Covered California II

Enrollment for Covered California began one month ago, and will end on January 15, 2014. The online internet enrollment worked more smoothly and was easy to access. It functions fairly well and most of the time it proceeds without a hitch.

One problem I encountered was an inability to progress from {adding members}  to where the web page for adding new members. This attempt repeated itself a number of times when 'next' was selected. After several attempts the next page did appear, and the process proceeded without further difficulty.

The people who receive the 'best benefits/premium cost' are clearly in the Medi-Cal category if their income is at or below the poverty level. The web site performed fairly well with numerous pop-ups and drop down menu selection. Because of the relatively large number of selections and fields it was difficult to scan through deductibles, and/or co pays. The site allowed users to select and compare plans by checking the plans one wanted to compare.

The plans all have deductibles and co pays. The lower the premium the higher the copay and and deductible.  In many cases the insurance appears to be 'catastrophic coverage'  Common sense would make one wonder how many people could afford a deductible of $2500 to $10,000.

The financial algorithm was  designed by people who know little about health care or it's real expenses.  It seems the design was to fit health care into the budget process.

Jonathan Gruber, the principal economic adviser and designer is an expert in health economics at the macro level, and is no authority on patient care.  He has no medical experience or clinical credentials and is ignorant of patient-provider health process.  He had received numerous awards in healthcare economics.
Gruber has published more than 140 research articles (the majority of which were for NBER) and has edited six research volumes.^[11] He is a co-editor of the Journal of Public Economics, an associate editor of the Journal of Health Economics, and the author of Public Finance and Public Policy.^[12] In 2011, he wrote Health Care Reform: What It Is, Why It's Necessary, How It Works, a graphic novel delineating the Affordable Care Act, illustrated by Nathan Schreiber.^[2]

An allegation and video content of Gruber testifying in several resulted in an eruption of public outrage and discontent.

In January 2010, after news emerged that Gruber was under a $297,000 contract with the Department of Health and Human Services, while at the same time promoting the Obama administration's health care reform policies, some conservative commentators suggested a conflict of interest.^[18][19][20] Paul Krugman in The New York Times^[21] argued that, although Gruber didn't always disclose his HHS connections, the times when he didn't were no big deal. 

In November 2014, a series of videos emerged of Gruber speaking about the ACA at different events, from 2010 to 2013, in ways that proved to be controversial. Many of the videos show him talking about ways in which he felt the ACA was misleadingly crafted and/or marketed in order to get the bill passed, while in some of the videos he specifically refers to American voters as ill-informed or "stupid." In the first, most widely-publicized video taken at a panel discussion about the ACA at the University of Pennsylvania in October 2013, Gruber said the bill was deliberately written "in a tortured way" to disguise the fact that it creates a system by which "healthy people pay in and sick people get money." He said this obfuscation was needed due to "the stupidity of the American voter" in ensuring the bill's passage.

Writings:

Gruber's published works include:

• On February 15, 2006, the Center on Budget and Policy Priorities published an article by Gruber entitled "The Cost and Coverage Impact of the President's Health Insurance Budget Proposals"^[13]
• In a December 4, 2008, New York Times op-ed, "Medicine for the Job Market", he claimed that expanding health insurance, even in difficult financial times would stimulate the economy.^[14]
• On February 9, 2011, the Center for American Progress published an article by Gruber titled "Health Care Reform Without the Individual Mandate," analyzing the health insurance coverage impacts of alternative policy options for encouraging purchase of health insurance under the Patient Protection and Affordable Care Act, including the mandate, a late penalty, and auto-enrollment.^[15]

Covered California web site illuminates the copay/deductible inverse relationship and premium subsidy.  The working of Obamacare  obfuscates the ACA bill which was passed by the Democratic party.  Very troubling is  it did not include Republcan legislators in the design process. 

Contrary to Obama's proclamations many patients did not keep their physician,or hospital. Nancy Pelosi's uncannily accurate comment 'we won't know what is in it until we pass it'. Jonathan Gruber's "stupid" must also mean 'congress' was too stupid as well.

Portions of this article are attributable to 

New York Times, Covered California (online enrollment)

Poll: Americans better understand, still don’t love, health-care reform

Lake forming behind an Ice Dam

The recent melt-down of the Affordable Care Act's opening of the Health.gov website served to cast a spotlight on the entire law.  More than 60% of the public pretend to know what it is about. That is about the same as Congress knew when they voted to enact the bill into law.

Despite and perhaps because of it's sudden visibility and the topic of all news media most know of it's shortcomings and how it was passed with major deceptions on the part of the Democrats, HHS, and President Obama's administration.

According to the Seattle Times, "A poll released today by Harris Interactive dug more deeply into the opinions of the uninsured, who face penalties if they don’t get insurance by March of next year. The survey found that more than one-third of uninsured Americans say they are prepared to make health-insurance choices — but 31 percent said they didn’t know about the health insurance exchanges set up to sell the coverage.

On top of that, 61 percent of the uninsured say they have done “nothing” in the past year to get ready for the Affordable Care Act. More than half say they don’t know what they’re going to do about the requirement that they get insurance."

As you may recall, it’s been rough going since the Oct. 1 launch of online insurance markets created to enroll people in individual insurance plans. The federal site, which serves 36 states, essentially wasn’t working for weeks and only really kicked into gear over the last week or so. Washington state’s site had some hiccups, then got itself sorted out, but in the past few days has been down again for software fixes.

Added to those technical glitches like a bee sting on a raging sunburn was the outcry by folks who learned their individual and family insurance plans were being canceled at the end of the year. People felt betrayed by President Obama’s promise that if you liked your health care plan, you could keep it.

A survey conducted and released last week by Gallup found that only 37 percent of Americans approve of the Affordable Care Act or would like to see it expanded while 52 percent want it revised or repealed (the rest are undecided).

The crazy thing — given all of the recent attention to the problems with the roll out of the health-insurance exchanges — is that public opinion hasn’t changed a whole bunch from the same Gallup survey nearly three years ago. In January 2011, 37 percent of those surveyed approved of the ACA while 57 percent did not.

So it begs the question: How and Why was the ACA passed into law?

Many think this was a major move toward consolidating control of healthcare costs, and giving government a major role in 1/6th of the American Economy. It effectively destroys a major freedom of choice of what Americans buy in a market place.

How could public opinion remain so constant despite the tumult in recent news? It could come down to politics.

The Seattle Times teamed up with the Elway Poll in September to take the ACA pulse of Washington residents. It turned out that public opinion on health-care reform largely hewed with political leanings.

In that survey, 80 percent of Democrats approved of the Affordable Care Act, while 80 percent of Republicans did not.

This may reflect more upon the discordance between Democrats and Republicans overall, including budget difficulties which are also severe given the expanding national debt.  Republicans are vehement about corraling the national debit, which will again take canter stage in March 2014.

Arriving Track 1 on the Affordable Care Act

 

Where you stand depends on where you sit

Please stand back to avoid being ‘sucked’ under the train. Wait until the train has come to a complete stop before boarding or exiting (that may take some time)

Take some time to read the entire blog post from Phil Levy, the author of “Not running a hospital”

Technorati Tags: phil levy,not running a hospital,affordable care act,health,healthtrain

The Fallout

 

Health Train Express  has been around since 2005, and in those years I have posted 405 editions. It's been a catharsis, and I have looked forward to writing it. In the process I have made many 'literary giants' as I review the bloglists daily. (what was I doing with my time prior to this?)

Health Reform Expectations:

Most of us may go on practicing medicine as we did prior to the 'health reform' legislation. Truthfully it will change little for physicians, although it may threaten small to medium size practices just because of the bureaucratic overload which is already past implosion and critical mass.

It will however spawn new parasitic administrative functions in government and the private sector of health care.
Extant companies, consultants, legal firms are already marketing their skills to forecast and modify business plans to cope with health reform.

Don't be fooled for a moment that the health reform will be smooth and not subject to major revisions..There will be many roadblocks financially as the attempts are made to enforce the legislation, as well as opposition from providers, insurers, and yes, patients....

 

What we have here as an analogy is the 'fertilization of an egg with sperm' As it develops into an embryo we shall see various combinations, permutations,possible mutations and perhaps even an abortion, or worse a mutant born over the process of several years. Whether the mutant will be dysfunctional, or a working member of society is open to question.

 Timeline for Obamacare Rollout