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ObamaCare Clusterfuck: HHS will not market ObamaCare to the "Vulnerable and Unengaged" even though their health is "worse"


[T]he administration has turned to the science of mass marketing for help in understanding the lives of uninsured people, hoping to craft winning pitches for a surprisingly varied group in society.

America's more than 48 million uninsured people are no monolithic mass. A marketing analysis posted online by the federal Health and Human Services Department reveals six distinct groups, three of which appear critical to the success or failure of the program.

OK, stop right there. "Three of six." Looks to me like the Obama administration is performing its usual trick of segmenting the population, and then throwing some of us under the bus.

[The three groups are] the "Healthy & Young," comprising 48 percent of the uninsured, the "Sick, Active & Worried," (29 percent of the uninsured), and the "Passive & Unengaged" (15 percent).

The challenge for the administration is obvious: signing up lots of the Healthy & Young, as well as the Passive & Unengaged, to offset the higher costs of covering the sick and worried.

Stop again. Notice how the press is framing this framing this. The issue isn't health care; it's signing people up. As if HHS were an insurance company.... So, I wonder what the other three groups are? From the study:

Slide text:
CMS Six Segments Overview

  • Informed, Healthy & Educated [17.2%] The informed, health and educated population have a better health status, feel that Healthcare information is important and use prevention.
  • * Sick, Active & Worried [23.2%] The sick, active and worried population have a worse helath status, feel that healthcare information is important and are worried.
  • Mature & Secure [11.7%] The mature and secure population are of older age, a little better health status, feel that healthcare information is important, uses prevention and are not worried.
  • * Healthy & Young [19.6%] The healthy and young population are of younger age, better health care status, feel that healthcare information is not important, and is not worried.
  • * Passive & Unengaged [20.4%] The passive and skeptical audience has a little better health care status, do not feel that healthcare information is important, does not use prevention and is not worried.
  • Vulnerable & Unengaged [7.9%] The vulnerable and unengaged population has a worse health status, feels that healthcare information is not important and is worried.

And here's the strategy, and yes, it does focus on the three groups mentioned [marked with a "*"], not the three groups excluded:

Over 92% of the uninsured respondents in our study fall into one of three CMS Segments: 29% are Sick Active & Worried, 48% are Healthy & Young, and 15% are Passive & Unengaged. It is likely that the uninsured in these groups will share some common behavioral and attitudinal characteristics that relate to being uninsured, but they may also differ in important aspects that will be essential to consider in our outreach, education, and social marketing efforts. For example, those in the Sick Active & Worried segment are likely to have a chronic disease or pre-existing medical condition that makes it more difficult for them to qualify for affordable coverage in the current market. Those in the Healthy & Young segment may be less likely to perceive the value of health insurance. Those in the Passive & Unengaged segment may lack the skills or motivation (or both) to investigate their options. Clearly, each of these segments presents a distinct outreach challenge. We are currently exploring media and marketing responsiveness for these [three] audiences [and not, presumably, others].

So, let's recap:

1. The metric for ObamaCare's success is people signed up.

2. Delivering health care is not a metric for success.

3. Therefore, the "vulnerable and unengaged," who by the study's own admission have worse health status will have no marketing outreach devoted to them, simply because they are harder to reach.

The consequences in suffering and death should be obvious, even to an Obot (assuming for the sake of the argument that health insurance under ObamaCare will actually deliver care instead of denying it).

Yet surely both the "Sick, Active & Worried" and the "Vulnerable & Unengaged" are equally deserving of care!

HHS's approach to the ObamaCare rollout shows everything that's wrong with the Obama administration and the political class generally. There's no sense of elementary justice or fairness, no sense of "public purpose," whatever.

NOTE An alternative hypothesis: The final slide mentions "Commercial Lifestyle Databases: Experian Mosaic Example." I would really like to be able to correlate Obama's voter demographics with the demographics of this study. I'd bet that "Vulnerable & Unengaged" aren't Obama voters. Only that which helps Democrats in 2014 will get done, and exactly as in 2012, only the minimum needed to secure victory will be done.

Average: 5 (1 vote)


Submitted by jawbone on

going after SocSec Chained CPR and cuts to Medicare?

Surely that will piss off far more people than will become active Dem supporters due to ACA -- which won't have exchanges on line (or will it?) much before the election or at least before voter decision making is pretty set in place.

jo6pac's picture
Submitted by jo6pac on

0 plan is pure genuis the repugs take the blame and demodogs will slide through as you point out and 0 gets the credit from the elite to be cashed in just like big dog did after his time at potus. Yes and when it comes to health care bill from hell bill we on Main Street are thrown under the bus. I thought it was pretty scary when even when the orange mence site wrote about what 0 was going to do honestly instead of their normal follow along with what ever the potus wants.

NWLuna's picture
Submitted by NWLuna on

those in the Sick Active & Worried segment are likely to have a chronic disease or pre-existing medical condition

No shi!

I suspect the authors of this report are in the "What, me worry?" category. All that separates Young & Healthy from Sick & Worried is a diagnosis.

Medicare For All!

mellon's picture
Submitted by mellon on

I think they know perfectly well what's happening. ITS TOO EXPENSIVE.

Obama is a LAWYER and he is being very lawyerly and trying to maintain plausible deniability.

Liz Fowler, a Wellpoint VP wrote the bill. Its a bailout bill for insurers whose products have become too expensive for most Americans. Their cozy win win relationship with politicians allows politicians to avoid taking any responsibility for health care in the US, which seems to allow the US to have far more detached politicians - a very bad thing because what happens here effects the whle world greatly, especially, unfortunately with health care deform.

The poor people may get subsidies but the real costs are structured so that they oftentimes wont be able to afford to get care they need (not preventative care, actual care) And the use patterns of people in medical debt are identical to those of the uninsured. Which has long been known.

So, any people in OC who have a chronic illness will fall rapidly into debt and be prevented from going to doctors from that point onward by that outstanding balance. So then the insurance company is getting free money. The so called insured is unable to get even the minimal care they previously could get for free in free clinics and their money will be spent on a premium for health insurance they cannot actually use. They wont have any money for drugs. Also, they will be forced into the low quality, gag claused 'provider network' when before they might have actually gotten some good honest non-gag claused care when they paid cash. (HMOS dont allow that) Before they might have been able to afford to buy some drugs for chronic illnesses by being uninsured and paying cash but once they become sured te insurance has to be the one who pays the drug bill and if the person falls behind as they invariably will, they will get cut off. Also, since in most of the states where there are a lot of poor people if the persons income falls below the threshold the people cannot by Obamacare anymore and they oftentimes wont be able to get former free clinic care either, there will be a perverse incentive for desperate people to lie and say they have an income even if they dont- because there will be no care at all, if they dont. Also for low paid workers, a small raise may mean a huge increase in costs, so OC will help keep wages down, a benefit which they could not get from single payer.

This is a good explanation of patients problems in Massachusetts under Romneycare. In short, its destroying what little ability to save money some chronically ill poor people had before. Many preferred the system before where there were very low cost or free clinics and the poor people could use their tiny amount of cash to buy whatever Rx drugs they needed. Now the "insurance" takes that money and poor people not infrequently can't even afford to see a doctor, and get prescriptions they need.

So, I think its highly likely that with Obamacare, a great deal of that subsidy money will literally be free money for insurers who will have no obligations (because of the poor 'insured" being sucked into a black hole of debt ) to actually deliver any care. Surprise! So, I think its likely that money will go to lower the costs for wealthy people who can afford to use their newly cheaper non-group health insurance. It already has.