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ObamaCare Clusterfuck: Will the exchanges (now "marketplaces") really be ready?

Citizen's Council for Health Freedom, reader-funded attendance at an ObamaCare conference in DC

"States haven't made a lot of progress yet in connecting to the data hub; systems don't 'talk' to each other. Hope that systems will be in place perhaps by 2015." -- Susan Dentzer, RWJF

"Will they be ready? No one knows the answer to that. There's a political and a technical consideration...If a state chooses not to cooperate, then it's very difficult for the feds to put up a very successful, exchange in a state." -- Brett Graham, Leavitt Partners.

"It's a three year implementation being done in 10 months. By its nature, it's unrealistic." -- Keven Counihan, Access Health CT

"The truth is, it's not going to be fully functioning on 10-1" -- Christine Ferguson, RI (Exchange)

"And October 1 is very very soon." -- Cynthia Crose, Arkansas Insurance Dept.

"I don't know what happens this fall if it's not ready. -- Sandy Praeger, NAIC

Oh, I know what happens: Obama makes a massive public relations push, says "it's ready," the career "progressives" chime in, and our famously free press rolls over (and what do any of them care, becaue they're already covered!

Anyhow, I've been saying the same thing: If you look at the technical detail, ObamaCare really is a clusterfuck. Because the big deal really isn't setting up the exchanges; heck, anybody can set up a website with a form. The big deal is the systems integration issue of passing data between the states and the Feds, and then between all the different Federal agencies.

None of which would be necessary if health care were a right, and your birth certificate was your eligibility.

NOTE Obviously, CCHF is a right wing site; so far as I can tell, they don't make stuff up. However, from the end of the same article:

The Exchange is a national wealth redistribution system, shifting the costs from the unhealthy to the healthy.

Yikes. I'd say, for starters, shifting costs from the sick to the not-yet sick. Anyhow, that's what insurance does, or, in the case of private insurance, should do.

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Notorious P.A.T.'s picture
Submitted by Notorious P.A.T. on

"shifting the costs from the unhealthy to the healthy"

That's a poor way of looking at it. Why not say "shifting money from the public to private companies that don't intend to provide anything in return"?

Submitted by lambert on

But see this article on the founder Twila Brase (I ran into the site when I was plowing through Nature looking for links. It's exactly the issue of discernment you raise here: Brase is, so far as I can tell, a right winger who doesn't make shit up.

Yes, it would be great to link to the network of leftwing sites that are really focused on a coherent critique of ObamaCare. Looks like there are two: PNHP and Corrente. And I haven't found the same detailed look at how the exchanges are being built anywhere but Brase's site and Corrente. It's not an accident they publish the dataflow diagram and I do a detailed breakdown of the forms. Thing is, I really don't like the ideology....

beowulf's picture
Submitted by beowulf on

"The discoveries of healing science must be the inheritance of all. That is clear. Disease must be attacked, whether it occurs in the poorest or the richest man or woman simply on the ground that it is the enemy; and it must be attacked just in the same way as the fire brigade will give its full assistance to the humblest cottage as readily as to the most important mansion. Our policy is to create a national health service in order to ensure that everybody in the country, irrespective of means, age, sex, or occupation, shall have equal opportunities to benefit from the best and most up-to-date medical and allied services available."

http://www.salon.com/2009/08/14/healthcare_28/

Submitted by lambert on

Is that simple plan on Medicare good to go as a concept or does it need fleshing out? If you toss links my way I can put it together... It's just that... Statutes and stuff....

beowulf's picture
Submitted by beowulf on

Its a timeless idea, but Sam Gibbons's universal Medicare bill is 22 years old so the legislative language would have to be updated to reflect changes in the program and tax law since then (for example, that was before the prescription drug benefit)

Matt Stoller once mentioned that his old boss Alan Grayson had a rule a bill should not be longer than 4 pages (which such a damn good point, only lobbyists know whats really in long bills). The universal Medicare bill is 3 pages long. Let me think of how to update it while adding no more than one additional page in the bargain. :o)