Tuesday, October 22, 2013

Thoughts on the healthcare.gov problems

Today's blog highlights two articles that give the best perspective on the system problem at healthcare.gov.  Similar problems apply to Maryland's system.  After pointing to the articles, i share some of my thoughts as to issues and possible directions to proceed.

The Health Site’s Chaotic Debut -NYT editorial.

Politico: The Obamacare bunker mentality

Here are my questions and thoughts re the computer system flaws at HHS and at Maryland Health Connection.

what are the problems? It would help to have more details.  
What timeframes are estimated to fix?
If a consumer calls or meets in person with a navigator (counselor), can that data be entered into the system?
Can the states with good systems be adapted for HHS or Maryland?
What options exist for HHS or Maryland? Delay the mandate? Other options?
Can we enroll Medicaid eligibles using the medicaid systems? 
Will more frequent briefings help?


  1. Though I am not in anyway overjoyed with the trouble that healthcare.gov is experiencing, and it seems that many of the issues might be structural, in the sense of needing to conform to existing complex government systems as well as poorly designed and executed from a technological perspective; I cannot help but think that the criticisms seem to miss some fundamental realities. The employer-based system that makes up a significant portion of previously available health insurance was/is in no way perfect in that it left a ton of people without any insurance, is not easy to navigate or in any way transparent in terms of choices and actual cost/benefit and never attempted to be automated at all and usually requires a human resource professional to explain and interface with the insurance company on the employees behalf. The Affordable Care Act, in its imperfect way, achieves so much more than the existing system in access and approach that I am certain that the in time we will come to appreciate its advantages and see the short-term difficulties as inconveniences on the path to something fairer and of value to society.

  2. Interestingly HHS was tasked with enrolling people in healthcare, something that the VA does every day and has done every day for many years. Why not use experienced government employees?

  3. What will be the accountability for Govt Contractor, who swallowed 900 M with 600 M cost over-run of tax payer money and deliver crappy product?