Program Design

This begins with an objective, cold-eyed analysis of the requirements of the program—which means no a priori assumptions can be made.  Even the most blatantly obvious underlying premises must be questioned and tested.

For instance.

The architects and designers of Obamacare (I’m being generous with those terms, but let’s go with them and see where we wind up) assumed, without checking, the following:

  • just about everyone wants health insurance
  • health insurance will make people healthier
  • those with health insurance are more likely to seek care from physicians and less likely to go to emergency rooms

Michael Barone, in the WSJ article at the link above, provided some data on the legitimacy of those unchecked assumptions.

  • a McKinsey & Co survey of those believed eligible for ObamaCare health-care exchange Plans found all of 11% of those who bought new these last couple of months were previously uninsured
  • two small insurance companies reported that only 25%-35% of those purchasing were previously uninsured

On those other two…assumptions…Barone described an in situ State of Oregon randomized experiment (in function, if not in intent) in the form of a lottery for allocating scarce Medicaid funds to applicants.

  • after two years of Oregon’s lottery, there was no significant difference between Medicaid-insured and uninsured in blood-sugar level, blood pressure, and cholesterol levels
  • those with Medicaid plans were 40% more likely to go to emergency rooms than those without insurance

Where were the Obamacare program architects and designers?

Four Months On

…and ObamaMart isn’t even letting its victims customers get ObamaMart’s errors corrected.

Now it’s a variant on Catch 22: first ObamaMart hits its customers with errors, then it can’t—or won’t—allow customers (22,000 of them) to correct those errors.  Those errors, so far, fall into three main categories.  They

  • charge too much for health insurance (quite apart from the fundamentally higher premiums compared to the canceled plans)
  • steer customers to the wrong insurance plan (quite apart from shunting them into Medicaid for which they’re not actually eligible)
  • deny customers coverage altogether (the ultimate insult: get the plan with which you were satisfied canceled by Obamacare, and then be told you’re not even eligible for Obamacare, the law that covers everybody)

Yet there is no mechanism in ObamaMart for dealing with these errors or correcting them.  Even when customers mail in their corrections, those just get scanned in and fed to the same computer systems that don’t work for the customers directly.  The backend that would allow Customer “Service” personnel to access those scanned-in customer-originated corrections in order to work them hasn’t been built.

ObamaMart’s workaround for one unlucky woman on a $22k per year salary whose erroneous Obamacare Plan is costing her $100/mo more on her premiums than she should be charged and a $4k higher deductible than she should be getting charged?  Pay up.  We’ll correct this later.  Promise.

Notice that those overcharges alone come to nearly a quarter of her annual income.  She’s supposed to pay an additional 25% of her annual income for ObamaMart’s error, and hope that, someday, she’ll get the right plan and her money back.

The Centers for Medicare and Medicaid Services, the HHS agency responsible for ObamaMart and for administering the Obamacare law, doesn’t care about this failure, either.  According to The Washington Post (the above link) [emphasis added],

Three knowledgeable individuals, speaking on the condition of anonymity about internal discussions, said it is unclear when the appeals process will become available.  So far, it is not among the top priorities for completing parts of the federal insurance exchange’s computer system that still do not work.

And that’s just Obama’s store.  Obama’s law is even more unworkable, expensive, and disastrous, as we’ve also been seeing, with the millions of health policy cancelations over these same last four months.  As the “glitches” continue to get fixed, as I have no doubt they will, even more of the failures of Obamacare itself will become apparent.

It’s also typical of this administration.  Wind it up, set it loose, and forget about it.  Who cares if it doesn’t work?  That’s someone else’s responsibility.

The VA Needs to Go

The Department of Veterans Affairs has linked the recent deaths of at least 19 vets diagnosed with cancer in 2010 and 2011 to appointment backlogs and delays at VA hospitals and clinics and resulting hindrances in care….

That this is something entirely correctible from within the VA is corroborated by the VA’s continued coverup of responsibility.  The VA so far has refused to identify those responsible for these veterans’ deaths or for the delay-caused or exacerbated injuries of many other vets, and the VA has refused to discipline or fire anyone—anyone at all—regarding this…problem, according to Congressman Jeff Miller (R, FL), House Veterans Affairs Committee Chairman.  Miller also said

I don’t want to hear the excuse anymore that “It was multi-faceted. … There were many people involved.”  If there were many people involved then they all need to go.

We are not asking for one particular person, we want to know exactly why things happened and who was held responsible.  At this point publicly, we haven’t seen anybody held responsible.

“They all need to go” must include General Eric Shinseki, Secretary of Veterans Affairs, who seems disinterested, or unable, to correct these problems.

Enough.  This VA needs to be gotten rid of entirely, and the function absorbed into the Department of Defense, where fellow veterans, both active and now-civilian, will be more likely to take such matters seriously.  That a Cabinet-level functionality like the present VA should behave in this way is utterly reprehensible and wholly unacceptable.

More Obamacare Dishonesty

It’s gotten so blatant that now they’re not even trying to disguise it.

What the Obama administration said publicly:

Per John Goodman:

Week after week, month after month, the Obama administration kept telling us everything’s working fine, there’s no problem and then they turn on a dime and fire their contractor.

President Barack Obama himself, through his Press Secretary, Jay Carney:

I didn’t see the article [containing statements to CGI’s replacement contractor on the ObamaMart re-do] I’m not aware of those statements[.]

What HHS said in its no-bid (!) contract request to Accenture, who’s replacing CGI on the ObamaMart Web development/fix:

the problems with the website puts “the entire health insurance industry at risk”…potentially leading to their default and disrupting continued services and coverage to consumers.

And

without the fixes “the entire health care reform program is jeopardized.”

And

if the problems were not fixed by mid-March, “they will result in financial harm to the government.”

Actually, not so much the government, beyond the precious egos of the current Senate and White House occupants, rather the financial harm is to those funding the government—us taxpayers—in the form of wasted taxes, higher health coverage costs, less access to the medical facilities of our choice, etc.

Among those fatal flaws is that ObamaMart’s back end—the part that’s supposed to transmit enrollment data, subsidy eligibility and amount, and so on to the insurer—hasn’t been built.  Not after almost four years since Obamacare was enacted, not nearly four months after the ObamaMart Web site was forced live and the failures of the site and of the law made manifest.

But the Obama administration continues to insist, publicly, that everything’s jake.

Obama’s Obamacare Tax Increases

Here are many of the ones that start this year.  As does President Barack Obama’s war on marriage, using his IRS to prosecute it.

  • top marginal tax rate rose to 39.6% for those at higher incomes
    • $400,000 for single filers
    • $450,000 for married couples filing jointly
    • $425,000 for heads of household
  • itemized deductions and personal exemptions phase out as income increases
    • beginning at $300,000 for married couples filing jointly
    • $250,000 for singles
  • higher capital gains taxes—up to 20% for some taxpayers
  • additional 0.9% Medicare tax
    • on earnings over $250,000 for married couples filing jointly
    • $200,000 for singles and heads of household
  • 3.8% tax on investment income
    • on earnings over $250,000 for married couples filing jointly
    • $200,000 for singles and heads of household

Notice that marriage penalty.