Re: Healthcare

1

According to what I read, the site is a lot better to navigate and submit with, but now they have to fix the problems with the backend processing.

I just talked to my parents in Texas, and they got individual coverage for right now without realizing it might expire at year-end. So perhaps I'll get some more hands-on knowledge about the federal, rather than Californian, website.


Posted by: Minivet | Link to this comment | 12- 2-13 9:07 AM
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Oh jesus. Why is signing up for four weeks of coverage even an option?


Posted by: heebie-geebie | Link to this comment | 12- 2-13 9:08 AM
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Oo: previously the "window-shopping" option on healthcare.gov did not vary premiums by age, which is a huge factor (and I heard, though I didn't confirm, that it displayed premiums for a lower-than-average age). Now it does let you input age, though still not income.


Posted by: Minivet | Link to this comment | 12- 2-13 9:09 AM
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3: I've used healthsherpas for window shopping which does take age and income. Don't know how accurate it is, however.


Posted by: JP Stormcrow | Link to this comment | 12- 2-13 12:15 PM
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the media will be assholes about it is my guess.


Posted by: text | Link to this comment | 12- 2-13 12:28 PM
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the media will be assholes about it is my guess a metaphysical certainty. Oh look. Anecdotes with no numerical data- are 50% of insurance transmissions failing? 5%? 1%? Who knows, someone can give us a juicy quote!


Posted by: SP | Link to this comment | 12- 2-13 12:46 PM
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You ever wonder if Fox News might not be entirely impartial on this subject?


Posted by: Minivet | Link to this comment | 12- 2-13 1:21 PM
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6: Numbers I had previously seen quoted were ~5% with a target of under 1% before the insurers would regard it as "working".


Posted by: JP Stormcrow | Link to this comment | 12- 2-13 2:24 PM
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Yes, I saw the 5% number elsewhere, but the NYT story is just factless bitching.


Posted by: SP | Link to this comment | 12- 2-13 2:32 PM
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I'll repost what I did at the end of another thread:

And earlier I had indicated that we should hold discussion on most of this until May, but I will say that this article in the NYT with more detail on some of the technical choices made behind the scenes did give me more pause that I anticipated. Things like basic network infrastructure and hosting.

Article was a few days back, and it does look like a number of those items were addressed, but I may feel the need to dial back some of my criticism of the criticizers (but I don't want to be too hasty on that ...). In part because who wants to feed the frenzy of things like this massive cluster waltz of imbecility on MTP starring David Gregory, Andrea Mitchell, David Brooks, and Chuck Todd. Which prompted Stephanie Rawlings-Blake, the young mayor of Baltimore, to all but come out and say, "What is wrong with you, you fucking ghouls?"


Posted by: JP Stormcrow | Link to this comment | 12- 2-13 2:38 PM
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Yggles things the website issue is a fundamental set-back for progressives because he thinks getting health insurance is comparable to getting a garbage can.


Posted by: Moby Hick | Link to this comment | 12- 2-13 3:15 PM
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2: Would it be better for people to go uncovered for four weeks? The insurance companies certainly aren't going to implement the ACA requirements a day earlier than they have to.


Posted by: Minivet | Link to this comment | 12- 2-13 5:43 PM
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10: That Meet the Press episode was indeed ghastly, but I'm surprised the DKos write-up doesn't include the panel's hammering away at the notion that the very project of liberalism is clearly in question! It's quite possible that government is just not capable of a project of this magnitude, it's just not nimble enough! Just look, they had to call in the private sector to save the day, and what does that tell you, eh, eh?? Uh-huh.

As Digby pointed out the other day: the private sector contractors fucked up in the first place, ahem.

It was disgusting, I tell you what. The entire panel -- excepting Rawlings-Blake* -- was all over that narrative, which I'd honestly thought had been sidelined by now.

* Accuracy where it's due: Rawlings-Blake isn't considered an unalloyed sweetheart as Mayor of Baltimore, but then again, it's not clear anyone could be.


Posted by: parsimon | Link to this comment | 12- 2-13 6:56 PM
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12: It's not clear to me why coverage for December 1, 2013 is available. The MD exchange site shows 12/1/13 as its default date for beginning coverage, with a drop-down menu to switch to 1/1/14. Why is that?

Is there a swathe of people whose current coverage ended at the end of November? Or is this just a way to get people to sign on to a non-ACA plan for a month? (Seems like more of a headache for insurance companies than it's worth.)


Posted by: parsimon | Link to this comment | 12- 2-13 7:03 PM
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Lastly in my serial commenting: 11: I'm as likely to read that Yglesias post as you were to read the McArdle from yesterday.


Posted by: parsimon | Link to this comment | 12- 2-13 7:07 PM
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I was on a conference call. I read more broadly when I can't move.


Posted by: Moby Hick | Link to this comment | 12- 2-13 7:28 PM
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Shit is fucked up and bullshit, as I've previously noted elsewhere.


Posted by: SP | Link to this comment | 12- 2-13 8:57 PM
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Hey parsi, I know that MoveOn is looking for ACA success stories, so you may want to consider telling them about your outcome. (You previously mentioned you thought it would be positive; don't know if you've put that to the test yet.)


Posted by: Sir Kraab | Link to this comment | 12- 3-13 2:37 AM
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14: Weird. I, too, didn't think exchanges could get anyone coverage before 1/1.


Posted by: Minivet | Link to this comment | 12- 3-13 7:42 AM
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If I worked for V/erizon T/erremark I'd be stuffing myself down a rabbit hole right now. Wow, your whole business model is based on being the Managed Hosting Guys who are All Serious and Carrier-y, Not Like That Bookshop Or The Californian Hippie Website Directory Or Some Bunch Of Foreigners, and you took on the most high profile website launch ever and got sacked within a quarter. The humiliation must be extreme.

The feds have given the job to HP. I cannot imagine what might go wrong.


Posted by: Alex | Link to this comment | 12- 3-13 8:23 AM
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"Despite an impressive effort, in the end we felt that Terremark wasn't sufficiently bureaucratic and ponderous". (Somewhere I got the impression that the "sacking" decision was made even before the launch.


Posted by: JP Stormcrow | Link to this comment | 12- 3-13 8:49 AM
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19: I'm so confused. I thought you meant above that your parents had bought four weeks of coverage off the exchange.


Posted by: heebie-geebie | Link to this comment | 12- 3-13 8:55 AM
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22: No, privately.


Posted by: Minivet | Link to this comment | 12- 3-13 9:31 AM
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And I think they got it sometime last month.


Posted by: Minivet | Link to this comment | 12- 3-13 9:32 AM
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Speaking of the general topic, there really are some aspects of the Republican "resistance" to the ACA which are extremely borderline. For instance this California "Healthcare guide" website which they have promoted through franked mailings. Deceptive and full of FUD. And I know it is a futile, pointless exercise, but I do occasionally think how it would have been received and covered by the media if the Dems had done something similar in opposition to Medicare Part D or some other Bush-era initiative.


Posted by: JP Stormcrow | Link to this comment | 12- 3-13 12:10 PM
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Interesting. I wonder if they'll distribute literature to crisis pregnancy centers.


Posted by: Minivet | Link to this comment | 12- 3-13 12:23 PM
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18: Hey parsi, I know that MoveOn is looking for ACA success stories, so you may want to consider telling them about your outcome. (You previously mentioned you thought it would be positive; don't know if you've put that to the test yet.)

Okay - I'll look into their call for stories. Mine doesn't generalize awfully widely: with a pre-existing condition, I couldn't get individual coverage, so I found a way to get group coverage as a self-employed person. A so-called Group of One, allowable only in certain states, and according to which I'm a business with just myself as the sole employee (though I could in theory have hired people and covered them under the group plan). End result: $527/mo premium with $2000 annual deductible. The premium rate rose by 40% when I hit age 45, since it's not offset by any additional (younger) employees in the group.

The ACA is a godsend because I can't be denied for a pre-existing condition, so I can get individual coverage ... plus a subsidy. I'm looking at something like $200/mo premium with $1000 deductible now, a rough annual savings of at least $4000.* Plus I won't be looking at an insane rate increase on the order of 40%, due the ratio limit of 3 to 1 for oldsters versus youngsters under the ACA.

I spell all this out just in case people are curious why things are -- pending actual confirmation from the insurance carrier of my chosen exchange plan -- such an improvement in my case, but it's unclear to me how many other people will find themselves similarly aided. I'm switching from a group to an individual plan, which most of the time is *not* advantageous to people. I think.

* That $4000 annual savings is going to be a boost to the economy, at least in some small way.


Posted by: parsimon | Link to this comment | 12- 3-13 6:06 PM
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Whoops, that was longer than I thought. I just cannot say how important all this is to me.


Posted by: parsimon | Link to this comment | 12- 3-13 6:07 PM
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Mine doesn't generalize awfully widely

I say this affectionately, but: Don't be nuts. Your story is a powerful, specific corrective to reams of vague doubts being maliciously spread. Moreover, "wide" is relative -- it's a country of 310 million people and 22 million sole proprietorships. You think 1% of them might have preexisting conditions and be over 45?

Shorter me: Your story matters.

Also, since this is the politics thread: A transcript of Jorge Ramos's interview with Bill Clinton.


Posted by: Witt | Link to this comment | 12- 3-13 6:41 PM
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Parsi, glad to hear that this looks like an improvement for you. Getting dealt from off the bottom of the deck for doing your own thing really sucks.


Posted by: lw | Link to this comment | 12- 3-13 7:08 PM
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Okay, Witt. It's just that I suspect most people in my position would have gone without health insurance altogether, so given the individual mandate, they're looking at a financial burden they didn't experience before. I can see the pushback narrative coming already.

30: Indeed.

I think I busted out a month or two ago with: Freedom! I really mean that. Talking to my brother a few days ago, I remarked that for all that this country purports to celebrate entrepreneurship and small business, it sure as hell has been penalizing it.

Didn't togolosh say once or twice that he'd regretfully declined to strike out on his own for this reason?


Posted by: parsimon | Link to this comment | 12- 3-13 7:33 PM
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It's just that I suspect most people in my position would have gone without health insurance altogether

True, but plenty of people keep insurance despite punishing rates because they don't perceive another choice (and because if they lose it they know they might not get it back). According to a regular survey by AHRQ, in 2005 the median individual-market insurance premium (for one person, not holding benefits constant, and across all age groups) was $155, and the 90th percentile was $489.


Posted by: Minivet | Link to this comment | 12- 3-13 10:00 PM
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I couldn't get individual coverage, so I found a way to get group coverage as a self-employed person. A so-called Group of One

An insurance product with a pool of one person? That's...exciting.


Posted by: Alex | Link to this comment | 12- 4-13 8:36 AM
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Group of One, the latest installment in the continuing adventures of the Irresponsible Actuary and the sequel to No Degrees of Freedom.


Posted by: Moby Hick | Link to this comment | 12- 4-13 8:47 AM
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There are some derivatives - longevity swaps - whose payoff depends on the longevity of a relatively small population (pensioners from a single company or even a single factory) relative to longevity of the population as a whole. Bumping off the right handful of pensioners could really skew the average in a potentially profitable way.

I'm thinking we get Carl Hiassen to script. A series of increasingly unlikely senior deaths in South Florida have one common factor: their pension provider! Can geriatric ex-journalist Pat Shanahan track the killer before his dodgy hip finally gives out?


Posted by: ajay | Link to this comment | 12- 4-13 9:11 AM
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36

"Forget it, Jake. It's Alzheimer's."


Posted by: ajay | Link to this comment | 12- 4-13 9:12 AM
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37

I suppose Chinatown is on Netflix. I've never seen it.


Posted by: Moby Hick | Link to this comment | 12- 4-13 9:13 AM
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38

Watch it now.


Posted by: Ginger Yellow | Link to this comment | 12- 4-13 9:15 AM
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39

I have to go see a man about a root canal in twenty minutes.


Posted by: Moby Hick | Link to this comment | 12- 4-13 9:16 AM
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An insurance product with a pool of one person? That's...exciting.

that's why the quoted sentence doesn't say "insurance", just "coverage".


Posted by: Cryptic ned | Link to this comment | 12- 4-13 9:19 AM
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35. I thought tontines were illegal these days.


Posted by: chris y | Link to this comment | 12- 4-13 9:26 AM
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39: I just had someone carve open the roof of my mouth. To remove a hole. Now I'm at the pharmacy waiting for my Vicodin.


Posted by: essear | Link to this comment | 12- 4-13 9:35 AM
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It's not a tontine - if you're a pension provider, you run the risk that your pensioners will live longer than you expected, so you hedge that risk by (through a swap) effectively betting that they will. If they live a long time, you have to pay out more pension, but you win your bet and use the winnings to cover it, so you're fine. If they all die young you have to pay out on your bet, but you save on pensions.

Now, let us assume for the moment that you are a dishonest man.
(MAX BIALYSTOCK: Assume away.)

You could take the other side of that bet from the pension provider - betting that the pensioners will actually die early - you could then nip round the retirement homes of Florida murdering a carefully selected list of OAPs, and making the average dip low enough to make your bet pay off.


Posted by: ajay | Link to this comment | 12- 4-13 9:36 AM
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42: I'm not even getting drilled today (I think). I'm just getting it looked at to see if the tooth can be saved.


Posted by: Moby Hick | Link to this comment | 12- 4-13 9:37 AM
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Just completed a health questionnaire. It's about to get real.


Posted by: Moby Hick | Link to this comment | 12- 4-13 10:08 AM
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43.last: Or just lend your support to the Obamacare Death Panels.


Posted by: JP Stormcrow | Link to this comment | 12- 4-13 10:10 AM
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I'm having some sort of race to see if the Novocaine wears off or the Vicodin kicks in faster.


Posted by: essear | Link to this comment | 12- 4-13 10:12 AM
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Plastic-coated paper bib on.


Posted by: Moby Hick | Link to this comment | 12- 4-13 10:17 AM
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Keep up the liveblogging! I should have liveblogged my surgery. ("This feels weird." "That was an awkward cracking sound.")


Posted by: essear | Link to this comment | 12- 4-13 10:20 AM
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I'm already out. They won't do anything until I have my next appointment.


Posted by: Moby Hick | Link to this comment | 12- 4-13 10:40 AM
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I have to go see a man about a root canal in twenty minutes.

Well, the film does feature some impromptu nasal surgery, so it's somewhat appropriate.


Posted by: Ginger Yellow | Link to this comment | 12- 4-13 10:41 AM
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The most disconcerting part of wisdom tooth removal for me was the disgusting vividness of the bone-conducted sound.


Posted by: lw | Link to this comment | 12- 4-13 10:43 AM
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I'm already out. They won't do anything until I have my next appointment

That's a relief. You wouldn't want to be ambushed on your way to work by your dentist.


Posted by: Ginger Yellow | Link to this comment | 12- 4-13 10:45 AM
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My dentist goes to my Crossfit class. IT COULD HAPPEN!


Posted by: heebie-geebie | Link to this comment | 12- 4-13 10:46 AM
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Do you all realize that this is the only place in my entire life where I speak openly about going to crossfit? Otherwise I speak vaguely about "going to exercise" or at most "going to an exercise class". The local Crossfit folks are heavily pushing us to check in on FB, and no, that sounds way too embarrassing. I don't even want to Like them but I would Like to get the status updates about cancelled classes and such.


Posted by: heebie-geebie | Link to this comment | 12- 4-13 10:48 AM
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Just call it aerobics.


Posted by: Sifu Tweety | Link to this comment | 12- 4-13 11:00 AM
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Beautiful Halford-trolling there, Sifu.


Posted by: x.trapnel | Link to this comment | 12- 4-13 11:02 AM
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I've certainly given the impression that it was a Spin Class before. Inadvertently, but I left it uncorrected once I realized that's that they thought I was going to.


Posted by: heebie-geebie | Link to this comment | 12- 4-13 11:08 AM
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I don't get spin classes.


Posted by: Moby Hick | Link to this comment | 12- 4-13 11:12 AM
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It's like being in a washing machine, but different.


Posted by: heebie-geebie | Link to this comment | 12- 4-13 11:16 AM
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Calling them Dervish 101 is now deprecated.


Posted by: LizardBreath | Link to this comment | 12- 4-13 11:17 AM
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It's something people made up so they could talk about exercise without it becoming a bike thread.


Posted by: SP | Link to this comment | 12- 4-13 11:27 AM
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I should have liveblogged my surgery.

I once had a tooth removal take much longer than the dentist had indicated. (I was told it should take ~15 minutes; I was in the chair for over an hour.) At some point around 45 minutes in, the dentist left to go get something, and the nurse started chatting with me. I wish I had lived-blogged that:

Nurse: "Once we get the tooth out, we'll be putting in cadaver bone. Do you know what that is?"

Me: [silence, lots of implements and gauze in my mouth]

Nurse: "Cadaver bone?"

Me: "Uhhh, derd perpl?"

Nurse: "Exactly!"


Posted by: Stanley | Link to this comment | 12- 4-13 2:05 PM
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"lived-blogged"


Posted by: Stanley | Link to this comment | 12- 4-13 2:08 PM
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Cadaver bone?

"I don't care what the cops said. I was just moving the corpse and my pants slipped down."


Posted by: Moby Hick | Link to this comment | 12- 4-13 2:10 PM
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Sometimes I repeat myself and change the details a bit.


Posted by: Stanley | Link to this comment | 12- 4-13 3:05 PM
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66: You and Hunter Thompson.


Posted by: JP Stormcrow | Link to this comment | 12- 4-13 3:13 PM
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How will the media cover: Let Ron Fournier tell you how.

"But anyhow, they have to sell it, but they can't over sell it," Fournier told Ingraham. "They can't spin, and they have a hard time not spinning. Last week I did a column that just focused on what they do with photos, that shows that this is a propaganda outfit, that they do put out government sponsored propaganda, and they are running a government-sponsored media organization."


Posted by: JP Stormcrow | Link to this comment | 12- 5-13 6:45 AM
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You wouldn't want to be ambushed on your way to work by your dentist.

I don't know - for people who suffer from dentist-related anxiety, it might be the kindest way. No more booking the appointment weeks in advance, feeling the dread build, sitting in a waiting room for half an hour... you're just walking to work one morning, maybe listening to music or thinking about your first meeting, when an unmarked van pulls up alongside you, two burly dental nurses leap out and grab your arms, you see the mask descending towards your face and hear the hiss of gas... and then blackness, until you wake up in a recovery room with a very sore jaw.
I'm thinking about the film "Pierrepoint" where the title character explains how he took great pride in getting it down to less than thirty seconds between him walking into the condemned cell and the prisoner being dead - he regarded it as the most humane way to do it.


Posted by: ajay | Link to this comment | 12- 5-13 7:34 AM
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Cato, DDS


Posted by: Sifu Tweety | Link to this comment | 12- 5-13 7:38 AM
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38: I concur with this. Seeing it for the first time was one of the best moments of 2013 for me.


Posted by: Alex | Link to this comment | 12- 5-13 8:15 AM
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70: nosflow will be pleased to hear that I initially thought this was some reference to the orator.


Posted by: ajay | Link to this comment | 12- 5-13 8:49 AM
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Caries delenda est.


Posted by: Opinionated Cato the Elder, DDS | Link to this comment | 12- 5-13 8:59 AM
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That's just brilliant.


Posted by: Moby Hick | Link to this comment | 12- 5-13 9:01 AM
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