“You can keep the plan you have.”
Everyone weights in, including Bill Clinton. Everyone has an opinion, on both sides of the aisle; Democrats and Republicans, the Tea Party is running with the idea of the Train Wreak.
The website doesn’t work as well as it should. It is certainly a problem; I think we can all agree.
Sign-up in the federal marketplace for private insurance are far below projections or what is necessary to claim success. The slow sign-up is consistent with the Massachusetts experience and reflective of the gross problems of Healthcare.gov. There are so many different issues, more than are being addressed by the media, the talking heads or by the clamoring politicians afraid of their re-election prospects.
What should we be thinking right now? Who is to blame for the failures? What are the answers?
Without pointing fingers at any single person or entity, is it possible to answer these questions? Probably not, so let’s point some fingers and remind ourselves of what the ACA was supposed to be and who is behind some of the failures and who is not.
Healthcare.gov is a website with a complex integrated system underlying it. It was underfunded, poorly managed from its onset and deployed without appropriate testing. Further to this, thanks to the many obstructionist Republican Governors who refused to establish state exchanges, the Federal exchange is far bigger than originally expected. What does this sizing mean? It means greater complexity, more integration to individual private insurance companies in individual states. Add to this the entrance barriers set up by those states that chose to ‘opt-out’.
Can we blame this entirely, no we can’t. We can point to this as part of the problem though.
We also have to blame the contractors, all of them, responsible for the design and deployment of the Healthcare.gov solution. No, not just the website the entire system; it does not work and this is a clear design flaw. The flaw isn’t just in the front-end, what you or I might see, but in the back-end everything from how it was sized to how it is integrated to the all the other systems it must integrate with to provide the services it was intended for. The contractors hired to provide this system were given a Statement of Work (SOW) to develop this system with what I am certain were clear milestones and requirements, they failed to meet the most critical of these. None of us can know for certain how oversight was provided over the various stages of the contract, how milestones were validated or whether there were periodic quality gates to insure requirements were being met. We do know though taxpayer money was paid to private contractors to deliver a system that does not work and that is doing great harm to citizens and this administration.
Does part of the blame for the system failure fall on the government agency in charge of the development? Yes, it does. They were responsible for oversight. Who within that agency is responsible? Ultimately, it is the head of the agency; however, knowing what I do about this process it is unlikely the top of the line was sitting in status report meetings, performing tests or otherwise involved in the daily activities of this project. There was an accountable deputy.
Here is what I do know, The President of the United States is not responsible for the failure of Healthcare.gov as a computer system or website frontend and we truly need to stop beating him about the head and shoulders for this specific failure.
Finally, ‘You can keep your plan if you like it’. Yes, the President said this repeatedly. I think he believed it. In fact, within ACA all the policies now being cancelled by the Private insurance carriers were grandfathered for at least two years. This means Americans should have been able to keep their policies through 2015. Let’s talk about both the junk and what else the Private market is doing shall we?
- High deductibles
- High co-pay
- Annual spending limits
- No catastrophic coverage
These were primarily Defective products, not grandfathered and in many cases, states had thrown the companies out years ago. On the other hand, there were policies that did meet the standard for being grandfathered, even if they did not meet the ‘Basic Coverage’ standard of the ACA. What is happening with these? Why are policyholders receiving letters of cancellation of policies they like, that the President of the United States promised they could keep. There is a simple answer.
The Private Insurance Carrier decided to re-price their product to ensure they were making a PROFIT.
When the ACA was designed and passed, it was a gimme to the Private Marketplace. It kept Private Insurers in the game, offering them a broader market even if they had to meet some new restrictions and regulations. Although the law was designed in favor of citizens, allowing them to keep their current policies, it cannot force the private insurer to continue offering that policy to the market.
Blaming the President for the greed of the Private Insurer is idiotic, truly stupid. For those making the most noise, I offer this tidbit to chew on. The acts of the Private Market are consistent with Capitalism at its finest.
This is what everyone wants, right? Free Market Capitalism and Competition
Well this is what you got, so stop bitching. The Private Insurance marketplace is doing exactly what they choose; they are evaluating their products, cancelling those that no longer meet their profitability standards and offering alternatives. They are using marketing techniques, while you and I might find them slightly shady; there is nothing illegal about what they are doing. If those receiving the cancellation letters are too lazy, stupid or stubborn to look for alternatives; shame on them.
I am tired of hearing the ACA is a failure. We have only gotten started and even today, with what has already been implemented it has helped Americans. Do we need to look at the ACA and potentially tweak the law? Yes, we do and we should. But this trash talk in Congress, on the street and in the media is ignorant and without merit.
QBG_Tilted Tiara 
There’s also a popular comparison of Healthcare.gov to Katrina. (I expect that one of those people will eventually slip up and will also refer to the debacle as “Obama’s Benghazi”). There are a lot of problems with this comparison (Kstreet607 had a good post on that today), but the common theme with those who make this Katrina comparison is that they are the same people who, to use the Katrina analogy for a second, kept blowing up the levees around NOLA before the storm hit.
Those who make this comparison are idiots, or something worse. I saw Kstreet’s post and thought it quite good. The real problem is this is private industry acting in the way they have always acted. People don’t seem to understand this. Partnership between the public and private sector is always difficult, each with their own expectations and in this case without sufficient ‘rules’ to prevent what has been the outcome, cancelled policies that should have been continued for at least another year. But what the hell, Blame the President.
It is all ridiculous, instead of politicians attacking everything that is put forward in government just because their favoured party didn’t suggest it just belittles the whole concept. I don’t know much about American politics and policies but it isn’t rocket science to see that the world is in a mess, why is it such a big deal not to sit down and act like adults.
The President of the United States of America is a decent guy in my estimations, and yet there is this hatred going on… Hopefully time will show a different side to politics and it needs to if confidence is to be restored. I am not talking about any one particular subject here, indeed to me it just makes sense to get a grip on everything and start doing what they ALL are paid for, and that is to govern the country to its best potential without all of this ridiculousness in between.
This should be a wake-up call for ALL governments around the world, however, and unfortunately at the grass roots level of society the smaller voices are seldom heard, unless there is an election looming.
Andro xxxx
I’m with Carrie. I just wish we had launched the site right the first time, when it debuted, or taken the time needed. Earlier this month, when the President promised the site would be ready and functioning by Nov 30th, I immediately thought, not enough time. Why did he shoot himself in the foot by giving himself such an early deadline? It’s embarrassing and most unfortunate that it happened this way, giving more ammunition to the Repubs, who see this failure as a reason/justification to throw the baby out with the bath water. They are so blinded by their hatred of Obama, it’s so, so frustrating.
It is getting better everyday. I am okay with aggressive deadlines, I am okay with bringing in experts and doing status reports that tell what is being knocked out. I think the latest one said they had addressed 200 bugs to the system and this last week there had been zero unscheduled system downs. I am even okay with the President trying to negotiate with the private market to extend the policies.
You are right Monica, this was a terrible situation. But I don’t think it would have mattered whether it was perfect or imperfert. Honestly? I think no matter what the situation the other side would have continued to go after it, this just hurt the Democrats and pushed the GOP agenda into a better light. The Dems, lily-livered pussies that they are, they just ran for cover instead of standing firm on principle. That to me is the worst of the situation.
My mom, Fox News lover that she is, has the station on for hours and hours each day. It’s been interesting (and downright horrifying) to listen to them the past few months.
Now, I, along with most reasonable people, admit that the website rollout has been a disaster, and, that someone wasn’t doing their job letting it go live like that. Fine. Website #FAIL. But, a website does not a program make. The website is the tool, and, until the tool is fixed, one cannot rant and rave about low enrollment numbers, and how the low enrollment proves it is a disastrous program (this is part of the Fox News position). I want to reach right through the screen and shout at the Fox hosts: “Of course the enrollment numbers are low! The site doesn’t work, so people can’t sign up!”
This is what I’ve learned from listening to Fox News over the past year:
1. Obamacare is evil, even worse than the gays.
2. We have to get rid of Obamacare.
3. OMG! The website is broken! People cannot sign-up for this program we want to take away from them! The site needs to be fixed now, so people can become a part of this program we hate so much!
4. Millions of people have lost their health insurance (with no mention of all the fact checking reports done afterwards that show that all the people that have appeared on Fox have never looked at the Healthcare Exchange, and, most have found they can get better plans, for cheaper –but, that isn’t part of the Fox Narrative, so we just pretend that it doesn’t happen)
5. Millions of people now have no insurance because the insurance companies dumped their cheap, substandard policies (ok, so they don’t mention the substandard part). So, millions of people now have no insurance, but, why this is suddenly news, when there are already 40 million people without insurance is never mentioned. Apparently it’s only the few million with crappy insurance that would be cancelled the moment a claim was filed, are the only people worth mentioning.
6. For weeks, Fox has been saying “Let people get their old insurance back.” So, this week, when The President said “ok, let’s let people have their old insurance back,” I literally watched a ten minute discussion of how Obama couldn’t do that, and it would be illegal for him to do that. So, takeaway — when Fox News says it’s a good idea, everyone should stop and listen, when Obama listens, takes their advice, suddenly Obama is a tyrant.
I think you and I know each other well enough to know that I’m not saying the administration was perfect in this — there should have been bells and alarms sounding months before the website went live, someone should have thought about the effect of the change to the policies, and the confusion it would create when people could no longer get cheap-ass, worthless insurance. The White House, and the Dems have been very poor on healthcare messaging from the beginning. So, there’s blame there. They did very little to educate people before hand, and did little to stamp out the fire once it started. So, they have a fair amount of culpability in the fury.
But, to listen to those on the right talk about the ACA as a failure when every Republican controlled state said “NO” to setting up their own markets, when Fox News is adding it’s shrill voice of distortion, it’s no wonder people are confused and angry. Let’s face it. A large number of our citizens are grossly under-informed. It’s no wonder the GOP is circling like sharks, ready to rip apart the law.
As always, good post …
There is more than a fair amount of culpability, there is a huge amount of it. The administration did little to educate frankly. The messaging was abysmal. I think most reasonable people, even those of us who support the ACA as a good start know the legislation needs tweaks it is imperfect at best. Most of us knew as we watched the Red States opt-out it was going to be a rough roll out. Most of us knew as we watched the money rolling in for the negative ad campaign this was going to go badly.
That there wasn’t anything on the other side, no Democrats speaking up. No positive ads, no education, no Insurance companies. Yes, you are right they are circling like sharks and the blood is thick in the water.
Your experience with a web site fiasco parallels a multi-billion scandal we had with our previous state government which decided in their “wisdom” to hire “professionals” to create a new payroll system for nurses throughout the state in our public hospitals. What a circus that has turned out to be with nurses overpaid and underpaid and frustrated nurses going on strike. Governments are not very good in handling business enterprise are they? The system had to be scrapped at a huge loss.
Strangely I have worked with the Feds, States and Local Governments on IT projects, some are excellent and some are disasters. For the most part, governments simply are not agile enough to do this work, they don’t accept change well and layer on far to many rules. The IT companies who get in bed with them learn to work the system, we call them the Beltway Bandits.
If government would learn to act more like the private sector when it came to some parts of their activities, procurement and contracting being one; they would be far more sucessful.
This all sounds like Venus to me because I do not live in the United States. Still, I shake my head. I wasn’t hatched under a rock and know about greed but…
The way things are going in my country…hopefully we will not be close behind you. 😉
I don’t think you will ever get as bad as we are, you are still ahead of us on the “happiest country” list. Though that Toronto Mayor is quite the hoot.
Can you see my head hung in SHAME?
Awww, come on now he is a hoot and a half. How often do we get to watch a circus from your side of the border?
He is that and digging a deeper hole by the minute. Someone should duct tape his mouth since he can’t stop spewing ugly words.
What is that saying? Oh, yes “Silence is Golden, Duct Tape is Silver and Cheap.”
He can’t shut up. I feel for his wife and children.
“Although the law was designed in favor of citizens” I think not Val. The ACA is pure politics at it’s worst. Politicians of both stripes (Democrats want to be my mommy and Republicans want to be my daddy) don’t give a rats ass about anything except getting rich, not having to obey the same laws as us commoners, and (using ACA as an example) make themselves and their families exempt.
My body is none of the government’s business. The sick care system in this country is broken. It’s based on doctors trained to a Newtonian universe expectation when the universe is quantum. Only in America can a few bags of salt water cost over $500. Yeah right!
Yes, you are right healthcare is expensive. Health Insurance is even worse. For those of us who don’t qualify for Medicaid, aren’t old enough for medicare, have pre-existing conditions and don’t have the benefit of an employer we were without any coverage and thus at risk all the time. The ACA, it is better than the alternative. It is imperfect, I agree; but, it is better than what we had prior to its passage.
Now, for the first time in 22 years I cannot be refused coverage. Now I can see a doctor, without the fear of bankruptcy if I need more surgery. Now my medication, which I take every single day and cannot live without is covered. I am only one of millions in similar situation.
The ACA does not invade our privacy. It mearly opens the marketplace for private insurers to compete for our business. It creates some rules and prevents them from gauging us, though they are still taking advantage of the loopholes.
You are right, costs are out of control. But until we as a nation begin to demand more, until we begin as citizens to pull together and view healthcare as a right of all citizens not just those who can afford to pay $500 for a few bags of salt water, this is what we will have.
Val you always write these posts extremely well, I just wish I knew enough about your political arena to comment intelligently…. But all new systems it seems have their gremlins… And so it seems this is no exception!
Thank you Sue. I am a bit passionate about this, but I try to keep my Pragmatism Hat on most of the time. You are right, trying to roll something this big is bound to have problems. That people expect perfection, well I can only say, “Your ignorance is showing.”
This, like everything of this nature has its issues. It is an imperfect piece of legislation, added to a terribly imperfect launch and finally add all those who want it to fail. You have all the ingredients for the perfect storm.
Storms Val are brewing in every country, In France there were big protests over the rise in their VAT taxes, and in London demo’s were around the Halloween date, And yet both these events didnt get publicized on Main stream TV, For fear I think that other would jump on the storm bandwagon of discontent!
People will only stand for so much before they show their anger
I think Sue, people are beginning to be tired. Change is important and people standing up and demanding the right changes, just as the did in the 60’s might be the way of it. A full on shift is possibly what has to happen, everywhere we look it is getting terrible and without people standing up to the greed and stupidity it can only get worse.
You used the right word there Val in the word ‘Shift’. This is what Will happen in my own opinion for the World can not continue along the same path as it is going..
We need a Shift in awareness as to the workings behind the politicians, and to understand also how things are contrived not in the Peoples best interest, but those who are behind those in Power.. The Big Boys who operate the show who pull the said strings .
When enough of us WAKE UP in seeing how our Reality is an illusion! then a Shift in Consciousness is what will swing things into change.. But we are each of us responsible for our actions and if we just keep sitting on the fence being fleeced then we deserve to be called Sheepal!
Excellent, intelligent, and informative post, Val. I wish I could force-fed this to every Republican congressperson. Or at least to the Democrats who are beginning to waffle in their support of the law. I’m hoping and praying that we’ll all hang tight until the “dawn,” because I am confident that it will get better. Your blog post helps me keep the faith.
You know the problem E? We are so polarized right now, it is nearly impossible to get anyone to sit down and talk, sit down and listen. The ACA, it isn’t perfect. In fact it is far from perfect. Most of us wish it were better. Were it not for the compromise in fear Democrats and the Hell to the No Republicans we might have gotten something better.
If you don’t like it, damn fix it. The fix isn’t repeal it is find the problems, think of the citizens you represent and fix the problems. This nonsense of finger pointing and digging in heels, ringing hands and running for the hills at the first sign you might not be elected; well it is for the birds.
All this misinformation, it is frightening. What is wrong with getting citizens insured in the private market? What is wrong with some rules? I simply do not get it.
Any new program of this magnitude requires time, patience, and forward-thinking to implement. I suspect Medicare had plenty of issues and detractors upon its inception. But that doesn’t mean the program should be scrapped; it just means things need to be fine-tuned and honed. Think of how much progress we could be making if opponents would quit fighting the law and start helping with problem-solving. Surely they can put their heated energy to better use, especially when they have no alternative plan, unless they consider leaving millions of Americans uninsured a plan.
You are so right, every big undertaking has difficulties, we forget this though and focus only on the right now. Everything is right now, we seem to have an inability to see even 30 days into the future, let alone 6 months or 5 years. It is frightening to me, the other problem we have is our inability to look at our past, our history and compare actions and outcomes.
Yes, one would think all that energy could be put to better use. I think they are having fun, Congress reminds me of that childs toy; Rock em Sock em Robots.
Haha, yes!
This is a well thought out and very timely post. I completely agree with all of your points, Really dug your research into the website debacle. As a former commercial site designer, and BETA tester for new software I’ve been appalled and pissed off at the POS we taxpayers have wasted our money on.
I can personally name 5 people off the top of my head who could have built a working viable site. Given the time and resources that were available these 5 back-end programming experts (ha, my friends lol) could have worked out an easy to use, expandable, viable site. No way I’m the only one with programmers as friends who feel the same way. Hell, every genius programming geek in the country must be thinking ‘WTF?! I would have done it for half the cost… and damn I’d be rich too!.’
The blame does go to the head of the committee overseeing the website build. NOT the president. It’s been 2 years and the GOP are still butthurt that they lost.
We voted Obama in on the promise of healthcare for all Americans. Get over it you selfish, blind f**ktards.
Switching over to what should have been a milestone in American citizen’s rights as taxpayers and voters has been derailed due to poor planning. Have no doubt you’re right that when it comes down to the investigation heads will roll. Hope it is one head: the bastard/biatch responsible for oversight of the programming and design team.
Sincerely enjoyed your piece Val. Keep that attitude to motivate more people!
It isn’t really the site, not the frontend anyway that is the real problem. I wrote about this issue earlier. This is the business I am in, systems integration that is; like you I know lots of people who could have done better. The problem is, I have worked on government contracts, I know the processes contractors have work within this issues they are confronted with. I know the types of hoops they have to jump through, all to often they are doing more jumping through hoops than coding. Not making excuses for CGI, only looking at the bigger picture of what likely when wrong with the backend of the system integration.
I am glad you like this, I hope we can all continue to keep our blinders off and look at the problems with clear eyes. Perhaps if we do so we can push our government to give us what we need and deserve, a complete Health System that works. Not Private Insurance companies out to make a profit but Single Payer Medicare.
Rolling out a computer website like this is huge. Microsoft does it and every time there are problems. My sister is a computer geek. She never uses new software. She will use microsoft after they have fixed the problems, glitches and the the patches have been issued. I feel that this website will work well in time. Hugs, Barbara
you got it! no way this should have been made live without a test done on a large scale, maybe involving one state. I never download or use software as soon as it is available.
Think it will eventually work as well Barbara 🙂
But this is not a Website, it is the frontend delivery system of a complex integrated multi-state solution for Business-to-Consumer sales. It is Amazon on steroids. That is what I have tried to say before. Whenever we refer to it as a website we downplay the complexity of what Healthcare.gov really is and then we play right into the hands of the other side.
You are right, it is hard and it was bound to have glitches. But on our side of the fence we have to say what it really is, why it is hard. Yes, it will work in time. Yes, given time and a new Congress the ACA will likely get better also, some of the kinks in the law be ironed out. But in the meantime, at least on our side we should stop using the same language they use, this allows them to undermine the law further by simplifying and pointing fingers.
I appreciate your correction. You are right. I asked my sister. She has a degree in computer networking and next month will have her computer security. Hugs, Barbara
I truly am not trying to be a witch, really. But we all started calling it a website because the other side called it a website. Even those of us in this business got lazy, we started doing the same thing when we knew better. A couple of weeks ago I realized we were feeding the beast, we were making it worse. I wanted to put my head through a wall.
So now, I go around saying to any and everybody who will listen… It isn’t a website. I sound like a broken record. Sometimes I sound like something else. I apologize if I sounded like the second one.
I did not take it as you being ……. I talked to my sister when she got home from school and she says you were right. It is just like calling it Obamacare. It is the affordable health act and I trying really hard to use the correct name. Hugs to you, my friend. Barbara
Yup. Stop bitching. Especially the GOP who would never have gone with a simple expansion of Medicare.
Simple right? But I am now more worried about those damned Democrats.
Oy!
Reblogged this on The ObamaCrat™.
Why thank you my friend. I am always proud when you host me