Not Quite a Train Wreck

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The Right wants to spin the dysfunctions of the ACA federal website as the train wreck they predicted. But dread pirate mistermix writes,

I’d have to consult a psychiatrist or a circus owner to get an expert opinion, but I have a couple of unschooled guesses why the Obamacare rollout isn’t occupying banner headlines on Fox and shooting to the top of Memeorandum.

First, the right is dealing with an audience that’s been told that Obamacare will lead to an end of the American way of life as we know it, create panels that determine whether you live or die, and make you stand in line for hours to get even a band-aid from some doctor (not your own) toiling under the thumb of faceless bureaucrats. Compared to all that, a website that crashes or takes a long time to complete an enrollment is almost a good news story.

Second, if you start talking about exchanges having trouble signing people up, you must acknowledge the fact that people are signing up. If you acknowledge that, you acknowledge that a four year effort to kill off Obamacare has amounted to precisely nothing.

Garance Franke-Ruta writes,

Much of the debate about the Obamacare rollout has centered on whether or not its early troubles will turn people off the idea that government can do big things well. But people do not turn to government programs because they believe in them. They turn to them because they need them, and the market is not meeting their needs. When your alternative is not something excellent but nothing, you use whatever is there. A bad lunch is still lunch, an overrun city college is still a pathway to prosperity, and Medicaid is far better than six months of calls from debt collectors.

That’s going to save the Obamacare rollout.

Paul Krugman writes,

For now, the big news about Obamacare is the debacle of HealthCare.gov, the Web portal through which Americans are supposed to buy insurance on the new health care exchanges. For now, at least, HealthCare.gov isn’t working for many users.

It’s important to realize, however, that this botch has nothing to do with the law’s substance, and will get fixed. After all, a number of states have successfully opened their own exchanges, doing for their residents exactly what the federal system is supposed to do everywhere else. Connecticut’s exchange is working fine, as is Kentucky’s. New York, after some early problems, seems to be getting there. So, a bit more slowly, does California.

Professor Krugman also points out that the “rate shock” some experts were predicting isn’t happening, in spite of the bold-face lies on Fox News that it is.

The problems with the federal website are seriously bad, however, and may take weeks to straighten out. If it isn’t fixed by December 15, this could have an impact on the ACA rollout. So let’s hope it gets fixed.

See also Hey, Ted Cruz! These Texans Say Obamacare Is Helping Them.

23 thoughts on “Not Quite a Train Wreck”

  1. I’m wondering whether in this, “The Age of Privatization,” if some private company(ies), instead of government workers, aren’t responsible for the IT problems behind people having trouble accessing, and signing-up, for PPACA?

    Maybe some enterprising reporter could look into the what, when, where, why, how, and who’s doing the IT support.

    And Republicans can’t really complain about too many people having problems signing-on, because it would admit that many people see the need for the services that PPACA may provide for them.
    And that would mean that the program is popular – at least enough to generate a lot of interest.
    Otherwise, if they do, they’ll sound like that great American philosopher, Yogi Berra,* when he said, “THAT place? Nobody don’t go there no more. It’s too crowded.”

    *Of course, the great Yogi has much more native intelligence than any Conservative.

  2. I’m in a hurry, but I heard via a spokesperson on NPR precisely what CUNDgulag is talking about. The websites and IT functions were outsourced. They are the products of private sector companies, awarded government contracts.

  3. Yeah, the contract went to Accenture and they subcontracted it to India with the inevitable time delays (time differences do this) and misunderstandings (two people divided by the same language as Winston Churchill said of the US and UK). Accenture was spun off from Arthur Andersen a dozen years ago. Andersen was the one that gave us Enron.

    As of a few days ago, the state with the most enrollees was Washington. Home of the made in US software industry.

  4. I don’t understand why people were thinking that they’d be able to expect a lot from the federal web site on opening day, given years of horror stories about bungled software rollouts across the federal government. This one is high visibility, but it seems closer than say, the Veterans Administration system that is still being worked on, or the FBI case file system that, as I recall, had to get scrapped completely after we handed over millions to the contractors providing it.

    There appears to be something in the mix of federal contracting, lobbyists, and DC bureaucrats with ignorant oversight that seems to guarantee bad software engineering.

    I expect there were no nefarious motives in the bungling of healthcare.gov, just the usual profit motive and incompetence. Not that I’d be surprised to find there were some Nutjob zealots in the contractor pool, deliberately monkeywrenching it and thinking they were saving us all from the horror of Obamacare.

  5. I wonder , if at some point , we won’t learn someone might be hacking into the site HELPING it to fail. In a world of Koch sponsored dirty tricks it would not shock me at all. Also on other sites I keep seeing righties saying that they don’t need the insurance, but that they have been spending time on the site anyhow. Could it be the site is being clogged up by a bunch of people who have no intention of shopping for anything?

  6. Rate shock IS happening for me, personally, and for others. My insurer, whom I like, wants to move me from my barebones, catastrophic plan, to the lowest level “bronze” plan, which means my rate will jump from $280/month to $480/month.

    As I see it, the four tiers – bronze, silver, gold, platinum – are WAY TOO LIMITED, requiring people to buy features they don’t need or want. In my case, the bronze plan includes a drug benefit that my current plan lacks (I take no prescription drugs), and also lets me insure dependents (I have none).

    Righties complain (whether it’s true or not, I don’t know) that these plans include maternity benfits – which, as a guy, I certainly don’t need; if I was a post-menopausal woman, they likewise have no need. My current plan doesn’t pay for any maternity, pre- or post-natal care, which as a guy, I guess I’ve just been willing to just suck that up.

    In all other ways, the copays, deductibles, max out of pocket and so on between the two plans are roughly the same.

    And so what’s needed is a sub-basement “Tin” tier or an “Iron” tier that is truly barebones, and would go a long way toward quelling complaints about the “Affordable” part of ACA. It galls me that these extra features were no doubt a sop to the pharmaceutical industry.

    So what am I going to do? I know from having shopped for insurance before, that the rate my insurer is quoting me for the bronze plan, is about what you’d pay for insurance with all those extra features. So in that sense, there is no rate shock. But I resent having to pay for stuff I don’t want.

    Because I believe in universal coverage for all citizens, and because ObamaCare, as flawed as it is, is a step in the direction, I’m just going to go along with it. But not having a cheap, truly barebones plan, for the millions of people in this country who are relatively healthy, is an incredibly stupid move if you want to get the public to accept this.

  8. I am a government employee (a state, not federal) and the way a lot of contracts work is that there is incredible pressure on the government to accept the lowest, or nearly lowest, bid that looks like it could cover the work required. This leads to contractors lowballing their bids on purpose to get the contract, while knowing or suspecting they can’t really complete the project for that price. Then they either delay completion or charge extra, and/or higher, fees to fix the problems created by their own lowballing.

    I wonder if this is part of the problem with healthcare.gov.

  9. @justme – I’m sure tech-oriented wingnuts would be absolutely delighted to try and crash healthcare.gov, without any help from the Koch Bros – but from what I’ve read of its design, the people building it had no clue about designing it to perform under even reasonable, much less, maximum loads. I often saw this in my career, where inexperienced software people would build something that worked okay on their desktop, but it would absolutely get crushed the moment it hit the real world.

    There’s also the Agile methodology that’s taken the software world by storm. What it means, is that you build something knowing that it’s rough around the edges, for the purpose of getting something quickly into the hands of users who will then be better able to tell you what they really want. This works great when you have a tolerant bunch of users who don’t mind being guinea pigs, but it’s a disaster when it’s gotta work perfectly the first time. It wouldn’t surprise me that healthcare.gov was done by people who knew nothing else besides Agile.

  10. moonbat … there is a “catastrophic plan” level for people under 30 or for people who qualify under various hardship exemptions … but I think here again what they are trying to do is prevent death spiral. The removal of the pre-existing conditions thing has far-reaching implications. If, today, something happened to you leading to a necessity for meds costing megabucks, you’d just be out of luck, as trying to get insurance that includes med benefits would be impossible, or at the very least very, very costly, because that would be a pre-existing condition. If there was a “lead” plan that did not include med benefits, and you took that, and next year something happens that makes med benefits necessary, you could just move up to bronze or silver no questions asked. In other words, if they allowed people to pick and choose what features they wanted, people would pick only the features they specifically need at the current point in time, and then move up to higher levels as and when it becomes necessary … which makes good economic sense from an individual POV, but would just completely kill the system as a whole.

    The whole getting rid of pre-existing conditions thing is by far the most popular part of the law, but people need to understand that this has implications.

    The only way this works is that the millions of people in this country who are relatively healthy have to be included in the exact same pool as the millions that have pre-existing conditions that would formerly not have been covered at all.

    -Ian

  11. I helped get 19 dogs and cats off to the spay/neuter clinic this morning. Their offspring will never show up to plague us at the animal shelter or be neglected on chains in back yards. The cost per animal is running about $60. It is being paid now, like insurance against disasters of animal care in the future. The neighbors’ taxes help pay for the shelter, whether or not they have a pet. Various charities contribute the small grant we use to help low-income pet owners. It all ends up costing some more, others less, directly, but indirectly we all benefit. Long-term, it is like Obamacare: it does not matter whether you specifically have leukemia: your neighbor might, or you might. Or some guy on the next block whom you’ve never met. Imagine living in a society where people can go to the doctor when they need to! Imagine living in a society where animals are beloved pets. It is all about being a connected member of the society. Yes, I am in idealist. But I am pragmatic enough to know that only ideals can lead to standards that lift us as a society.

  12. Moonbat: the required mental health coverage is also a waste– nobody is so nuts as to need meds in our house. Also a bummer for us: a “choice” of blue cross or blue cross in my state– they really should have structured the whole thing at the federal level at the get-go and not involved the states at all– that would have also gotten everybody medicaid expansion without running afoul of state governments or the SCOTUS.

  13. I haven’t been to the ACA website, I hope it is better than Salon.com, opening that site is hazardous to ones PC health. Your links should contain a warning!

  14. Off THIS topic but on the topic of ACA , the rude pundit has a must read piece and it’s not filled with his normal” Rudeness ” but instead a little trip down memory lane!

  15. Moon, whether you realize it or not, us healthy people have been subsidizing the less-than-healthy since insurance was created.

    Hate to break any bubbles, but that is how insurance works. It just happens that insurance companies have been able, in the past, to exclude huge chunks of people to artificially keep some rates down, at the same time other people with pre-existing conditions have been able to sneak in (I’ve known a few).

    As much as the ACA is not what is truly needed, at least it begins to patch some of the holes inherent in the current distributed processing system. Some groups of people are doubly insured (to no additional benefit) while others are uninsurable under the old system.

  16. Tom, this is the second time I’ve heard that statement (possibly from you twice).

    What state is that? And why is there no choice?

  17. Dan: NC has only bc/bs (and Coventry health ONLY in a few countries). Other providers weren’t interested, I gather, even though it looks like ACA allows them to jack up their rates a LOT, at least in my case.

  18. Tom,
    How much do you think Pope and his puppet Governor, McCrory, have to do with that lack of choice?

    Ever since the last election, when McCrory won, and got a Republican legislature, the friends I have in NC (I lived and worked there for 9 years in the 00’s) have been stunned by what’s been happening in that state – and none of what’s happening, is good.

  20. CUNDGULAG: We have NO love for Pope, McCrory, and their women-hating, vote-suppressing, wage-killing, fracking friends here in NC, but I doubt they’ve got direct hooks into. The private insurance industry.

  21. I’m out in rural Colorado – three providers to choose from – my lowest exchange premium for 2 people is $1060 per month (about 16% of our income). Right now we are paying $370 for almost the same coverage (oop max is about $1200 higher per year is only diff I saw). Not surprising that we don’t really have $700 extra per month to throw at the same coverage, so we will not be participating in the exchange. Anthem, who offers the $1060 plan, has just sent a letter that we can keep what we have for one more year- at $405 per month. Oh- and between two of us we work four jobs to earn just enough that we will not receive a subsidy.
    This is all because we are letting private insurers do this with a hodgepodge of rules. You know what we would get in Germany for $1060 on the private market? 10 Euro copays (no deductable) and dental, vision and long term disability covered, plus Krankengeld for missing work (longer than 14 days or so, the insurance pays a part of your salary). In Canada – BC, we would pay $120/month for their insurance. Yes, we now cannot be penalized for preexisting conditions and yes, I believe that we should all help cover maternity and prostate and breast conditions, regardless of gender, but the private insurance here is still a total rip-off.

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