OP-ED

Should the Obamacare Exchanges Be Shut Down?

My sense is that the biggest reason Obamacare is now in trouble is because of the top-secret way in which the administration has handled the rollout. If they had developed the computer system in a transparent way, the marketplace would have told them long ago this would not work.

No one outside the inner circle at the Department of Health and Human Services has any idea what’s really going on behind the Wizard’s curtain. Hasn’t for months. Doesn’t now.

So any technical advice any of us could give would be, to say the least, uninformed.

If I were on the inside, and it were up to me, the first thing I would do is bring in a group of heavyweight information technology experts to tell me just what was really going on. The administration cannot trust the people who have been working on this because they told them to launch this mess on October 1 and almost three weeks in there has been no improvement on the website or in the backroom––they no longer have credibility.

I would ask those experts to very quickly answer three questions:

  1. Can this thing be fixed on the fly––as the administration appears to be trying to do?
  2. If it can’t be fixed on the fly––and three weeks into this that sure looks doubtful––then can it be taken down for one or two months with a high degree of confidence it can be brought back up in time to enroll people sooner rather than later?
  3. If the first two options are not possible, just how long will the computer system have to be shutdown before Obamacare can be launched in a way that there can be confidence it will work smoothly?

Then I would take their advice.

Right now the Obama administration appears to only be looking at this through a political lens: How do they minimize the political fallout?

There are two things wrong with that perspective.

First, the politics of this can’t get any worse. This is now a political joke. Republicans can make lots of snarky comments about Obamacare and they won’t be able to do more damage to Obamacare than the administration is doing to itself. Any Republican reaction to taking the system down won’t last more than a couple of news cycles. More, the President would never lose politically by making a decision about every American already knows he has to make.

Second, the Obama administration, by keeping this computer system up and so far not being able to fix it, is not only wasting people’s time they are on their way to destroying Obamacare.

As I have repeatedly said on this blog, the real longer-term threat Obamacare faces is that not nearly enough healthy people will sign-up for coverage in order for the program to be able to pay the medical costs for the sick people who enroll.

Left as is, I have to believe that the only people willing to put up with the repeated attempts and frustration with the Obamacare website and call centers are people so sick and in need of health insurance they have no alternative.

The greatest threat to Obamacare right now is a computer system the Obama administration continues to defend. And maybe their inability to understand how much damage they are themselves doing to the President’s signature domestic accomplishment.

When these computer problems are finally fixed, then we can move onto the main event: Can Obamacare work?

Robert Laszewski has been a fixture in Washington health policy circles for the better part of three decades. He currently serves as the president of Health Policy and Strategy Associates of Alexandria, Virginia. You can read more of his thoughtful analysis of healthcare industry trends at The Health Policy and Marketplace Blog, where this post first appeared.

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AurthurMr JamesDr. Rick LippinJason BarronDavid Ruggere Recent comment authors
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Dr. Rick Lippin
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Dr. Rick Lippin

Arthur- ok with me

Robert Sherman
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Robert Sherman

We already have concierge medicine. It’s called Medicare. The govt takes our money and uses it to pay bureaucrats in Washington and NY and contractors in the Midwest. We go to specialists who can’t live on the fee schedule Medicare offers which is less than taxicab drivers earn. We pay them direct and get nothing from Medicare. Small wonder Medicare’s costs are going down. If you get rid of the doctors, there are no costs for it. Insurance does not equal health care. Take away the anti-trust exemption and reform tort laws and that will get cheaper. Also take away… Read more »

Mr James
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Mr James

Actually, we pay specialists very well due to the RUC. We begger primary care.

Dr. Rick Lippin
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Dr. Rick Lippin

Here is where we have to go- “change or die” Here is my grossly overly simplified US “Healthcare Plan” – Close 1/3rd of US Hospitals within 5 years. There are too many and too geographically concentrated. Reward efficient ones who don’t horribly gouge/rape the system- Have you checked your hospital bills lately? – Every US citizen DESERVES as painfree and as dignified a death as modern medicine has to offer- Have you checked the medical expenditures in the last 6 months of “life”? – Strong emphasis on both individual (behavioral change) and institutional (public health) prevention. We need both. –… Read more »

Aurthur
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Aurthur

– Single Payer by 2020 – Medicare, by in large, “works” – Or at least there is the framework for it to work.

More likely to be Medicaid for all not on Medicare. Then the administration can cost shift from Medicaid to Medicare since there will be no private insurance sector for the providers to overcharge.

Jason Barron
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Jason Barron

Why is it that a FRIEND and a donator to the Obama Administration get a NO BID CONTRACT for this web-site that cost over $500,000,000+? And the cost is rising. Why is it that when and if Bush or Regan or any Republican would do this it would NEVER HAPPEN or we would hear about it 24/7 on EVERY news station? Well I guess that is what you get when you payoff the most of the News media and keep everyone else QUIET OR ELSE. Thank God only DEMS signed the Obama Care into law. Now with 2014 coming they,… Read more »

Mr James
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Mr James

To get an idea of the panic, posters on leftie blogs were actually speculating that Republican moles were inside the contractors and purposely sabotages the coding.

David Ruggere
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David Ruggere

Just like Newton’s laws, every action has an equal and opposite reaction, the same is true in business. Let’s not kid ourselves; the government and healthcare are business industries. Insurance companies operate in the healthcare industry to earn a profit. The government should be run like a business, even though the CEO would be fired in the private sector, if finances were run the way the federal government does it. To the application of Newton’s law in the healthcare industry or any business industry, the government wants to make healthcare insurance affordable to those who cannot afford it. They want… Read more »

Maria E. Milton
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Maria E. Milton

Obamacare Genocide in Action: What is Already Underway October 21, 2013 • 9:08AM On June 24, 2009, Lyndon LaRouche’s Executive Intelligence Review submitted testimony to the House Ways and Means Committee of the U.S. Congress, which argued, in detail, that “ObamaCare is Genocide,” and presented an alternative of what must be done. In its upcoming issue, dated Oct. 25, 2013, EIR will present a Fact Sheet that will include its preliminary findings on how this genocide has been carried out over the three and a half years since the implementation of the Affordable Care Act (ACA) in the spring of… Read more »

Robert Sherman
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Robert Sherman

Most of our doctors have opted out of Medicare because of horrendously low fee schedules making it only a transfer of money from us to it to provide free insurance to others. It would be better to just tax everyone to pay the bills for those who either can’t afford it or simply don’t feel like paying for them. Meanwhile our secondary carrier, CIGNA struggles with all its might to figure out how to properly process claims when the doctor has opted out of Medicare. There should be a national marketplace with a cafeteria of benefits and tort reform. We… Read more »

Brian Koetkemeyer
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Brian Koetkemeyer

I have done the obamacare website, it only took me two weeks. And found that most Insurance companies have RAISED their monthely premiums 77 to 100 dollars permonth across the board, And the comprable healthcoverage through obamacare is costing me 77 $ more per month FOR THE SAME EXACT PLAN. My current plan is being abolished the end of the year, so i cannot continue to use that plan. So , with obamacare i have to accept a cheaper plan with a HIGHER deductable, with LESS coverage and MORE out of pocket money if i get sick or need surgery.… Read more »

Bill Smith
Guest

The Obamacare exchanges are a huge step forward and should be appreciated by all. I really feel goverment is doing a great job, bringing forward this bill. Here is a website, if anyone wants more info about Obamacare.
http://insuranceexchangehq.com/obamacare-basics-and-faqs/

Adam
Guest
Adam

One other thing. Health care investors are salivating at the opportunities associated with concierge medicine. I predict that, within a couple of years, we’ll have vast concierge franchise operations. There will be $20,000 per year 5-star enterprises, featuring Stanford and Hopkins grads and other medical superstars, and less expensive options staffed by more modestly decorated docs. Cash only, thank you very much. Anyone who’s been to less developed countries understands these sorts of bifurcated medical systems. it’s coming here, thanks in part to the ACA. Again, good job Dems!

Adam
Guest
Adam

Obamacare passed without a single Republican vote. It bears this president’s name. Nancy Pelosi wouldn’t let the public read it. Harry Reid used procedural tricks in conference to pass it. Yes, Dems, this is your baby. You own it.

Enjoy!

LegacyFlyer
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LegacyFlyer

There is good news. Apparently the Feds have released a program to help
people sign up.

See: http://www.theonion.com/articles/new-improved-obamacare-program-released-on-35-flop,34294/

Michael Powe
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Michael Powe

http://huff.to/16lD6cM I think the technical issues are pretty well described in article linked above. Further, according to another report recently, the company that designed the front end has taken its name off the site — a move which had to be approved, and was, by the HHS. The reason seems obvious — the site development was not done according to the original plan and the designers did not want to take the heat for a management failure. What I have read elsewhere is that HHS was warned last JUNE by the developers that the project was unlikely to meet the… Read more »

Adrian Gropper, MD
Guest

The Obamacare exchanges are a huge step forward and should be appreciated warts and all. They will be compatible with private insurance, public options, Medicare for All, and business benefits management regardless of the political winds. For the first time at the federal level, we have real on-line marketing and interactivity with real citizens.

We need to be asking for more transparency and Blue Button Plus automation form both our state and federal agencies and the insurance exchanges, both federal and state, are a good place to start.

More about this https://thehealthcareblog.com/blog/2013/08/15/the-federal-health-data-services-hub-hubbub/

Becky Spoon
Guest

Obamacare is the biggest most deviously disguised piece of pro-corporate-welfare crap ever passed over on a misinformed and misled public. We need “Medicare for All” (starting with the president and members of congress on down)…or a real (not fake like the one Democrats offered but did not pass) public option at the very least.