Wednesday, November 27, 2013
Monday, November 18, 2013
If we truly want health reform, we need to rethink the process.
I did not have my computer this past weekend, however I reverted to an older edition of my ‘software’….#2 yellow pencil and a yellow legal pad.
Thoughts flashed through my cranial space.
“ObamaCare”………..whose care is it, anyway? Obama is not delivering the care, so why should his name be on it.? The plan was orchestrated by Ezekiel Emanuel, a well known authority and academic expert on health policy matters. also elder sibling of Rahm Emanuel, known for his family traits of high achievers, and lack of humility or ability to be diplomatic. Rahm and Zeke used to go at it, something like this,
Emanuel and his brother Rahm frequently argue about healthcare policy. Emanuel mimics his brother's end of the conversation: "You want to change the whole healthcare system, and I can’t even get SCHIP [State Children’s Health Insurance Program] passed with dedicated funding? What kind of idiot are you?"
Dr Emanuel spent thousands of hours and several years developing the plan. He was head of the NIH at one time as well. He was pretty high up in medical organizations and must be an expert on health care, yes? NO ? He has an outstanding bibliography having written papers on euthanasia, rationing, death panels, end of life and other optimistic and positive views on life.
I don’t believe he has seen a patient in many years, nor ever operated a medical practice business. The law rightly should be named after the author, let’s call it “Ezekiel Care”, or “Emanuel Care”. That sounds holy and authoritative. After all the law is over 1200 pages long, only slightly shorter than my bible at 1400 pages.
Obamacare is written much like the bible….a multitude of The Secretary of HHS shall………it does sound a bit biblical, indeed. Many ‘thou shalt’s under penalty of ……. Obamacare reads a bit like hail and brimstone. And it will truly end with an apocalypse. I am still figuring out who the 7 horsemen will be in this apocalypse.
However, as usual I digress…
Health Reform is too important to be in the political arena, nor reformed by the ingrained establishments of Congress, the Department of Health and Human Services (HHS) or the Center for Medicare Services (CMS).
Americans are now highly suspicious about both parties and see much self interest in Congress, progress bogged down by process and parliamentary. There is little if any creative thought going on in those mighty buildings.
In order for Americans to have faith and trust in a health system, the system cannot be devised or run by those in Washington, D.C. Perhaps even a referendum must be organized to win approval of a totally new organization.
Health is a ‘like no other’ service. It involves life or death matters (not only) with almost a religious sense of ethics, priorities and privacy matters.
Reform must be proposed by neutral agnostic non political principals. Who will be these leaders? That in itself will determine the ultimate outcome, success or failure of what is proposed. It will take Jeffersonian creativity to accomplishment and a strong believer in the Constitution. It has a great deal to do with freedom and individual rights.
All of our leaders and Supreme Court Justices are sworn to uphold the U.S. Constitution, however often fail to deliver on their oaths.
The task is awesome to develop a consensus among patients, providers, insurers, hospitals and regulators.
Empty Mandates are worthless, the proposal must have genuine timely deliverables to succeed. It should not be a ‘ Ponzi scheme’ dependent upon the early success of capitalization to work.
We need to begin again….Repeal Obama Care.
Friday, November 15, 2013
Monday, November 11, 2013
That is less than six months from now. Forbes magazine this week has an op-ed by Steve Hayward.
“Prediction: even if HealthCare.gov is fixed by the end of the month (unlikely), Obamacare is going to be repealed well in advance of next year’s election. And if the website continues to fail, the push for repeal—from endangered Democrats—will occur very rapidly. The website is a sideshow: the real action is the number of people and businesses who are losing their health plans or having to pay a lot more. Fixing the website will only delay the inevitable.
This video is from 1993 when Hillary-care was being discussed. Many of the same concerns as we see today, however much further down the road.
CBS Audio Transcript mp3
Monday's CBS This Morning revealed how "a trusted Obama health care adviser warned the White House it was losing control of ObamaCare". Major Garrett underlined that "the warnings were dire and specific, and ultimately ignored" by the Obama administration. Instead, they "relied on appointed bureaucrats and senior White House health care advisers" to implement the health care law. Garrett also pointed out how "the White House became secretive about the law's complexity and regulatory reach" because they were apparently "fearful of constant attacks from congressional Republicans" over the controversial issue.Garrett also pointed out how "the White House became secretive about the law's complexity and regulatory reach" because they were apparently "fearful of constant attacks from congressional Republicans" over the controversial issue.
Despite this bold statement there are many clinging to a sinking ship.
As Obamacare rolls out fitfully there will be many confounding variables….stay tuned.
One thing for certain (if there is any) is that “Obamacare” elicits a guttural reaction for many people. If you are in favor of it then you might be a left wing liberal, a socialist, or maybe even a ‘Pinko”. If you are against it then you are a right wing conservative, possibly a racist, or worse.
A lofty goal, to insure all our citizens should be removed from the political stage.
Not only was Nancy Pelosi correct in her statement “We won’t know what is in it until we pass it”. Even after it’s passage into law most people will not find out what is in it until they look over the policies on the Healthcare.gov website (if you can use it). The ultimate test is how badly you want it….using the web site is a mixed experience. On some days it works, partially, on other days it is like the old Microsoft “blue screen of death”…
The latest exciting news is that a ‘band of brothers’ has a website named “Sherpa Health” It took three 20 something's and three weeks to created the site.
To quote from the web site, “"The Health Sherpa is a free guide that makes it easier to find and sign up for health insurance under the Affordable Care Act. We only use carefully vetted, publicly available data," the site reads. "The Health Sherpa is not affiliated with any lobby, trade group or government agency and has no political agenda."
I tried Covered California, then the National Healthcare.gov to start. It took several days, however I think I am registered, however there was no way to immediately confirm my registration. There was a rather vague message about how I wanted to be notified, email, telephone, regular mail (or morse code….just kidding)
Three Guys Built a Better Healthcare.gov and while it does not have some of the complexity and linkages to ‘back end’ processes of HHS, IRS and eligibility authorizations it serves as a very friendly usable site for the ‘unintelligent’ (including me)
"It isn't a fair apples-to-apples comparison," Kalogeropoulos said. "Unlike Healthcare.gov, our site doesn't connect to the IRS, DHS, and various state exchanges and authorities. Furthermore, we're using the government's data, so our site is only possible because of the hard work that the Healthcare.gov team has done."
But it does cast light on the difference between what can be done by a small group of experts, steeped in Silicon Valley's anything-is-possible mentality, and a massive government project in which politics and bureaucracy seem to have helped create an unwieldy mess.
HHS and CMS spent hundreds of millions of dollars to erect Healthcare.gov. For a few dollars less (reportedly for a few hundred dollars). Sherpa Health does give credit to HHS for the background data bank which is used by Sherpa Health.
Even at this early date there have been surprises, insurance cancellations, healthcare.gov failures, and there will be more regarding penalties, individual mandates, employer mandates, and conflicts such as HIPAA regulations. The early success or failure may be a telltale sign for the financial future of the Affordable Care Act.
Good luck to us all.
Thursday, November 7, 2013
Full Committee Hearing - The Online Federal Health Insurance Marketplace: Enrollment Challenges and the Path Forward
This morning I awoke to my alarm set to the time of the Senate’s committee hearing on the Affordable Care Act and the botching of it’s “Go live” date. Usually “Go Live” dates are immense are of importance and a clear sign of significant change in an industry.
It is still uncertain if the ‘baby’ was born.
President Obama continues to alter his signature promise in selling the Affordable Care Act back in 2009 and 2010.
"If you like your plan, you can keep your plan," he said back then.
But that simple pledge has had to change as the Affordable Care Act has been implemented and a small percentage of Americans, albeit millions of people, have received cancellation notices from their insurance companies. And for the second time in two weeks, he's tweaked the line.
On FactCheck.org a website published by Annenberg Public Policy Center, the myths are further analyzed. The number of experts is legion. Our senators asked many questions but failed to see the what the light of discontent is about and the depth of concerns.
The committee discusses that the Health Benefit Exchange is not the Affordable Care Act. I don’t think anyone thinks it is,, However no one indicated that discontent rises not in the HBX, but in the uncertainty of what the remainder of the ACA will cause to happen or not happen. The front page open to the public (if and when it works) is not reassuring to the public.
The discontent of consumers is trust and faith have been lost in regard to the entire program. Technology cannot replace a trust in the basic tenets of the act. There are many flaws, each a small one, however failure is usually results from multiple errors.
There are proponents of Obamacare who are endlessly optimistic, and offer enduring patience as one of the solutions.
There has been a growing discontent among those not of the mind that given more time the Affordable Care Act will work. If that is the case, there is sufficient time to place matters on hold and delay certain mandates while the law is modified to give authority to redirect the law as needed.
To push on in the face of serious doubt and to ignore the possible demise of the entire act would not be more than foolhardy.