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."
Only if unsuccessful (Score:5, Interesting)
The Republicans can only get rid of it if it is unsuccessful, which is why they tried so hard to get rid of it before it was enacted. Even so, repealing it would take a Republican president and simple majority in both the house and senate, which is much harder.
Luckily for the Republicans they will always be able to find some metrics that show that it was a failure. Health care premiums will continue to rise no matter what until we serious talk about rationing care, so any health care plan written by either party will always leave room for complaints.
Re:Let's just hope (Score:3, Interesting)
. . . the same wonks that gave us so many failed DMV systems haven't found work in this sector too.
You're joking right? It's the exact same people.
SAIC is already in on the action. [seekingalpha.com]
That's the company that scammed New York out of all that money.
Re:Is there really any point to this? (Score:2, Interesting)
So said, funding = telling provinces how to do it. Gotcha, can you tell me when the last time the federal government dictated where to build a hospital in Ontario, Alberta, or even Quebec? Right. How about the number of doctors that need to be hired in each specific province. Right. And let me know when you get around to reading the federal healthcare act again, which should take you all of about 8 minutes. I'll see you sometime next year when you're done reading the ACA.
Re:Only if unsuccessful (Score:5, Interesting)
The reason we pay so much for health care is because the recipient doesn't know and/or doesn't care how much it costs, namely because they don't pay for it. Likewise, they don't shop around. So even though it is all privatized, there isn't really much of a free market system.
Every doctor I've known (which admittedly isn't many) who has worked in a country with a nationalized health care system always talks about how it is problematic because as the end of the year approaches they have to stop caring for their patients because the money has run out. In addition to that, the pay is crap compared to here, which results in a brain drain (notice how when a foreign country needs the *best* care for a particular patient, they pay to have them shipped here for their operation. Always here. In the US resides the world's top centers for cancer, neurology, cardio, and numerous other medical disciplines, and this didn't happen by accident.)
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.)
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. This socialized medicine shit is absolutely NOT without its set of problems, and price ceilings and rationing have always resulted in more problems than they solve, especially for products with inelastic demand (in the 70's we did both for gasoline, and the result was shitty. And that's just for gasoline - the notion that people want to try it with health care - basically playing with people's lives - is stupid.)
Re:Is there really any point to this? (Score:2, Interesting)
you obviously don't know what you're talking about. $92 a year? Bullshit. For me it will cost an addition $8,000 dollars for health insurance, PLUS the cost of my diabetic wife's insulin, needle, test strips, etc have all doubled in price. For a grand total of almost $14,000 a year. I don't know where you got your $92 quote but it's WAAAAAAAY off. btw, I make less than 100k a year.
As for the second part, people in this country don't get turned away because they're poor, they get medicare or medicaid (depending on age).
Re:Is there really any point to this? (Score:4, Interesting)
Actually they're quite wide. Go and read the healthcare act then look at the provinces. In fact those "warning shots" have been at Quebec most of the time, because they simply dump the money direct into general revenue, then take it back out. In order to claim that the money came directly from their own general fund. Aka useless BS Quebec type stuff.
And to highlight difference, in Ontario I pay nothing. I don't pay for any tests or diagnostics out of pocket. I pay for notes from my doctor, and that's it. And if I end up in another province, I still won't be billed--because OHIP will cover it.
Re:Is there really any point to this? (Yes) (Score:3, Interesting)
Before clicking on any health care related article in Forbes, you need to ask yourself "am I about to read something written by Avik Roy?" If so, just stop. He spews crap. Now, I have not actually clicked on your link yet, but I am about to. And we will see if my powers of prediction are at all accurate.
Re:Only if unsuccessful (Score:5, Interesting)
The reason we pay so much for health care [blah blah blah, untested opinions and unproven hypotheses]. ...
- basically playing with people's lives is stupid.)
Bullshit.
Here, have another vantage point to consider, fool: Say you're an individual who has a serious medical problem..... "Nice life you have there, would be terrible if something happened to it. Better pay whatever the fuck we say, or you die." Given that folks who CAN pay WILL pay whatever it takes to not die, which direction do you expect such "free market" forces to direct the price regardless of cost to provide? Even if folks DO CARE how much living costs... So, I think there should probably be SOME kind of collaborative interest on the individuals' side because alone they have likely have little leverage when it comes to health care and that whole "divide and conquer" thing.
Personally, I'm not an absolutist. I'm a scientist. I think we should try a few systems out, maybe a few hybrid ones, in various smaller test areas. Gather some evidence as to what seems to work, and roll forward making examinations and modifications as we go along. However, governments and politicians and their moronic divisionist supporters are all NOT scientists and IRRESPONSIBLY roll out huge changes to entire countries without any fucking evidence at all.
So, when it comes to this sort of thing: Any change is at least an opportunity to SEE WHAT WORKS. Unlike you morons I don't have preconceived notions about what's best. I wait for time to tell. Sadly you all want to take the slowest and most dangerous route to country-wide or world-wide possible harm or success in every fucking debate.
TL;DR: Fuck all of you morons.
Re:Only if unsuccessful (Score:5, Interesting)
The reason we pay so much for health care is because the recipient doesn't know and/or doesn't care how much it costs, namely because they don't pay for it. Likewise, they don't shop around. So even though it is all privatized, there isn't really much of a free market system.
That's not true. There are countries with government-run insurance, like Canada and Germany, and government-run socialized medicine, like the UK, where patients don't know how much it costs, or care (except to the degree that a good citizen doesn't like to see tax money wasted), and they spend roughly half what we do.
Most of the difference is in the insurance system. For every $1 you pay in health insurance premiums, 15 cents of that right off the top goes to the insurance company (look up a health insurance company financial statement under "loss ratio"), and for every 85 cents that your doctor gets, another 15 cents goes for the administrative costs of dealing with the insurance companies. Another difference is in our use of expensive medicines (erythropoetin for kidney dialysis was Medicare's single most expensive drug, and the dialysis centers, which made a profit on it, were overusing it to the point that they were actually killing people with it), and high-tech equipment (such as CAT scans, which are so overused that they're causing a significant number of radiation-associated cancers). Specialists make around $300,000 a year. Malpractice is about 2% of the health care dollar, so there's no big savings there.
Patient choice has almost nothing to do with it. The doctor has to agree on a treatment (and the more expensive procedures they do, the more money they make). A doctor tells you, "You have to do this now or you can die." What choice do you have?
Here's an example of an unusually well-informed patient, a physician assistant himself, who got appendicitis, did his research, and wanted to be treated with antibiotics, rather than surgery (which can actually be safer):
http://www.kevinmd.com/blog/2013/09/77-percent-success-good-guy-insurance.html [kevinmd.com]
A 77 percent success rate is good enough for a guy without insurance
Andrew T. Gray, PA-C
September 26, 2013
How many patients know enough to resist a doctor's sales pitch: "You have to do this immediately or you could die"?
Every doctor I've known (which admittedly isn't many) who has worked in a country with a nationalized health care system always talks about how it is problematic because as the end of the year approaches they have to stop caring for their patients because the money has run out. In addition to that, the pay is crap compared to here, which results in a brain drain (notice how when a foreign country needs the *best* care for a particular patient, they pay to have them shipped here for their operation. Always here. In the US resides the world's top centers for cancer, neurology, cardio, and numerous other medical disciplines, and this didn't happen by accident.)
Well, I've talked to a few doctors from the UK, Canada, Germany, Sweden, and a few other countries, and I've read the studies that compare their outcomes for standard indicators like infant mortality and life expectancy, and for common procedures like cancer and heart disease. Basically the outcomes in all the developed countries are about the same. I wouldn't disparage American medical research, but if you read the New England Journal of Medicine every week, as I do, you'll see that some of the most important studies are also done in Europe, Australia, and elsewhere, The American studies are often done to get an expensive new drug approved, but the foreign studies are often done to test whether a common treatment actually works (for example this week an Australian doctor wrote an article about whether IV fluids do more harm than good). We didn't discover the AIDS virus; Luc Montagnier of France did. We didn't discover s
Re: Freeeeedumb! (Score:1, Interesting)
I'll take freedom from mortgage and foreclosure fraud.
And freedom from contaminated food.
Freedom from a few other things too.
Re:Is there really any point to this? (Score:2, Interesting)
If you like the American system so damned much, I urge you to move there.
For some reason when this topic comes up, we never seem to hear much about stories like this:
Report: Thousands fled Canada for health care in 2011 [dailycaller.com]
A Canadian study released Wednesday found that many provinces in our neighbor to the north have seen patients fleeing the country and opting for medical treatment in the United States.
The nonpartisan Fraser Institute reported that 46,159 Canadians sought medical treatment outside of Canada in 2011, as wait times increased 104 percent — more than double — compared with statistics from 1993.
Specialist physicians surveyed across 12 specialties and 10 provinces reported an average total wait time of 19 weeks between the time a general practitioner refers a patient and the time a specialist provides elective treatment — the longest they have ever recorded.
2700 pages of legislation (Score:5, Interesting)
"You have to pass the bill to know what's in it." - Nancy Pelosi [heritage.org]
And this representative from California was re-elected. Huh. Well as Ron White says "You can't fix stupid."
If you wanted to fix the US Healthcare system by making care affordable for all and allowing people with pre-existing conditions to get insured, then it wouldn't take 2700 pages of other crap that's in the legislative package. What we didn't get was:
1) No direct influence over rising expenditures for Medical Care. You have a system which doesn't abide by market forces and hospital administrators get paid millions of dollars in salaries and benefits. [ctpost.com] When you're seriously ill, you don't usually have the time to shop around so whatever they charge you (or your insurance) is what's charged. Sure, there's negotiations and maximums that insurance companies negotiate but that drives further business through insurance companies, forcing you to deal with them.
2) There was no discussion on tort reform so thousands of ambulance chasers can still sue the doctors and hospitals when your scars comes out a little bit strange. [huffingtonpost.com] A big component to care is the necessary malpractice insurance which can cost upwards of $200,000 in some high cost states. [ehow.com] Add that to office staff, paying the Nurse, the building costs and the medical coder to bill the insurance companies correctly and you can see easily why it costs a lot to see a doctor over a routine sniffle.
3) The Drug companies were let largely intact. There are a few costs they'll have to put up with but they're still expected to rake in Billions in profits under the ACA. [forbes.com] Ask yourself why that pill you're taking is $5 and why, if it was allowed, you could get it for $.25. Sure the drug industry will claim that "these are inferior" but really it's a smokescreen.
4) The Single Payer system died. Nobody wanted to go against the big Insurance Firms and their lobbyists so we love big business in this country, so why not throw a few billion dollars their way. Well, they do now have to spend more on direct costs for Insurance which is good but allowing interstate competition and other market driven forces into the process would have been much better. That's what the exchanges are supposed to do but here we have the US Government trying to create markets rather than creating incentives with appropriate regulatory oversight for markets to flourish. Oh wait, considering the Financial Collapse, the Regulatory Process failed, so DC can't be trusted with that.
To be honest, you could have taken this 2700 pages, cut out the BS, the Pork like the "Exchanges" which Deloitte is now merrily feeding upon it seems and done away with it and had legislation that was no more than 10 pages long. Starting next year you'll hear more pigs in DC all lining up because the Feds have just blessed one industry with unlimited monopoly powers and you have to pay what they want to charge you. You have no choice, so invest in big Pharma, Hostpital chains and big medical concerns because they'll be raking it in even more.