraft only after a rigorous planning and demonstration project. No company such as Boeing or Lockheed is going to demonstrate their aircraft to buyers without a very high probability of success. Having your product crash or fail miserably to meet the standards will lose the battle..


Success                                                          Failure

This is the way it should be in  not only health care but many areas of government. No doubt this program was let out to bid several years ago using standard grant process.

Anyone who applies for a Federal or State Grant realizes the complexity and length of time to  navigate the process.  It is so complex that specialized grant writers and companies offer these services to enterprises that want a grant.  Some times ‘form’ outweighs ‘function’.

The workings of the individual mandate are striking the shores, and very soon the inner bands of the employer mandate will strike shore.

The Affordable Care Act portends to improve patient wellness, access, and affordability.  Much of this is yet to be demonstrated.

ObamaCare and You: The Health Insurance Marketplace and Small Business (from Health Works Collective)

Small business experts tell a different story than what we are hearing from media sources:

John Arensmeyer is founder and CEO of the Small Business Majority, a nationally recognized small business organization and advocacy group on critical public policy issues facing America’s small businesses —including health care reform. Arensmeyer has said that the Affordable Care Act (ACA) will help lower small businesses' high healthcare costs and give them more choice in the insurance market.

Here are some of the  items discussed:

What is the SBM looking for as the ACA goes live?   Our primary focus is making sure small businesses know what their options are. That they know about the small business exchanges or the individual exchanges. That they have the facts and know if they have any responsibilities -- which most of them don’t, if they are under 50 employees -

What small businesses are leaving insurance for their employees to solve and dropping any existing insurance coverage(s) they currently have for them?

JA: We haven’t heard many stories of that from around the country. There are businesses that have been unable to provide and they’re not all of a sudden going to begin providing. But in terms of businesses that have been providing thinking of dropping it, no, they are thinking the other way, looking at the options in the new marketplaces and seeing if they can continue to offer. 

Will enough healthy folks sign up to balance the sick and newly covered?

JA: Yes, that’s one of the major cost containment features of the new law.

Will exchanges generally feature a narrower network of doctors and hospitals than SBM would prefer? Do you see any hope for expansion?

JA: We don’t see a narrowing of networks within the plans at the moment.

What if any special issues or challenges will you be monitoring?

JA: The biggest issue for us is seeing how information is being understood, or not, by small business owners and how we can improve that. Now we’re making sure that owners know what their options are, making sure that agents and brokers working with them know how the system works. We’ll be looking if there are breakdowns in any of that and how we can fix it.

HWC: What has surprised you about the rollout thus far?

JA: We’re pleasantly surprised by the sheer volume of interest. It’s created some technical issues, but in a way it’s a good problem to have. We’d rather have reports of glitches than reports of no one showing up.

Lot’s of surprises there.  Have we been mislead ?


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