Why do we have Grand Theft Auto V, but not a working healthcare.gov. My 14-year old son and his buddies can sit on the rug in the playroom and blow away Los Angeles police men with rocket launchers and machine guns, while crouching behind cement barricades, but a single mother in Tennessee can’t log onto a website to apply for health insurance.
We have this…
But not this…
This is a Class A fuck up. Why are we in this situation? Well, there are lots of theories.
My theory is that government IT has always sucked. I mean my voting booth uses less technology than my favorite video game from 1977.
Congress didn’t even use the Internet until 1995. Even Newt Gingrich knew that was insane. I think my dad had an e-mail account before 1995.
Well, what’s to be done? I guess Verizon is stepping in to help out. Probably a good decision that should have been made six months ago. They are going to have to just throw money at this problem right now, but government has to stop acting like the 70-year old guy in front of me in the ATM line. We need an upgrade now.
Apt. 11d 
Because when you think of great software development, you think Verizon?
A friend of mine is a software project manager and wrote a pretty nice post on this:
I’m also sure I’m not alone in being shocked at the “5 million lines of code need to be rewritten” story or the idea that the whole system involves 500 million lines of code. That’s so crazy that I’m tempted to think it must be false.
I worked for a successful software company that started during the dot-com bubble and grew to over 500 employees when it was acquired in 2012. We processed billions of dollars of financial transactions, sent billions of emails per year, and handled hundreds of millions of user accounts. Total lines of source code produced by the team of 5-100 software engineers over a decade? 2 million. (When I mention that to other developers, they’re horrified by the shocking bloat that 2M lines of Java implies — correctly so.)
The media coverage I’ve heard has ranged from the stupid to the profoundly ignorant. This morning’s local AM radio show had a caller who explained in an authoritative voice that rewriting 5M lines of code would take at least six to nine months.
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“Because when you think of great software development, you think Verizon?” LOL.
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One of the explanations I’ve seen for the “five million lines of code need to be rewritten” thing is that they were copied from other sites, rather than written from scratch. I don’t know if that makes any sense from the technical side.
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I don’t buy the 500 million lines of code either. That seems improbable – did they not use stored procedures, etc.? Don’t any of these journalists have ANY kind of bullshit detector?
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Does your friend have any thoughts on what’s wrong with the Common Application for colleges and universities? Because that’s another case that seems pretty inexplicable. I would love to know what an actual IT professional thinks happened there.
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None of my friends in software have college-aged kids, so it hasn’t come up. However, this kind of fisaco is not unique to the federal government: Tim Bray’s article “Why the Obamacare Website Sucks” points out that this is just an exaggeration of the usual problems with enterprise software (about which read his “Doing It Wrong” as well).
I do suspect that federal procurement is thoroughly broken, and not just on this project. I had a few friends who did engineering work for NASA back in the mid 1990s–well, really for sub-subcontractors–and they’d tell stories of enormous efforts being abandoned because of high-level requirement changes. Usually in those cases, the waste would manifest itself through skyrocketing costs and missed deadlines.
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I wasn’t aware of the Common Application issues (my oldest has 6 more years to freak out about college applications). Was there an upgrade or redesign or something to the application? It’s not clear. It would be really sad if the errors were related to poor support/maintenance, which is another pervasive problem in the software industry.
Sometimes it’s hard to convince website purchasers that they are buying a living, breathing thing, similar to a pet that requires feeding and maintenance, rather than an inanimate object, like a can opener which works flawlessly right up until it stops.
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Here’s an article about the Common App issues —
http://www.insidehighered.com/news/2013/10/16/common-application-glitches-block-students-applying
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Megan McArdle is continuing to be very good on the rollout. She’s been amazing on the subject of Obamacare for the past several years.
http://www.bloomberg.com/news/2013-10-21/is-obamacare-in-a-death-spiral-.html
The death spiral is the thing to watch for. If primarily sick, older people sign up, then the insurance rates will go up, which will cause younger, healthier people to drop out, which will mean that insurance rates will go up, which will cause more young healthy people to drop out, etc. That’s the health insurance death spiral, which has already happened in places like New York State.
I know a lot of progressive types thought, well if that happens, we get single payer! (The existence of that Plan B may explain why so little effort was put into making Plan A work.) That strikes me as being the underpants gnomes theory of health insurance.
1. Wreck private insurance system.
2. ????
3. Single Payer!!!!
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McMegan used that underpants gnome theory to explain the tea party view of the shutdown just a couple of days ago. I found myself laughing that she’s writing somewhere so square she had to explain in detail where it came from.
But, I don’t see what “wreck private insurance” has to do with Obamacare. This is covering people who in nearly every case are currently not covered. You can’t have a death spiral if you’re already at the bottom. The individual mandate is the only realistic alternative to single-payer, either through a formal single-payer system or the current system of leaving people uncared for until they get sick enough that the government will step in one way or another.
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The administration decided to go forward with a fake “individual mandate.” A $95 or 1% of income fine (whichever is higher–and only to be collected via confiscation of tax refunds) is not enough to force young, healthy people who do not wish to sign up to sign up and contribute their young, healthy selves to the risk pool. It’s particularly unfortunate, as others have pointed out, that the writers of the ACA decided to put children up to 26 on parents’ insurance. That means that those young people (who are probably more affluent and better-advised than the average US young person) will not be available to the insurance pools.
Obamacare cannot work without the mandate, and there is no mandate in the law as it stands.
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The mandate level is too low. Ironically, Republican carping about the individual mandate being a huge burden is probably going to counteract that to at least some degree. Also, the penalty increases over time, but still stays a bit low.
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“But, I don’t see what “wreck private insurance” has to do with Obamacare.”
The ACA has eliminated the option of true catastrophic health insurance insurance plans by adding in all sorts of extra minimum preventive stuff, hence pushing up the price of those plans for people who truly want just catastrophic. Rather than being health insurance, those policies are now prepayment plans for routine health care.
I would argue that it made little sense to do that. The sort of person who has the sort of future orientation and resources to pay for a catastrophic health plan is also very likely the sort of person who can and will pay for routine preventive care out of pocket.
But, what can you expect from a guy who probably still doesn’t understand the difference between the different kinds of car insurance?
http://www.powerlineblog.com/archives/2010/02/025686.php
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If the Republicans would have actually proposed a catastrophic only plan at any point prior to the actual implementation of Obamacare, that would have been just super. There was none of this stuff from anybody in any position of influence during the drafting of the bill or the 2 years following. The effort was always to kill it and trying anything of substance was a last minute thought. It really is a complete repudiation of any idea of Republicans as a party of government. The massive about face on this matter from 2008 to 2013 is just staggering. Any notion of covering the uninsured was dumped.
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About 5% of the population, or roughly 10% of the private insurance market, was covered by individual policies before Obamacare became law. Those policies are subject to the same rules as the people getting newly covered: guaranteed issue, no ability to price based on health, a very generous mandated benefits package, no lifetime limits, etc. That’s why so many people are complaining about having heir policies cancelled and replaced by something more expensive. IF Obamacare fails, it will take out the whole individual policy market (as happened in New York and Massachusetts when they implemented guaranteed issue/community rating), not just the market for policies to the uninsured. The employer market will still be largely fine, if more expensive. But the individual market will be gravely affected, to the point where it will not make sense for almost anyone to buy a policy, and the small business market could also take a big hit, as they often have similar adverse selection issues.
I’m not saying that this will definitely happen, but this is what will happen if young and healthy people do not sign up; it will become functionally impossible to obtain private insurance outside of a fairly large employer.
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I can think of three good consumer websites: Facebook, Netflix, and Amazon. They do what they are supposed to do, for a variety of different users, on a variety of platforms, and are almost never down. When they do fail, which is not frequently, it is usually in minor ways, and it makes news. (For example, a Netflix streaming failure is usually fixed in a couple of hours, and it does not affect the DVD operations.)
I do not know why these companies can seem to make their end-user software work, when those of so many other companies seem to fail. Are the requirements easier? Do they do better testing? Do they have better people? I do not know, but given a choice between watching something on Netflix vs. Hulu, I’ll take Netflix every time.
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I have all kinds of trouble getting Netflix to stream without interruption.
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We also have Netflix streaming failures, although I think it tends to be because of internet issues on our end.
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That’s possible. I called Verizon to complain and they said something about us having too many devices hooked to the internet. Two computers, two tablets, two ipods, one Kindle, and the Wii.
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One big question is whether or not the end users of the software are paying for the software and/or making purchasing and requirement decisions. If usability and functionality are not what makes money for the software provider, they’ll suffer.
I once worked at a company that made enterprise software designed to make huge, heterogeneous problems more manageable. Most of the sales were made at the CIO or VP level, however, and the result was an absurdist farce. In some cases, the end users (who were not consulted on the purchase) would just pretend to install the software and tell their VP that it was saving them loads of time or whatever else they wanted to hear. In one case, we learned that a last-minute regression had caused the new version of a product to simply not work at all if the user tried to install it, but had had no support complaints. That product had brought in around $300K of revenue, but nobody had ever used it.
I see this dynamic at work all the time. My credit union has a great website, and I love it. My 401(k) has a joke of a website which makes up for abysmal usability with terrible security. Guess who made the purchasing decisions in each case?
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Sort of topically: Part-time employment for those who want to work full time dropped from August to September and is still below what it was in September of 2012.
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The missing link.
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“. . . .or the current system of leaving people uncared for until they get sick enough that the government will step in one way or another.”
This is the big thing that folks who work at hospitals (and I seem to know a lot of them, in the form of physicians, health care administrators, etc.) are painfully aware of. Right now hospitals/group care/private practices engage in all kinds of complicated accounting/finances to manage the care of the uninsured. It is a significant administrative cost and a significant emotional burden and a significant source of income. Some organizations are required to treat (in the form of emergency room care). But even organizations that aren’t required to treat in a particular instance (say, Children’s Hospital providing pediatric leukemia treatment) want to provide care, even when they aren’t required to. At the same time they have to balance their books.
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My husband and a friend were recalling over lunch an article in a tech magazine they both read about 6 months ago. They recalled that that writer (an experienced software project manager) had written that in his opinion such a project was a 6 to 8 year project. If it could be done at all. (My husband isn’t certain it can be done. There are too many independent entities which are supposed to work together seamlessly and with confidentiality.) In their opinion, everything all at once was also too much; incrementally adding one state, one insurance company at a time might have worked (over time.)
“Throwing money at it” will waste a lot of money. There is no guarantee that such an approach will work. It sounds good to people who think writing software is like word processing. It isn’t. It’s like playing chess, or architecture–programs are structures of logic. A misplaced comma can have huge consequences. It will take a long time for the Verizon team to read the existing team’s records of what they’ve done.
Again, my husband the software guy cited a Dilbert cartoon (think it was Dilbert): Pointy haired boss: “And how long will it take to get the project done if we give you twice the staff?” Dilbert: “Twice as long.”
This is such a massive project, if it ever works (unproven), just keeping it running will be a huge undertaking. Software vendors and hardware vendors will continually update their wares, which will introduce bugs which will need fixing. That’s in addition to every different company and entity involved running on different platforms, different computers, etc. It’s also a very tempting target for hackers, I would think. Access to all that personal information and financial details?
Grand Theft Auto has been around for a long time. The “game engine” behind the game may be very similar. I gather software houses don’t redesign entire games when they bring out new versions. They may change the landscape, add a new feature or two, but earlier games are models. The game companies also employ people who do nothing except work on certain games. They employ testers who test the games. (Dream job of many teenage boys.) We can buy Grand Theft Auto V because Grand Theft Auto I – IV were successful.
Many software companies, especially game companies, failed. There are lots of failed software projects and tech companies. Trying to do a 6 to 8 year project in 2 years is one way to fail.
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cranberry has the best response. This: “There are too many independent entities which are supposed to work together seamlessly and with confidentiality.”
Amazon, Google, Netflix–they don’t have to interact with giant already in existence databases with COBOL on top of them. They wrote their stuff from the ground up to do pretty basic, simple things. Grand Theft Auto is self-contained. As cranberry mentioned, the game engine is probably basically the same as it’s always been, and it’s a similar game engine to Halo and Call of Duty, so lots of people know lots about it. It doesn’t have to allow an in-game purchase from Amazon or a sign-in to your tax auditor to function.
I’m not saying the complexity excuses what’s happened, but like many clients, the government has no idea how hard it is to build a complex piece of software. They see Amazon functioning fine and say, oh that shouldn’t be too hard. I don’t doubt that there are millions of lines of code back there. Whether every single one needs to be re-written, who knows. But even major tweaking is going to be a complex process.
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No, there’s no adverse selection problem with flood insurance, because the insurance companies can very easily tell what your flood risk is, and price accordingly. The problem with flood insurance is that if you live right next to a body of water, it will cost you thousands and thousands of dollars a year to insure your home against a flood. Many people would like to be able to live next to a body of water, but cannot afford to pay thousands and thousands of dollars for insurance.
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“About 5% of the population, or roughly 10% of the private insurance market, was covered by individual policies before Obamacare became law.”
This is interesting, because one of the commentators here recently claimed that the individual insurance market did not function in any state. In other words, New York’s market was no worse than anywhere else, and there was nothing for Obamacare to destroy. Clearly, someone doesn’t know what he or she is talking about.
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I think we have a different definition of functioning. Unless you are in near perfect health, the non-group coverage is either unavailable or priced prohibitively high. It’s available only where it is needed least, which is one reason by 15% of people are uninsured despite massive expansions of government programs subsidizing coverage for children.
Also, does that 5% include people on COBRA? I can’t find those figures. If so, that should be counted differently since COBRA is time-limited (and provided because of a government mandate passed back when Republicans were still trying).
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This is really not correct. I’m not minimizing the challenges of people who can’t buy insurance–I have a chronic disease, so it’s quite a personal issue for me–but it simply isn’t true that no one who needed insurance could buy it because insurers wouldn’t sell it to them. That is a problem, but it was nothing like the largest problem; overall, it was an extremely small factor in the number of uninsured.
The most common reasons for being uninsured were: 1) Didn’t bother to sign up for Medicaid/S-Chip, even though eligible (25% of the uninsured), 2) Illegal immigrants who tend not to buy financial products through which they can be traced (and also have low incomes) (10%), 3) young healthy folks who weren’t willing or organized enough to purchase and pay for the quite affordable policies insurers were happy to sell them (this group was about 35-40% of the uninsured, though there is overlap with other groups already named).
Exclusions for pre-existing conditions seem like they’re a huge portion of the market because you remember the one person you meet who can’t get insurance, and because they absolutely dominate media coverage of the uninsured. But they’re about 1% of the population, according to one expert I recently heard from–or about 6.5% of the uninsured. Pre-ex exclusions have been forbidden in the employer market since the 1990s, and thanks to HIPAA, insurers also have to cover folks in the individual market as long as they’ve been continuously insured (unless their state had an alternate high risk pool). Most of the uninsured were uninsured because they were not willing or able to pay for insurance that was at least as cheap as what is now on offer, not because “the market was broken”, except in the sense that it was not selling its product below cost.
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Private insurance provides (or provided, since I think the ACA has some protections) next to no protection against rescission when you get sick. That’s not useful insurance.
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I do understand that a huge portion of uninsured are young people who could but don’t buy coverage. I guess I should consider that more of a “free rider” issue than a market failure problem. It’s also a problem that Obamacare addresses reasonably (or close to reasonably, since I think the penalty is too low) and on which the right wing groups have completely flipped their positions on the past few years.
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Again, recission was a mediagenic problem that affected very, very few people. They can’t just revoke your policy at will; they have to prove that you were deceitful on your application. Otherwise you get folks who wait to get sick and then sign up. I’m not saying the practice was great, but it wasn’t really all that common. These simply are not the biggest issues for the uninsured; the biggest issues for the uninsured are that insurance is a relatively expensive product, and they don’t have the money, or they’d rather spend it on something else. Declaring the market broken because a small number of sick patients (by no means all the sick patients) can’t get coverage is a bit extreme. People with houses on flood plains generally can’t afford market-rate flood insurance, either, but that’s not really a market failure.
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I had understood that flood insurance was highly affected by adverse selection, so that seems an apt comparison. I won’t stick to the term “market failure,” but whatever you call it, It creates a situation where many, many fewer people can protect themselves than if the system were designed even slightly better. Thankfully, I live at the top of the hill and hundreds of feet above a river, literally and, right now, metaphorically.
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There are way too many unknowns here. I’ve written a half dozen blog posts about the ACA and then deleted them, because I felt like I didn’t have enough information to say something intelligent. That’s one of the reasons that I keep logging onto healthcare.gov. I want to figure this thing out.
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For any type of insurance program to work – car, home, health – there can’t be free riders. It’s not possible to only provide car insurance to people who are always getting into car accidents. For car insurance to work, it needs people like me who have never been in a car accident. And I happily buy car insurance, because you never know when you’re going to need it.
Young, healthy people need to have health insurance not only because we need their money, but because young, healthy people sometimes suddenly become unhealthy. Shit happens. And then very expensive problems happen that have to be absorbed by hospitals, which jack up the price on all services to cover the unexpected health problems of the formerly-healthy individual.
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This is just not a large problem for the health care system. Yes, hospitals complain a lot about it, but in fact, it’s about $40 billion a year, out of total spending of something like $2.5 trillion. Moreover, in Massachusetts–which for various reasons can expect to have a better experience than most states (for one thing, they have relatively few illegal immigrants)–the cost of uncompensated are, which had been projected to fall to near zero, instead fell only about 40%. Curing the free rider problem is not the reason that we need to get young, healthy folks into the system. We need to get them into the system so that they can pay a couple thousand a year in premiums while consuming almost no resources
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I have paid thousands of dollars into car insurance over the years and have never used it. I have paid thousands in home insurance and never used it. We have a life insurance policy and, to date, we’re not dead. [spitting sound] For any insurance system to work, most people have to never collect benefits. And most people go along with that idea, because they like the security.
A free rider isn’t just a person who a young person who suddenly gets sick. A free rider is a person who only signs for health insurance only when they get older and sicker.
I may make it to 80 without every getting in a car accident or having a tree fall on my house. But I KNOW that I will get some sort of sickness between now and 80. I will collect on my investment in health insurance at some point. If I skip out on paying into the system until I’m 50 and then sign up, then I am a free rider.
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Laura said:
“If I skip out on paying into the system until I’m 50 and then sign up, then I am a free rider.”
Not if the rates you have to pay at 50 reflect the real risk of you getting sick.
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Maybe everyone needs insurance, but the government doesn’t mandate that your car insurance cover tune-ups, or that your homeowner’s insurance cover the electricity bill. In contrast, Sebelius believes that health insurance that doesn’t cover routine care “isn’t really insurance.” (She doesn’t understand what the word means.) Also, the government doesn’t mandate that good drivers and bad drivers and young drivers and old drivers all pay the same for auto insurance, but that is the rule for health insurance in New York. It’s part of the liberal Democratic program of taking from the young (the poorest age group) to give to the old (the richest old group) that in New York, 20-year-olds and 60-year-olds pay the same for health insurance, to the great benefit of the old, but the same rule doesn’t apply to auto insurance, where it would benefit the young.
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NJ requires that I have car insurance. http://www.state.nj.us/mvc/Vehicle/InsuranceRequirements.htm
Right now, the young aren’t required to have any health insurance, but if they get unexpectedly sick, hospitals have to pay for their services, which then get passed onto the middle aged who do pay for health insurance.
I’m already paying for old people’s health coverage through Medicare. Been doing it for a long time.
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I think y81 means that young people pay higher car insurance rates (because they drive like shit, generally speaking). Obamacare allow rates to be set by age, but apparently New York doesn’t. Car insurers can take gender into account (see previous parenthetical), but Obamacare doesn’t allow that for what I consider justifiable reasons.
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New York and Vermont, apparently. Also, true of Switzerland, which used to be the model of what a conservative reform would look like back when conservatives were trying.
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Every state has uninsured motorists: http://usatoday30.usatoday.com/news/nation/story/2011-09-11/uninsured-drivers/50363390/1. Legally mandating participation doesn’t guarantee participation.
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Also, some states allow you not to carry car insurance.
“Depending on where you live, you may be able to cruise the streets without auto insurance — and you won’t be breaking any laws.
“In some states — such as California, Tennessee, Washington, Texas and Ohio — it’s perfectly legal to skip carrying car insurance if you can prove you have the financial ability to cover liability costs if you get in a wreck. And if you live in New Hampshire, you don’t even need to prove your financial fitness.”
http://money.msn.com/auto-insurance/never-buy-car-insurance-again-insurance.aspx
Of course, it generally makes more financial sense to carry car insurance, but the meme of “everybody has to have car insurance to drive, so you ought to be required to carry health insurance, too” is, shall we say, not reality-based.
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WARNING — FULL ON RANT COMING…
Who are these uninsured, healthy, young people? They aren’t lawyers or finance types or doctors. Those are all full time workers who get health insurance from their jobs.
So who are they? Well, I was one of them for a short time, because my grad school didn’t give me health insurance or a stipend. I ended up getting insurance as a policy analyst. Steve went for much, much longer without health insurance, because he didn’t get any from college teaching. We almost decided to go without health insurance last year, because COBRA cost so much. Some of my freelance writer and editor friends don’t have health insurance. Part time workers don’t have health insurance. My cousin and her family don’t have health insurance, because their business isn’t very profitable. And why don’t they have health insurance? BECAUSE THEIR FREAKIN’ JOBS DON’T PAY THEM ENOUGH TO AFFORD HEALTH INSURANCE. They can’t even afford even the bottom of the barrel stuff.
The problem isn’t with the cost of health insurance, private or ACA. The problem is that there is a large section of the population that doesn’t make enough money to pay for any kind of insurance.
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The first time I had health insurance, I was a grad student. Previously, when I was in the Peace Corps, our health care was primarily provided by the Peace Corps nurses, so there was never any bureaucratic side to it–you’d just walk in, see the nurses, maybe walk out with a bottle of cough syrup. So when I was a grad student and had health insurance, I didn’t really know what to do with it. I can’t quite remember if my dental was at all covered by it (I had wisdom teeth extracted then), but I had maybe one or two doctor’s appointments (and I’m leaning toward one) the entire four years that either I or my husband was in grad school. I’m not totally sure that my husband ever saw a doctor when we were in grad school.
I only started seeing a doctor regularly when I got pregnant at 26 (that may sound young, but I’d been out of undergrad for six years by then). Furthermore, I think I was 30 before I bothered to get a primary care doctor. (I had an ear infection and was in awful pain and discovered, much to my dismay, that I didn’t have anybody to see me NOW–my insurance company was referring me to an urgent care center in &*($%^!@ Virginia. I made an appointment with a specialist, and they saw me right away, but from then on, I knew I needed to be a patient in good standing of a primary care doctor.) Sometime later, I started making regular primary care appointments for my husband. He, of course, had been brought up in Canada so being insured was not a novelty, but being a guy, going to the doctor was not his thing. Were he single, I wonder how often he would see the doctor, insurance or no insurance.
It took us both a long time to get broken in to the whole culture of going to the doctor, using insurance, etc. If you’re a young person, healthy, not having kids yet, and not hypochondriac, I think it’s a fairly normal pattern to follow.
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Laura said:
“The problem isn’t with the cost of health insurance, private or ACA. The problem is that there is a large section of the population that doesn’t make enough money to pay for any kind of insurance.”
I think that is very true. You have to ask yourself, is this a health insurance problem or a poverty problem?
As I’ve mentioned before, my parents have been uninsured for as long as I can remember, although my dad just aged into Medicare. I used to worry about that (and it genuinely would have been a problem when I was a kid), but on reflection, their assets are currently such that they can actually absorb any medical issue into the higher six digits. It wouldn’t be enjoyable to sell off big chunks of the family farm to pay for medical, but it could be done. They have enough assets and income that (up to the higher six figures) it doesn’t matter if they are insured or uninsured.
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Me too, me too!
I think I went 10 or 12 years without health insurance, and fortunately, that wasn’t contiguous years. There was a short bit when I had a tumor–whew, thank goodness for the full time job while working on my Ph.D.
Ding ding: yup, we never made enough money for insurance. Spending even $200 when you’re only earning 30k a year isn’t doable. It seems like more fuzzy maths……(I like math with an “s”; lol)
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There aren’t a lot of other countries where the majority of the population makes more than $30,000 a year, though. And $200 a month is what a young single person who makes $30,000 a year will spend under Obamacare in many places, for a policy with a $6500 deductible, so it had better be affordable, or the whole thing is going to collapse.
I say this as someone who also went uninsured when I made about that–not because I couldn’t pay $200, but because I lived in New York State, which had guaranteed issue and community rating rules that had resulted in the cheapest policy in the state, for a young person, costing $436 a month. Since I had $1000 a month in student loan payments, obviously that wasn’t happening, as it would have taken most of the rest of my take home.
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I’m confused. Our hostess complains that COBRA coverage is so expensive that she and her husband almost went without. Obamacare isn’t going to make insurance cheaper. It will make it more expensive, because of the numerous mandated benefits. (Individual policies might become cheaper if the risk pool were sufficiently expanded, but they won’t become cheaper than COBRA coverage, which already reflects group rates.) Obamacare provides subsidies, which might conceivably benefit a college professor, depending on his level, but which will definitely not benefit people at Steve’s and Laura’s income. So the “rant” seems sort of beside the point.
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I’m confused by your confusion. Employer-provided coverage is tax advantaged for the employer, so there is a strong tendency for it to provide coverage on far more generous terms (in terms of co-pays, deductibles, etc.) than individual policies. I put my own family’s info into the Kaiser Obamacare Calculator and found that we’d get no subsidy and pay $5,000 a year, which is less than 1/2 of what we would pay with COBRA.
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So you are saying that an Obamacare policy would be cheaper for Laura’s family than her husband’s COBRA coverage (assuming she could get through on the exchanges)? Maybe, although only because you assume the policy she bought would be much less generous. But let’s have the facts. What are the actual numbers? Most of the articles I have read on healthy, upper-middle-class families have indicated that they are seeing their premiums go up, not down.
Put more generally, the purpose and intent of Obamacare is not to make health insurance cheaper for upper-middle-class families. It is to make it more available to lower-income families. That is why Laura’s rant seems beside the point to me.
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I took the broader point of the rant to mean that current system was so bad it fails multiple groups of people in different ways.
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If my inclusion of our COBRA payments makes the rant more confusing, then omit it from the rant.
The point is that people need health insurance. The existing individual plans right now are still too expensive for massive amounts of people. There are too many jobs out there that don’t provide insurance and don’t pay enough for people to buy private insurance. Hell, they barely support people who need to pay rent and buy food. Those low paying, benefit-less jobs grow every day.
We’ve got to figure out a way that a family can take their kids to the dentist or take themselves to get a strep throat culture. We’ve got to figure out how to care for a 25 year old or 40 year old who gets some terrible news from a doctor. The status quo isn’t working. That fact should be obvious to everyone. If the Republicans aren’t happy with the ACA, then they have to come up with another idea.
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What is the ACA doing about dental? I know Medicaid does dental and of course the ACA is a massive expansion of Medicaid, but I hadn’t heard that the ACA had much else to do with dental.
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Also, what is dental even doing in this conversation? Large dental bills and large medical bills are of completely different orders of magnitude. A big dental bill might go into four figures, while a large medical bill goes into six figures without much trouble at all. A really big medical bill might break into low seven figures.
Dental is very important, but it’s not the same sort of critter as medical.
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Covers pediatric dental. You can buy plans that do adult dental, but they’re often pretty expensive. Kaiser does dental, but then you have to do everything in Kaiser’s network.
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Laura said:
“Even Newt Gingrich knew that was insane.”
Newt Gingrich is a huge technophile and pretty much always has been. Everybody who knows anything about Newt Gingrich knows that. The word “even” does not belong in that sentence.
http://www.opposingviews.com/i/technology/gadgets/who-knew-newt-gingrich-sci-fi-loving-technophile
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I thought COBRA was expensive there was no employer contribution for it. Essentially, the buyer is picking up the entire cost, when during the prior employement the employer would have been picking up a portion of the cost, perhaps even a majority of the cost. Is there some other reason for why COBRA is so expensive?
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Instapundit just picked this up from the Washington Examiner:
“The contractors, CGI Federal and Quality Software Services, said the two weeks of testing done in late September wasn’t enough to ensure the many components from different contractors operating smoothly in unison before the entire system went online Oct. 1.
“We would’ve loved to have months to be able to do that,” CGI Federal Senior Vice President Cheryl Campbell said Thursday during a House Energy and Commerce Committee hearing to investigate why the healthcare.gov website hasn’t worked as planned.
“Andrew Slavitt, an executive with Quality Software Services’ parent company, said “ideally, integrated testing would’ve occurred well before” it did.
“He said while it was difficult to estimate exactly how much testing time was needed, “months would’ve been nice.”
“The federal Centers for Medicare and Medicaid Services, not a specialized technical company, conducted the tests.”
http://washingtonexaminer.com/builders-of-obamacare-website-say-more-testing-was-needed/article/2537775
Oh my goodness. i’m not a techie, but there were some huge errors in the process that didn’t need to happen. Namely, 1) everything needed to be tested working together at the same time, rather than separately 2) they needed lots of time after that to do fixes and 3)Centers for Medicare and Medicaid Services was not the right entity to do the testing.
In related news, my husband tells me that Microsoft’s Windows 8 is TERRIBLE. On the other hand, nobody’s going to get fined for not buying Windows 8.
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Two weeks of testing for one of the biggest IT projects ever. Two weeks!
That’s how some of us used to write term papers, but that didn’t harm anybody besides ourselves (and the grader).
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Windows 8 has been working okay for me. But I don’t put much demand on my computer, just simple word processing and some internet surfing. I was happy with Windows 1. In fact, I was happy with DOS.
In fact, I am still a child of the sixties, who believes that planned obsolescence is wrong and that the Revolution will not be televised. My wife and I are the only human beings still living who believe these things.
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Obamacare: the Screw the Adjuncts law: http://dailycaller.com/2013/10/27/heres-how-obamacare-makes-life-hell-for-college-profs/
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Thanks. I use these as reminders to check through/delete the spam folder on my e-mail.
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