Tuesday, November 5, 2013

The President makes a fair point...

The Affordable Care Act is bad news. It has been since the beginning. Why? Because it's not going to improve healthcare, healthcare delivery, or even healthcare access for the vast majority of Americans who have needs in these arenas. Why? Because the ACA--Obamacare--is first and foremost about expanding health insurance via government mandates. And of course, when insurance is mandated it ceases to be real insurance, becoming nothing more than a fee that may or may not provide service value equal to or greater than cumulative payments. Who wins in such a situation? Why, the "insurance" companies do.

Already, millions upon millions of Americans are getting policies cancelled, policies that will end up being replaced by more expensive policies. This is being justified under the rubric that the old policies were flawed, did not provide sufficient coverage, and the like. But people knew what they were getting when they signed up for these policies, didn't they? Now, they will have to pay more money for things they didn't want and may not even be able to utilize. Again, it's a huge win for the insurance companies. By this time next year, I expect to see all manner of studies demonstrating that the average premium paid for health insurance has increased dramatically.

At the same time, the website--Healthcare.gov--created by the ACA to help citizens find health insurance has been a complete train wreck. It's had more bugs and crashes than Windows ME (and that's really saying something) and has failed to attract a significant number of enrollees. People trying to use it in good faith have been constantly stymied, to the point that it has become something of a punchline for comedians and critics of both the Administration in general and Obamacare in particular.

Needless to say, the Administration is pushing back--or trying to push back, at any rate--on both of these issues, the widespread cancellation of policies and the awfulness of the website. With regard to the first, Obama is being forced to "recalibrate" the truth, as he sold this legislation under the promise that if it passed, Americans would be able to keep their policies if they so desired. Obviously, that's not what has happened. The recalibration involves Obama going back in time and claiming that what he said was not what he said, that there was an unspoken caveat to his promise. But I've come to expect such things from Obama, so I don't really see the point in dwelling on this; his fanboys and sycophants in the media are unable to admit to reality here, regardless.

As to the second issue, the problems with the website, Obama--and most everyone else in his Administration--is playing the role of a shocked overlord, admitting that the problems are unacceptable and the like, promising to get to the bottom of things, suggesting that heads may even roll. Of course, the last is just rhetoric. No one--of any significance--is going to really get axed for all of this, especially not Sibelius.

But in accepting that the website is not "up to snuff," Obama also tried to shift the discussion just a hair by noting that the problems reflect technology issues in general that need to be addressed:
“Obviously we’ve been very frustrated, I personally have been very frustrated, with the problems around the website and health care,” Obama said. “It’s inexcusable and there are a whole range of things we’re going to need to do once we get this fixed, to talk about federal procurement when it comes to IT and how that’s organized.”
Interestingly enough, Obama's old website--now theoretically run by the non-partisan org Organizing for Action--BarackObama.com doesn't have any significant bugs and never really has, to the best of my knowledge. But I digress. Obama also noted something else, with regard to the website and Obamacare, something that is undoubtedly true:
“But in the meantime, as you go back to your home states, I just want to remind everybody that they can still apply for coverage by phone, by mail, in person. There was a time when the Internet didn’t exist,” he said. “It wasn’t that long ago. A lot of programs like Medicaid still don’t operate electronically.”
Seriously, the President is exactly right in this regard, though I fear he fails to see the big picture, why his "fair point" here is worth noting, worth exploring. And why is it? Because it leads to an inescapably obvious conclusion, or more correctly a pair of conclusions: for many Americans the issue of health insurance is nowhere near as vital to them as we are constantly told it is, or many of these same people are just too preoccupied with other things to worry about what should be a vital issue. Think about it. The President is right in more ways that he actually knows.

The internet has become something of a crutch because it is such a supremely useful tool. We've come to expect internet-based applications and services for most everything we do. Such expectations extend across all lines, private and government, profit and non-profit, business and personal. Even at state and local levels, we expect government to be "internet-ready." At the same time, we've--I mean the generic "we"--become lazy with regard to the specifics in all of these things. Even worse, we don't bother doing those things that are not web-based and easy to accomplish.

Consider the issue of health insurance. Suppose you tried to sign up on the website and couldn't because of glitches and delays. What do you do then? Or suppose it gives you options that just aren't acceptable to you, are too costly. What next? Apparently, by and large the next step is do nothing. Complain and forget about it in short order. Because I don't see lines and lines of people at government healthcare offices, looking to sign up, to go through their options. I haven't heard about government phonebanks being overwhelmed and expanded to serve a huge increase in calls.

And this reality tells me something: the supposed epidemic of healthcare problems isn't any such thing. Specifically? There are problems, problems that have impacted and will continue to impact many people. But the overall picture is not and has never been so bleak as many have claimed, otherwise people would be doing whatever they had to do to improve their situations, if the given policies could actually achieve such results. One or the other, either way the Administration's signature achievement is neither impressive nor necessary, a point Obama inadvertently makes clear.

Cheers, all.

1 comment:

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