Tag Archives: Obamacare

White House and HHS were warned about Obamacare web site problems in April

NBC News reports.

Excerpt:

The Obama administration, including Health and Human Services Secretary Kathleen Sebelius, was warned in April that there was insufficient time to complete testing before launching Healthcare.gov, according to a document released by a House committee investigating the website’s botched rollout.

The document, a 15-page slide show obtained by the Energy and Commerce Committee from the consulting firm McKinsey & Co., compares an ideal situation when rolling out a website such as Healthcare.gov with what developers were facing.

According to the committee, the presentation was given April 4 to a group including Sebelius and Marilyn Tavenner, the administrator of the Centers for Medicare and Medicaid Services, the HHS agency responsible for the rollout.

The document states that an ideal situation would be “end-to-end integrated operations and IT testing,” but that the situation at the time was one with “insufficient time and scope of end-to-end testing.” The document also says that a “limited initial launch” would be ideal, but that a “launch at full volume” was instead the plan.

Republicans are questioning testimony Sebelius gave to the committee during a hearing two weeks after she got the briefing, when she said development of the site was “on track and on time.”

“At this point, our energy and resources are focused on getting it up and running, and we are on track and the contracts have been led and we are monitoring it every step along the way,” Sebelius told the committee April 18. “I can tell you we are on track.”

In a statement, the chairman of the committee, Rep. Fred Upton, R-Mich., said that Sebelius had “appeared before our committee, looked us in the eye, and repeatedly testified everything was ‘on track and on time.’”

“We now know that was not the case and the secretary was aware implementation was in trouble,” he said.

So you can put this latest Obamacare lie by HSS head Kathleen Sebelius on the pile along with the Benghazi lies and the IRS prosecution of the Tea Party lies and the gunrunning to Mexican drug cartels Fast and Furious lies. Lies, lies, lies.

In fact, CNBC is now reporting that the Obamacare web site is still not complete – it is lacking about a third of its functionality, including payment capabilities.

Excerpt:

Another day, another big, bad black eye for HealthCare.gov.

A crucial system for making payments to insurers from people who enroll in that federal Obamacare marketplace has yet to be built, a senior government IT official admitted Tuesday.

The official, Henry Chao, visibly stunned Rep. Cory Gardner (R-Colo.) when he said under questioning before a House subcommittee that a significant fraction of HealthCare.gov—30 to 40 percent of it—has yet to be constructed.

“We still need to build the payments system to make the payments [to insurance companies] in January,” testified Chao, deputy chief information officer of the Centers for Medicare and Medicaid Services, the federal agency that operates HealthCare.gov.

That so-called financial management tool was originally supposed to be part of HealthCare.gov when it launched Oct. 1, but officials later suspended its launch as part of their effort to get the consumer interface part of the site ready. The tool will, when it works, transmit the subsidies that the government is kicking in for many enrollees to offset the costs of their monthly premiums.

This is not a defect in existing functionality, this is missing functionality. This project should never have been released to Production.

As someone who has worked on electronic payments extensively, let me just tell you that this is not a simple part of a web application. Billing and payment systems are some of the most difficult parts of an insurance application, requiring in depth knowledge of the business as well as technical knowledge. So don’t expect this all to be fixed with a wave of a magic want.

Doctor shortage: how Obamacare makes it harder to find a doctor

Remember how Obama promised that if you liked your doctor, then you could keep your doctor? It turns out that there is more to making policies than just saying what you’d like to do in a scripted campaign speech. The truth is that some health care policies will make you lose your doctor, regardless of what the President reads off of a teleprompter. Is Obamacare one of these policies? Let’s see.

Avik Roy writes about it in Forbes magazine.

Excerpt:

On Saturday, the Wall Street Journal reported that, due to Obamacare’s cuts to Medicare Advantage, among other factors, UnitedHealth expects its network of physicians “to be 85 percent to 90 percent of its current size by the end of 2014.” The result? Some retirees enrolled in Medicare Advantage will need to find new doctors. And it’s a trend that could accelerate in future years.

[…]Over the next ten years, Obamacare was designed to spend around $1.9 trillion on expanding health coverage to the uninsured. The law pays for this new spending with $1.2 trillion in new taxes, and $716 billion in cuts to Medicare, relative to prior law.

[…]The private insurers who supply Medicare Advantage plans, like UnitedHealth and Humana, have been responding to the cuts by squeezing out inefficiencies in the way they deliver care. One obvious way to do that is to pay doctors and hospitals less—or kick out the providers who refuse to accept lower reimbursement rates. And that’s what United has done, according to the WSJ report from Melinda Beck.

“Doctors in at least 10 states have received termination letters, some citing ‘significant changes and pressures in the health-care environment,’” writes Beck.

Another one of my favorite health care policy experts is the ex-Canadian Sally C. Pipes, who knows all about the horrors of single-payer health care. It killed her mother! Here’s what she had to say about the doctors shortage in a Forbes magazine article from earlier this year.

The first problem is that we have an aging doctor population and since we do such a poor job of educating our children (public school indoctrination centers) we aren’t making any new ones:

Right now, the United States is short some 20,000 doctors, according to the Association of American Medical Colleges. The shortage could quintuple over the next decade, thanks to the aging of the American population — and the aging and consequent retirement of many physicians. Nearly half of the 800,000-plus doctors in the United States are over the age of 50.

The second problem is that adding more regulations and burdensome paperwork makes a lot of people not want to be doctors any more:

Obamacare is further thinning the doctor corps. A Physicians Foundation survey of 13,000 doctors found that 60 percent of doctors would retire today if they could, up from 45 percent before the law passed.

The third problem is that the government isn’t reimbursing doctors as much as private insurance companies do, and it makes them refuse to take government-funded patients:

They’ve long limited the number of Medicaid patients they’ll treat, thanks to the program’s low reimbursement rates. According to a study published in Health Affairs, only 69 percent of doctors accepted new Medicaid patients in 2011. In Florida, just 59 percent do so. And a survey by the Texas Medical Association of doctors in the Lone Star State found that 68 percent either limit or refuse to take new Medicaid patients.

Medicaid pays about 60 percent as much as private insurance. For many doctors, the costs of treating someone on Medicaid are higher than what the government will pay them.

These underpayments have grown worse over time, as cash-strapped states have tried to rein in spending on Medicaid. Ohio hasn’t increased payments to doctors in three years; Kentucky hasn’t raised them in two decades. Colorado, Nebraska, South Carolina, Arizona, Oregon, and Arizona all cut payments in 2011.

By throwing nine million more people into the program without fixing this fatal flaw, Obamacare will make it even harder for Medicaid patients to find doctors.

It’s not just Medicaid that’s the problem, either. It’s the government-controlled exchanges.

Healthcare providers are signaling that they may turn away patients who purchase insurance through the exchanges, too.

In California, for example, folks covered by Blue Shield’s exchange plan will have access to about a third of its physician network. The UCLA Medical Center and its doctors are available to customers of just one plan for sale through the state exchange, Covered California. And the prestigious Cedars-Sinai Medical Center is not taking anyone with exchange insurance.

Now I know what you’re thinking – why not just force doctors to work for lower wages, like a good socialist country might? Well, that actually makes the shortage worse, because people don’t like to learn hard things and then work hard for little pay. And doctors work VERY hard – it’s not an easy profession to get into. That will just make all the doctors leave the country for other countries where they can be paid fairly for the work they do.

And in fact that is exactly what happened in a 100% socialized health care system in Venezuela, according to this report from the left-leaning Associated Press.

Excerpt:

Half the public health system’s doctors quit under Chavez, and half of those moved abroad, Natera said.

Now, support staff is leaving, too, victim of a wage crunch as wages across the economy fail to keep up with inflation.

At the Caracas blood bank, Lopez said 62 nurses have quit so far this year along with half the lab staff. It now can take donations only on weekday mornings.

I recommend reading that entire article for a glimpse of where the Democrats are trying to take us. There is not a dime’s worth of difference on policy between the Democrat party and the socialist party of Venezuela, except that the socialists have been in control in Venezuela for longer, and so they are further along the road to serfdom.

In other news, the Washington D.C. insurance commissioner was fired after raising concerns about the “fix” proposed by Obama in his speech last week. That’s also something that you might expect to see in a country like Venezuela. That’s what happens in authoritarian socialist countries. Whistleblowers and critics just disappear.

Students who voted for Obama react to losing their cheap private health care plan

Mysterious William sent me this story from Campus Reform.

Excerpt:

Students at Bowie State University assailed the Affordable Care Act (ACA) on Thursday after administrators cancelled a low cost school-wide health care plan due to new regulations in the law.

Many students told Campus Reform that the now cancelled plans, which provided coverage for just $50 per semester, were the only insurance they could afford.

“I can’t afford anything right now,” one said. “I can’t even afford my loans.”

“We don’t have that money,” said another. “We can barely afford books.”

Several students said that they felt they had been let down.

“It’s stupid and it’s Obama’s fault,” one said. “You haven’t done anything, Obama, and I’m disappointed in you.”

“What it was hyped up to be, was that it was supposed to solve a lot of problems and help a lot of people, and its not really doing that,” said another.

Many students had no idea the plans had been canceled, which was announced only in an email to their school addresses.

One of the students in the video rightly chastises Obama for not doing his homework on health care policy before putting through a law that doesn’t make health care better. But honestly it’s the students who haven’t done their homework – at least the ones who voted for Obama in 2012. Because these things were all known at the time. I was blogging about them all the way through 2009 to election day in 2012. And not my opinions but studies showing what the impact would be on health care costs, job creation, and so on. There is no way this plan could work, and anyone who was paying attention knew that. It’s sad for the students now, but maybe it’s a good thing for them to learn their lesson early.