Tech In the Hot Seat For Oct. 1st Obamacare Launch 326
bednarz writes "In four days, the health insurance marketplaces mandated by the Obama administration's Affordable Care Act are scheduled to open for business. Yet even before the sites launch, problems are emerging. Final security testing of the federal data hub isn't slated to happen until Sept. 30, one day before the rollout. Lawmakers have raised significant concerns about the ability of the system to protect personal health records and other private information. 'Lots and lots of late nights and weekends as people get ready for go-live,' says Patrick Howard, who leads Deloitte Consulting's public sector state health care practice."
Re:Is there really any point to this? (Yes) (Score:5, Insightful)
Yes, there is a point to this.
It may well be a long time before the Republicans have enough votes to get a repeal through the Senate. The way Demographics are headed, the Republican party of today will have to evolve significantly to stay relevant beyond this decade. And what Republicans fear about Obamacare more than anything else is that once it's implemented, people will decide that they like it, making it impossible for them to repeal it (much like Medicare and Social Security).
Re:Is there really any point to this? (Score:5, Insightful)
Re:Is there really any point to this? (Yes) (Score:3, Insightful)
The idea of having affordable health care as opposed to being told sorry but you must just go die someplace as quietly as possible does tend to make it more than likely it will succeed. In year's time this will be old news and the GOPTP will be whining about something else, looking for another hostage to take to get their agenda passed.
Re:Is there really any point to this? (Score:3, Insightful)
The healthcare act sets out "how" the system should be. And what min. level of care should be. Provinces decide "how" to do it. In the US, the ACA determines "how" states should do it, and even "how" to implement it. See the difference now?
Re:Is there really any point to this? (Score:3, Insightful)
Assuming a Republican could even get elected after the party trashes the economy (yet again), it wouldn't be easy to unwind ACA. For one thing, they have time to fix the technical glitches. They'd have a shot at fixing the programmatic glitches if the Republicans would stop acting like spoiled brats. Every entitlement has always required programmatic fixes, this will be no different. And those fixes would happen were the Republicans not hell bent on screwing Obama. I don't recall the Republicans being so worried about the economy or the health care system before the ACA. Now all of a sudden they've had a come to Jesus meeting.
And their budget objections have nothing to do with the budget. They simply do not like what the Federal government does...especially supporting Science. Science prevents them from making shit up and spewing it out over the media...ok, so it doesn't stop them, but at least it clear they are full of shit.
Re: Is there really any point to this? (Score:3, Insightful)
The "tea party" isn't a philosophy. It's a bunch of idiots and corporate patsies. At one point it had an underlying philosophy which, while fundamentally flawed, was at least consistent. Now it's just a bunch of reactionary Obama haters.
Re:Is there really any point to this? (Score:2, Insightful)
Tea Party is in favor of reforming SS, Medicare etc. It is typical of the deceptive way liberals operate to take the placard held by some idiot to represent an entire movement. Do you also take everything every junkie wrote on a cardboard during the occupy protests as representative of the liberal policies?
Re:Only if unsuccessful (Score:4, Insightful)
Rationing is a horrible idea because it just reproduces that problem, in addition to putting you on long ass waiting lists for even basic operations, and making the medical field less attractive as a career choice. It's already bad enough that we have waiting lists for organ transplants (Which by the way this problem is very solvable - have a look at how Iran does transplants. With as much shit as that country gets wrong, they shockingly nailed that one better than anybody else.)
That is only if you have a central body such as the government doing the rationing. You could also ration care the free market way by making poor people unable to pay for certain care. Regardless of the method, we need to understand that as we continue to make new medical breakthroughs we simply cannot spend all of our resources on keeping people alive forever.
If we finally start making breakthroughs that increase our healthy age (the age where you can work) then it isn't as much of a problem. But currently all we are doing is keeping people barely alive and spending a fortune to do it.
Re:Is there really any point to this? (Score:5, Insightful)
Here's the facts. I am a resident of British Columbia. I pay about $127 per month in Medical Services Premiums. For that I won't be given a bill at any hospital or any doctor if I have a medical issue. If I need a scan or some other diagnostic test, I will not be billed. Furthermore, if I end up needing healthcare in Prince Edward Island, I will still be protected.
Shoot, that sounds fantastic! Why can't we get something like that here in the U.S.?
Because we got FREEDOMS!!!!
Re:Is there really any point to this? (Yes) (Score:3, Insightful)
So you think because it has "affordable" in the name, that it actually is affordable. Don't you know of the tradition of that bills in congress are given names that are exactly opposite of the bill's effects?
Re:Is there really any point to this? (Yes) (Score:3, Insightful)
Religious right most definitely does not own the Republican party. It has moved more to the right fiscally, but it has become less religious.
Re:Only if unsuccessful (Score:5, Insightful)
Anyways, find a way to get the patient to actually care about the cost of their medical services, and you'll see the prices go down.
No, you won't. In fact, you'll see prices rise.
There are two cases in which someone would seek medical help -- life-threatening situations, and non-life-threatening.
In the vast majority of life threatening situations, people aren't going to care about the cost. You've heard about the stages of grief, right? Well bargaining's a big one. Most people will do ANYTHING to get just a few more years, or months, or days. They'll throw money away on homeopathic crap and colloidal silver and psychic voodoo. People don't generally go gently into that good night, and shifting more of the cost on to them won't change that.
But in non-life-threatening situations, people will look at the price tag, and decide that they don't need to see the doctor so bad after all. And so curable illnesses go untreated, and become far more dangerous. They might be contagious and spread their illness. They might lose a limb and end up unable to work and on the public dole. They might die. That might reduce costs in the short term, but in the long run the cost to society is far higher.
90 days waiting room, costs $1,000 - $1,300 /month (Score:3, Insightful)
In Canada:
A married couple with no children pay, on average, $11,381 in government healthcare premiums.
Those premiums cover 70% of healthcare costs.
The other 30% of costs are paid out of pocket.
89% of the time, the time for an appointment is less than 90 days.
11%of the time, you have to wait more than 3 months.
For any doctor other than a GP, the average wait time is longer than 30 days.
Patients are not permitted to pay for faster service.
Patients are not permitted to pay for higher quality care.
Patients may pay for services not covered by the government program.
In the US, costs are similar, but slightly higher. Wait times are measured in hours, not weeks. If you're not satisfied with one doctor, you can get a second opinion from another doctor.
The US system is of course not perfect. It does have (had?) a lot of advantages over the Canadian system.
Re:Freeeeedumb! (Score:2, Insightful)
That's right and I want:
- Freedom from having to pay my mortgage ... [insert any expense]
- Freedom from making payments on my car
- Freedom from paying for my groceries (single payer groceries!)
- Freedom from paying
Just need to vote for other people to pay for it and I'll be all set.
Re:Is there really any point to this? (Score:5, Insightful)
And what, you don't think the US system has a ton of horror stories. My run-in with serious illness was my wife's thyroid cancer, and the only real delay was because the initial symptoms aped salivary gland blockage. Within days that that specialist figured out that it was a probable tumor (initially they thought a carotid body tumor), we were driving to Victoria to see an ENT (ear-nose-throat specialist) whose specialization was cancerous tumors. She had surgery a few weeks later, which identified it as a thyroid tumor, and the big delay for removing the thyroid gland (total thyroidectomy) was that she had to heal sufficiently from the initial surgery.
Yes, there are delays and rationing, but really that happens in any system. In the US, in many places, rationing is basically defined by the size of your wallet. In Canada and other countries with universal systems, it's defined by utilization.
The public health system saved my wife's life, and other than her need to take thyroid replacement hormone for the rest of her life, she has fully recovered. Furthermore, I was laid off right in the middle of this nightmare, and the end result was that there was no bankruptcy or loss of our house.
I'll take the odd delay in treatment over no service at all or going bankrupt to save my loved ones' lives. If you like the American system so damned much, I urge you to move there.
Re:Freeeeedumb! (Score:5, Insightful)
These "freedoms" and more are available... but they come at a price.
For instance? No problem...
The county where I live offers an anus-puckering discount on poor families wanting to buy a home (imagine this - being offered a decent home in a neighborhood full of $250k homes for a mere $27k at 0% interest. No, that's not a typo.) Only thing is, the county gets to stop by and make sure you're still poor during the 5-year 'mortgage' period, else the rates and total price rises accordingly. Oh, and CPS gets to check in on your kids any time they want, among other governmental visits that would otherwise demand a warrant.
Groceries? No problem, present an appropriate sob story and proof that you lack income, and most states will lavish you with an EBT card. 'course, unless you get creative about how you dodge it, there's an approved list of foods you can and cannot buy.
Car payments? Well, most metro areas do subsidize free mass transit if you make less than a certain income level... but really - it's mass transit. That means you're stuck with living within walking distance of it, and no further.
How does this relate to healthcare? Well, there are folks already demanding that people be forced to wear health activity monitors [zdnet.com] if they want that subsidized health-care... but you're forced to buy the subsidized plan if you cannot otherwise afford it on your own, so guess what happens if you have the misfortune to be impoverished? Yup - the government now owns your health.
Long story short, the "freedom"s are there, but the dependencies and (IMHO) conditions you subject yourself to in order to receive them are, well... about to become rather dehumanizing.
Re:Is there really any point to this? (Score:4, Insightful)
You'd take the US system because you have enough money to participate in it. Healthcare is ALWAYS rationed. Currently we ration it based on who can pay the most. I'd rather it be rationed based on who needs care most urgently. Societies that choose this method always pay less as percentage of their GDP on healthcare, and get better healthcare outcomes than the US system.
Re:Let us opt out. (Score:4, Insightful)
And what portion of the total federal budget is taken up by SS today?
Negative 85.6 billion dollars. [ssa.gov]
Social Security has a net surplus right now. That will over the course of the next couple decades as the boomers retire, but that can be fixed by (for example) allowing the tax ceiling to be adjusted with inflation.
It's funny that you would claim our ideology thrives on misinformation and lies. Perhaps you're doing a bit of projecting?
Re:Let us opt out. (Score:4, Insightful)
You're lying. Or perhaps just regurgitating lies you heard on Fox or AM radio. Not a big difference, either way.
Here's an official Senate report [senate.gov] showing that removing the tax cap would ensure the solvency of Social Security for over 75 years (the maximum duration in their calculations).
Do you see how I keep citing numbers and figures? I'm able to do that because I'm telling the truth.
Re:90 days waiting room, costs $1,000 - $1,300 /mo (Score:3, Insightful)
My wife has been through several surgeries as well. I have health insurance through my employer that I pay about 300 dollars every two weeks for. I usually, due to her medical condition, spend about 4500 dollars out of pocket every year. It's a lot of money but it's better than losing my wife. We went through several doctors before we found what was wrong and frankly, if I was stuck with the idiots we started with she'd be dead. It's nice to pick and choose doctors as I've had to fire a few. The hard cold fact of the matter is that it costs a lot of money to keep people alive that would have died 100 years ago. I don't know about Canada's system, I only know the one I've been on for my 53 years and I know it's expensive but it works. The new one being foisted on us is pretty bad and likely to cost as much or more. I remember looking at the bastardized setup they cam up with and thinking that they might as well just socialize health care entirely. What they did has all the problems of both systems with none of the benefits. They passed it and now we're finding out what's in it.
Re:Is there really any point to this? (Yes) (Score:2, Insightful)
you are incorrect. if anything, the R's are more religious then ever before. they are doubling-down, in fact, on their 'core values'.
very few people really respect those core values once they see the light of day.
the jig is up. people see the R's for what they are. rich guys who want to keep the current power structure and, in fact, make things even more polarized.
if you heard the phrase 'american taliban', which of the 2 parties do you think more closely fits this description?
Re:fist pumping? US system? (Score:4, Insightful)
Insurance is not really capable of being competitive in the same ways manufacturers are. Insurance companies are more like middle management who go between the employees doing the work and the bosses wanting the work done. The differences in costs and coverage between states is likely due to requirements imposed by the states and the risks inherent in the cultures of the people within those states. That being said, there is a little room for competition to create savings or better services. The ACA will get around much of the state regulatory issues which is why we are seeing a lot of states insurance costs actually increasing. But even though the ACA has provisions in it requiring insurance providers to refund the differences if their profit is a certain amount over the coverage paid out, those same insurance providers will still be required to collect and have the ability to pay out for a worst case scenario developed by their actuaries and approved by the government. That is where the real costs of insurance comes from- they are required to keep a certain amount of capitol liquid and available to cover their obligations. Competition cannot get around that.
Insurance is also not health care. The main reason the health care is so expensive in the US is because the government became involved in it. In 1965, the US created medicare and was so overwhelmed by the costs of it, they created HMOs in an attempt to reduce their costs. They gave people with less of a medical education then your typical EMT, Paramedic or nurse the power to deny procedures in the name of cutting costs. Of course this morphed into a mandatory payment schedule where instead of paying the health care costs that are billed, they average the costs billed for an area and pay the average. This means that if one doc charged $10 for an office visit and another charges $30, the average is $20 and both doctors get reimbursed $20 for the visit. This is despite one office being in a rural town and the other being in a large city where overhead just for having the office might be 3 or 4 times as much as in the rural location. Now this cost billed can also be different than the costs billed to an insurance provider too. Well, what happened is that the medical industry who were getting more then expected, increased their rates to $20 and those getting less increased theirs to $60 so the average is now $40.
After a while, this proved to be way to expensive on the government side (granted, insurance providers at the same place might be charged $40 or less but the discounted rates were never part of the average) so the government started paying a percentage of the average. This meant that while the payment average should have been $40, they would only pay 80% meaning only $32 would be paid out. This was acceptable to some as long as they could bill the patient for the non-covered amounts. Well, that caused a lot of outrage and a law was passed saying they had to accept the payment as payment in full and couldn't go after the difference from the patient. People in the health care industry knew that if their costs were higher, the average would be higher and they would get what they wanted again, so they moved their costs up and the doc visit is now $120 or more. Rinse and repeat as this happened in some form close enough to this to call it accurate several times until the ACA was finally passed.
The Affordable Care Act simply doesn't have any mechanism to reduce costs of health care and by all indicators, it has increased the costs of most health insurance. It might even get worse because insurance companies cannot negotiate steep discounts for in network providers the same way as before. Cutting costs might be easier done if instead of average billing, we paid out a costs plus scheme (actual cost of providing the care plus a percentage of that as profit) on the government side. There will be no easy fix for the insurance side and it might get a lot worse.