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Related: Editorials & Other Articles, Issue Forums, Alliance Forums, Region ForumsThe Crapified Magic of the ObamaCare Marketplace
Are the issues raised by this article remotely accurate?
The Crapified Magic of the ObamaCare Marketplace
Posted on November 16, 2014
By Lambert Strether of Corrente.
Please, sir, I want some more. Charles Dickens, Oliver Twist
I confess that this second ObamaCare enrollment period is even harder to write about than the first, because watching our famously free press normalizing as shopping what is clearly an insane system is so painful and degrading to watch. Perhaps the website debacle last year an IT disaster for which nobody with executive authority has been held accountable, not even by our fiercely oppositional Republicans has had the paradoxical effect of setting the baseline for ObamaCares success so low that even the most marginal improvements induce a mutual group hug in the usual cluster of reporters, apparatchiks, and political appointees. At least the website works is an awfully easy story to write.
Anyhow, the stories read like coverage of holiday shopping (shoppers having replaced consumers). There are crowds, and sometimes balloons, or cookies. Venues are brightly lit. Some shoppers are intent, others confused. Some buy at once, others take the brochures home. There are greeters, floorwalkers, assistants. Random individuals are quoted by name! The experience is great, except when it isnt. Occasionally, there are problems, mostly technical. Computers! There are very few numbers, no context, and no analysis (Bloomberg, Reuters, WaPo, New York Times, Contra Costa Times, and many others.) Its as if the entire press corps took Obamas riff that buying health insurance should be like buying a flat-screen TV, and reverse engineered their stories out of it. Never mind that ObamaCare shoppers are highly unlikely to know what theyre actually buying.
To avoid becoming bogged down in all this dull normality, Id like to focus on three things: (1) The numbers game; (2) information technology; and (3) traps for the unwary enrollee.
(1) A General Lack of Purpose and Direction
A story almost as easy to write as the website is working this year is the numbers game: How many signups will there be? (Never mind that since health insurance is not the same as health care, we arent sure from the signup numbers what the concrete material benefits to enrollees are; you write the story with the numbers you have.) And thats a very safe story to write, since not only do we not know how many will enroll for the first time, we dont know how many will re-enroll, either. (IT issues prevent us from having these numbers, even if the vagaries of human behavior were taken into account.)
Politico has a puff piece on the much more precise strategy the administration is using this year, but International Business Times speaks of malaise:
The limited talk about the Affordable Care Act only 44,000 mentions on Twitter at press time Saturday for Obamacare and less than 50 for HealthCare.gov appears to fall in line with a general malaise about the law. While the number of uninsured Americans has fallen by about 10 million since last year, there as still 41 million people without coverage, and administration officials have said they are expecting a net gain of only 2 million people through HealthCare.gov during this open-enrollment period.
lots more...
marble falls
(57,106 posts)still_one
(92,219 posts)about? Prior to the ACA if you couldn't get health insurance because of a pre-existing condition, or you didn't qualify under Medicaid, but qualify under the Expanded Medicaid, etc. you have an opportunity not to end up bankrupt or dead because you don't have Medical Insurance.
Does that mean it is ideal? Of course not, and there are holes that need to be filled, but the 10 million uninsured now that the writer speaks of is NOT an insignificant amount. With all the anti ACA press 24/7 constantly polluting the airwaves, and misinformation from the media and the republicans, 10 million is a remarkable feet. I do know that a lot of people were left out because their asshole state governments would expand the Medicaid program in their states, and I have no doubt that figure would be much lower if those state did so.
It is so easy for intellecual writers to sit on their self-annointed throne, and complain, " they are expecting only 2 million people during this open-enrollment period through HealthCare.gov". Guess what, that doesn't include those states that setup there own exchanges.
Just like Medicare it is just getting started, and there was the same old nay sayers when Medicare came on the scene.
immoderate
(20,885 posts)You can't. I think it has to do with our "exceptionalism."
--imm
Spazito
(50,365 posts)The US 'healthcare system' before Obamacare. It was far worse. Going to "nakedcapitalism" to find anti-Obamacare articles says it all, imo.
still_one
(92,219 posts)immoderate
(20,885 posts)About what?
--imm
still_one
(92,219 posts)immoderate
(20,885 posts)All you need do to falsify my assertion is identify a worse healthcare system. Simple.
I'll even stipulate that we have the best hospitals and doctors. So why don't we have the best outcomes? Why does it cost Americans more, for inferior results? (Hint: It's because of our corrupt system. See? )
--imm
still_one
(92,219 posts)zappaman
(20,606 posts)woo me with science
(32,139 posts)A sure sign that the message in the article is important.
Healthcare as commodity. Obscenely overpriced "insurance" that people cannot afford to use, mandated...profits mandated...instead of care. And a system in which "consumers" must desperately "shop" for a new (lower-benefit, higher deductible, lower-tier) plan every year as premiums skyrocket and they are mercilessly priced out of the old one. And the lipstick on the pig, the subsidies, go directly to the profiteers. The pockets of Americans are looted, while the oligarchs have their obscene profits codified and protected in the law itself.
The bipartisan (despite all theater to the contrary) corporate ACA is already skyrocketing insurance company profits beyond the wildest dreams of its architects. The insurance companies wrote the thing, and it was *designed* to entrench an exploitative, profit-sucking system of middlemen that keeps costs spiraling at the expense of human beings who need care. Look instead for more "loopholes" like the one the Obama administration *already* carved out in order to help the companies shift even more costs to patients.
If most people understood how it is rigged, and how much is being stolen, they would be outraged. The mandate was a corporate wet dream - it ensures that obscene levels of money that should be going to health care instead are given as a cut to these thieving health insurance middlemen. It ensures continued spiraling costs. And it ensures a continued motive to deny care for profit.
http://www.democraticunderground.com/10025517310
Aetna Health Insurance will double Revenues to $100 billion by 2020 thanks to Obamacare
http://www.democraticunderground.com/1014670789
ObamaCare Enriches The Health Insurance Giants and Their Shareholders
http://www.forbes.com/sites/robertlenzner/2013/10/01/obamacare-enriches-only-the-health-insurance-giants-and-their-shareholders/
So far in 2013 the value of the S& P health insurance index has gained 43%. Thats more than double the gains made in the broad stock market index, the S & P 500. The shares of CIGNA are up 63%, Wellpoint 47% and United Healthcare 28%.
http://www.democraticunderground.com/10024970298
How bad is it?
http://www.pnhp.org/news/2013/june/medical-debt-a-curable-affliction-health-reform-won%E2%80%99t-fix
The high frequency of medical bankruptcy was often cited by advocates of health reform during the debate over the ACA. Yet the debate largely ignored the fact that most medical debtors actually have coverage. In order to protect Americans from bankruptcy, coverage must be truly comprehensive, that is, it must cover virtually 100 percent of all needed medical care. Unfortunately, the insurance policies mandated under ACA are required to cover only 60 percent of expected health-care costs.
56 MILLION Americans under age 65 will have trouble paying medical bills.
Over 35 MILLION American adults (ages 19-64) will be contacted by collections agencies for unpaid medical bills.
Nearly 17 MILLION American adults (ages 19-64) will receive a lower credit rating on account of their high medical bills.
Over 15 MILLION American adults (ages 19-64) will use up all their savings to pay medical bills.
Over 11 MILLION American adults (ages 19-64) will take on credit card debt to pay off their hospital bills.
Nearly 10 MILLION American adults (ages 19-64) will be unable to pay for basic necessities like rent, food, and heat due to their medical bills.
Over 16 MILLION children live in households struggling with medical bills.
Despite having year-round insurance coverage, 10 MILLION insured Americans ages 19-64 will face bills they are unable to pay.
1.7 MILLION Americans live in households that will declare bankruptcy due to their inability to pay their medical bills.
Three states will account for over one-quarter of those living in medical-related bankruptcy: California (248,002), Illinois (113,524), and Florida (99,780).
To save costs, over 25 MILLION adults (ages 19-64) will not take their prescription drugs as indicated, including skipping doses, taking less medicine than prescribed or delaying a refill.
99Forever
(14,524 posts)Gettin' all factsie and stuff.
I'm guessing you've made the "doubleplusungood" list again.
woo me with science
(32,139 posts)I got told to shove something up my nether regions this morning, a response I actually appreciated because it exposes the level of "argument" we are actually dealing with here from the Third Way:
http://www.democraticunderground.com/?com=view_post&forum=1002&pid=5822618
99Forever
(14,524 posts)... doncha know?
woo me with science
(32,139 posts)Corporate politicians and depressing the vote
http://www.democraticunderground.com/?com=view_post&forum=1002&pid=5824859
SidDithers
(44,228 posts)Sid
pnwmom
(108,980 posts)This is exactly why we needed the ACA. It was never expected to fix all the problems in the less than 8 months since enrollment ended, but it has made a good start.
Bandit
(21,475 posts)I believe there is something in the ACA that dictates no more than twenty percent of Profits can go to anything other than actual Health Care. Not to Administration or "overhead" but actually spent on Health care. Otherwise the money has to be returned.
KentuckyWoman
(6,687 posts)Not a big fan of Obamacare because it does not let people buy into Medicare instead of feeding for profit insurance.... not to mention I'd much rather single payer universal medical care.
However, rec'd because I'm hearing a lot of this crap come from the right lately and this post pretty much details it all in one post.
Comrade Grumpy
(13,184 posts)I qualify for a substantial subsidy. I am grateful.
But I still think our health care system ought to be nationalized.
BKH70041
(961 posts)What are the numbers of people signing up for it who don't receive subsidies? They're the ones who aren't costing anyone or anything other than themselves. That would be a start of getting the numbers necessary to see if this thing could ever become self-sustaining. Without that, then eventually the chipping away of services offered will begin in earnest, which I suspect will happen.