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ObamaCare Clusterfuck: The deadlines that are never real deadlines, because Obama

My new acronym: SMFH (Shaking My Fucking Head). I don't know why I ever imagined that the November 1 deadline would be meaningful as anything other than a narrative hook; after all, these guys "met" the October 1 deadline -- by which I mean, "the October 1 fucking launch deadline" -- by launching system that wasn't completely tested, couldn't handle more than 500 users at a time before crashing, couldn't identify users properly, couldn't calculate premiums properly, couldn't calculate subsidies properly, corrupted data, and didn't even have any back office software, so the insurance companies couldn't do their billing properly. ("Yep, I'm done painting your house. Well, except for the final coat. And the primer. And I didn't do all the surface prep....") It then took these guys two weeks to figure out they had a problem and call a meeting. This after Obama's tech savvy administration had three (3) years to build the system, which was only Obama's "signature domestic initiative." I'm telling ya, I'm SMFH. Again, I wasn't nearly cynical enough!

Anyhow, back to November 1, it's no surprise that the gauzy "vast majority" baseline is and was bullshit, and such obvious bullshit even our famously free press is picking up on it. (Of course, they're pissed off at Obama for other reasons, but still.) So, now that I've got that off my chest, let's deconstruct this story from AP:

Year-End Signups Crucial Test for Health Care Site

Not bad, not least because it says, implicitly, that the November 1 deadline was not crucial. Even more amazing, however, the headline actually points out -- follow me closely here -- that the purpose of ObamaCare is to sell insurance* -- as opposed to collecting hits, or producing a pleasant user experience, or falling over at the slightest load like a cow tipped by a drunken frat boy. More:

Until now, the main damage from the website's technology woes has been to Obama's poll ratings. But if it chokes again, it will be everyday people feeling the consequences.

Just SMFH. That's so elitist. For one thing, people are being mandated to purchase a (defective) product by a certain date, and Obama hasn't given them the tools to do what they are mandated to do. That has two effects, one obvious: People are wasting hours of their time, some of them days; in fact, it's a massive time tax with no return. If it were banksters having to do that, there'd be outrage. Second, people get to plan their lives, right? Especially financially? So it's really an outrage, even if we are used to outrage, that people are being forced to make decisions on products that directly affect their well being, and could cost thousands of dollars, under a deadline that's less than two weeks away, with tools that don't work yet (which the administration has three years to build). And all that when everybody and his brother got a delay, except the poor shlub with, er, "skin in the game."

Some of those at risk are among the more than 4 million consumers [sic] whose individual policies have been canceled because the coverage didn't comply with requirements of the new health care law. A smaller number, several hundred thousand, are in federal and state programs for people whose health problems already were a barrier to getting private insurance before the overhaul.

SMFH. We've cancelled 4 million, and "signed up" 100,000?** Pass the Victory Gin.

"It's important to recognize that none of these programs are going to work perfectly from the start and a big part of implementation is having mechanisms in place that anticipate problems and help mitigate their effects," added [Mark McClellan, now a health care policy expert with the Brookings Institution think tank in Washington.

SMFH. They launched the fucking thing with no end-to-end testing, so no fucking wonder it didn't "work perfectly from the start." (And... and... I mean, it really does boggle the mind, how bad this launch was. Sloppy. Irresponsible. Bullshit-laden. I don't have the adjectives! And, of course, not a firing offense! I mean, it's like these people are banksters!)

But on Monday, administration officials projected renewed confidence that they're on top of things. White House spokesman Jay Carney declared that the federal site serving 36 states got 375,000 visitors by noon.

SMFH. Who cares about vistors? The metric that matters is sign-ups that the administration hasn't managed to corrupt and fuck up, like they do everything: Clean, error-free 834s. And even though that was the crack tech teams's #1 priority, they failed to deliver on it.
Even as fixes continued on back-end features of the system, enrollment counselors said the consumer-facing front end was working noticeably better — but still was not free of glitches or delays. As Carney acknowledged, some of Monday morning's visitors were shuttled into a queue and advised when to return for speedier service. That's actually an improvement to handle high volume, he said.

SMFH. No. The improvement to handle high volume is capacity. Have you ever seen a queue at Expedia or Best Buy or Amazon? Even on Black Friday? No? (And I can't understand why capacity isn't the answer to peak loads for the ObamaCare website, either. Must be a bottleneck they can't get rid of, but what?(

In the central Illinois city of Mattoon, enrollment counselor Valerie Spencer said she and her team finally signed up their first person in the days leading up to Thanksgiving. Now they have a half-dozen success stories and dozens of consumers with appointments to finish applications at the Sarah Bush Lincoln Center, a small hospital serving the region.

SMFH. No. They don't have success until the policies are sold and the 834s are error free. Otherwise Valerie Spencer's
The health care law offers subsidized private insurance to middle class people who don't have access to job-based coverage. The White House is aiming for 7 million people to enroll for private plans through new state-based marketplaces also called exchanges. Low-income people will be steered to an expanded version of Medicaid in states accepting it. People have until Dec. 23 to sign up for coverage that starts on Jan. 1.

"It's crunch time and a lot of people are really nervous," Spencer said.

An even bigger enrollment surge is expected the first part of next year, ahead of a March 31 deadline to avoid the law's tax penalties for those who remain uninsured.

In Beverly Hills, Fla., north of Tampa, self-employed real estate appraiser Tom Woolford said he was finally able to get all the way through the process Sunday and enroll in a Blue Cross Blue Shield plan. Except nothing happened when he clicked a link to pay his first month's premium.

"As far as I know, I am in orbit someplace and nobody's got a transponder on me," said Woolford, who was otherwise pleased with the plan and his costs. He'll give it a week and see if the health plan reaches out to him.

If consumers still have unresolved issues, so do the feds. Among them:

THE BACK ROOM

Private insurers complain that much of the enrollment information they've gotten on individual consumers is practically useless. It is corrupted by errors, duplication or garbles. Efforts to fix underlying problems are underway, but the industry isn't happy with the progress and is growing increasingly concerned.

Over the weekend, as government officials trumpeted improvements to the website, the leading industry trade group pointedly called attention to the data mess. The president of the largest health insurance trade group said the website fix won't be complete until the entire system works from end to end. Karen Ignagni, president of America's Health Insurance Plans, raised the prospect that consumers might not be able to get access to needed benefits Jan. 1.

"There really needs to be an intense focus now on the back end of the process," said Joel Ario, who oversaw initial planning for the insurance marketplaces in the Obama administration and is now a top consultant with Manatt Health Solutions.

Administration spokeswoman Julie Bataille said that's already happening. More than 80 percent of insurers' problems were due to one bug that affected Social Security numbers, she said. That's been fixed.

CRAFTING A NEW PITCH

Largely because of the federal website problems, major advertising campaigns encouraging everyone from the young and hip to the middle aged and health conscious to enroll have been put on hold.

The worry now is that the technology debacle may have done lasting harm to the outreach plan. And even a revamped website with new bells and whistles is going to have to compete for attention with the year-end holidays.

"The real question in my mind is can they turn around the messaging?" said Caroline Pearson, who is tracking the overhaul for Avalere Health, a market analysis firm. "They've had eight weeks of terrible press. Can they begin to reach out with a message of things are fixed and we're back on track?"

It's unclear how much candor will creep into the pitch. Some enrollment counselors feel a need to acknowledge the problems.

Looking back on the weeks of failed attempts to enroll people through the marketplace, Spencer, in central Illinois, laments the feelings of broken trust.

"We told them we were here to help them and we (couldn't) help them," she said.

Still, some people returned again and again to keep trying to get through the process. "They keep trusting us and they keep coming back," Spencer said.

NOTE * By which of course I mean junk insurance that doesn't pay out, thereby creating a captive and profitable market for the health insurance companies in perpetuity; they must be really ticked at Obama that he butchered this so badly. Then again, being insiders who'd already had dealings with the guy, they probably expected it.

NOTE ** The administration games the definition of "sign up" to mean those who have selected a plan on the Exchange, but not paid for it (!!). And why not? Probably because they're just wanted to get through to the end of the horrible and cumbersome process to find out everything that was in store for them. And now they're trying to find out exactly how crapulicious the product is before they actually shell out any of the money they don't really have, any more, the economy being what it is.

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Rainbow Girl's picture
Submitted by Rainbow Girl on

Because Responsibility!

The ad campaigns for That new tax have huge potential -- cats, dogs, hamsters ... all things cute: getting citizens - consumers to fork over shekels for Puppy Policy or Kitty Policy will be a snap compared to selling junk to Invincibles.

Alexa's picture
Submitted by Alexa on

(medical) insurance!

You choose your own deductible--and it pays out at 90%.

;-)

Alexa

“If a dog won’t come to you after having looked you in the face, you should go home and examine your conscience.” -- Woodrow Wilson

[Avatar Photo Credit: Conflagrate, jurvetson's photostream, flickr]

Alexa's picture
Submitted by Alexa on

We've only dealt with two pet insurance companies--and had a good experience with both of them.

ASPCA paid on a "eye surgery"--removing a small growth from Murphee's eyelid. Paid as promised. But their plans were very limited.

The annual "cap" was approximately $8,000.

Later, switched Murphee to Trupanion, when she was eleven.

We had an $800 deductible (IIRC). Now, this deductible is per "illness" (but not incident).

And it also covers any "secondary" illnesses or conditions.

For instance, under the diagnosis of ALF/Hepatic Encepathology, all procedures, tests, office visits, etc., pertaining to these conditions, including her "sudden blindness," were covered.

The only expense that was covered at less than 90%, was her prescription (maintenance) food--it was covered indefinitely--but at 50%.

And Trupanion allows you to set your own deductible (up to $1000), so you can tailor your own premiums.

Murphee's premium actually dropped by several dollars after the first one-year renewal. She was twelve.

Trupanion even paid a couple of charges that I had literally drawn a line through on the vet's invoice (since they were not ACL/Hepatic Encephalopathy related).

I'm guessing that this was a "courtesy" gesture. And the charges did not total more than a couple of hundred dollars.

Those charges were on the final claim. But still--they were not part of the contract.

A Trupanion insurance adjuster actually called me 2-3 days after I faxed this claim--to offer their condolences.

But, as always--anyone should read the fine print (I know that you would, Dromaius, LOL!).

Trupanion offers catastrophic illness insurance. That's for sure.

Anyone looking for insurance to pay for exams, routine lab procedures and tests, etc., should look elsewhere.

But I really must give them an excellent recommendation.

Alexa

“If a dog won’t come to you after having looked you in the face, you should go home and examine your conscience.” -- Woodrow Wilson

[Avatar Photo Credit: Conflagrate, jurvetson's photostream, flickr]

Dromaius's picture
Submitted by Dromaius on

Anyone looking for insurance to pay for exams, routine lab procedures and tests, etc., should look elsewhere.

When insurance pays for those kinds of things, it's not really insurance, it's pre-payment of rountine services with an insurance company adder.

I am glad Trupanion served you well. It's one of those YMMV situations, probably.

Alexa's picture
Submitted by Alexa on

I do need to correct one thing that I said earlier:

One of Trupanion's "cost containment measures" is to NEVER pay the "Office Visit" fee or charge.

A little bit irritating--but understand the principle.

(I got carried away, and included that in my list by accident.)

But the non-payment of the Office Visit fee is stated up-front. There is no trickery involved.

Another feature of their product that I like--real decent transparency--the insurance contract (policy) is very easy to read and understand.

[Also, pretty darn good and helpful customer service reps, and very top notch insurance claims adjusters.]

Alexa

“If a dog won’t come to you after having looked you in the face, you should go home and examine your conscience.” -- Woodrow Wilson

[Avatar Photo Credit: Conflagrate, jurvetson's photostream, flickr]

Rainbow Girl's picture
Submitted by Rainbow Girl on

That settles it. Instead of lying about income to get subsidies the winning strategy is to pretend you are a dog and get one of those policies. Not clear yet how we handle this at the vet's office when in walks bi-ped humanoid. But there's got to be a way -- this is America, Land of Can Do!

Alexa's picture
Submitted by Alexa on

N/T

Alexa

“If a dog won’t come to you after having looked you in the face, you should go home and examine your conscience.” -- Woodrow Wilson

[Avatar Photo Credit: Conflagrate, jurvetson's photostream, flickr]