Peekaboo! I can see through your coverage The chattering class was out in force over the weekend, talking about the first month’s enrollment numbers in Obamacare and the broken website. Coupled with the kafuffle over the cancellation of insurance policies that don’t meet the new insurance standards and you have Mr. Obama in deep political doo-doo. Charles Krauthammer, always one to gleefully throw gasoline on a lit fire, announced that we were witnessing the end of liberalism. Other commentators suggested it was the beginning of the end of the Obama Administration. To which I yawned. Even at its beginning, something is coming to its end. That is the nature of all things human. What disturbs me is, in haste to act, we may not be witnessing the end to the illusion of healthcare coverage. Obama screwed up when he arrogantly proclaimed, “You can keep your insurance if you like it.”. By omitting the qualifier “and the policy meets the new coverage standards”, he opened himself to attack from the opponents of meaningful insurance coverage reform. What is lost in the shouts of GOP indignation is the acknowledgment that what was cancelled are policies with coverage that is inferior, substandard, and expensive for what you actually get. Many of these policies are to adequate healthcare insurance as Victoria Secret’s lingerie is to clothing. You have the illusion of protection in the dark, but when when you shine a light on it, there’s no real coverage. My son was a staffing company temp-to-hire employee living in Iowa City with “healthcare benefits” for which he paid a considerable amount each month. After emergency appendectomy surgery at University Hospitals, his policy left him with a bill exceeding $9000 for an overnight stay. His insurance policy covered little, certainly not what his parents would expect from their company provided health insurance. Juan Williams, a Fox News commentator, observed quite accurately, “The fact is if you are one of the estimated 2 million Americans whose health insurance plans may have been cancelled (last) month, you should not be blaming President Obama or the Affordable Care Act. You should be blaming your insurance company because they have not been providing you with coverage that meets the minimum basic standards for health care. Let me put it more bluntly: your insurance companies have been taking advantage of you and the Affordable Care Act puts in place consumer protection and tells them to stop abusing people. The government did not “force” insurance companies to cancel their own substandard policies. The insurance companies chose to do that rather than do what is right and bring the policies up to code. This would be like saying the government “forces” chemical companies to dispose of toxic waste safely rather than dumping it in the river. Or the government “forces” people to drive with intact windshields and working brake lights. How dare they “force” drivers to pay money to get those things fixed if they are broken? One of the most popular and important provisions of the Affordable Care Act is setting basic minimum standards of medical insurance coverage. Here are some of those standards: - Your insurance company is no longer allowed to cancel your policy if you get sick - Your insurance company cannot deny you coverage or charge you more if you have a pre-existing health condition - Your insurance company cannot impose lifetime caps on you health coverage. - And perhaps most relevant to current discussion about insurance companies canceling substandard policies, your insurance company must cover what are called “essential health benefits.” The slow enrollment start is a surprise to me only because it surprises the chattering classes. Changing patterns of human behaviors - whether teaching students in English class, quitting smoking, or getting people to buy healthcare insurance when they’ve never had it before - isnt like building a bridge or constructing a website. When you build a bridge or construct healthcare.gov website, you start knowing what you want to accomplish, what “completion” looks like, what materials and in what proportions you need them, and when they must be scheduled to arrive for assembly. You control assembly and are responsible for the strength of the bridge or the functionality of a website. There is a date at which the project must be completed. The status of completion is observable and finite. Without excuses you get it done because you have control over the material items in your universe. Those that fumbled the construction of the website, including the Secretary, should pay the price of failure. Fire them. However, building a company, fighting a war, or changing people’s behaviors to buy insurance when they’ve paid for coverage before can’t be measured on the same time line. And success cannot be measured in short intervals. We are now seven weeks into the launch of the Affordable Healthcare Act. The people who couldn’t kill the Affordable Healthcare Act before are calling it a failure and the news media is screaming that “the only thing left to save Obamacare is HOPE”. The law hasn’t even gone into full effect yet and people are ready to pronounce it a failure. Ain’t it a little early? For a study or something that started out very badly and then turned around, I went back to a timeline of events at the start of World War Two from January 1942 - starting roughly four weeks and ending eight weeks after Pearl Harbor. Here is a daily accounting of some of the events in January 1942. January 2: Manila is captured by Japanese forces. They also take Cavite naval base, and the American and Filipino troops continue the retreat into Bataan. 6: The British advance continues to El Agheila, on the western edge of Libya. 7: Siege of the Bataan Peninsula begins. : Heavy air attacks on Malta; it is estimated that the bomb tonnage dropped on the island is twice that dropped on London. 8: Japanese troops penetrated the outer lines of defense at Kuala Lumpur, Malaya. 9: Japanese advances in Borneo meet with little opposition. 11: Japanese troops capture Kuala Lumpur, Malaya. : Japan invades the Netherlands East Indies. 13: The German U-boat offensive comes closer to the US shores starting the Second Happy Time. 19: Japanese forces take large numbers of British troops prisoner, north of Singapore. 20: Japanese bomb Singapore as their troops approach the city. 21: Rommel begins a surprising counter-offensive at El Agheila; his troops, with new reinforcements and tanks, capture Agedabia, then push north to Beda Fomm. 23: The Battle of Rabaul, New Guinea begins. 24: Japanese troops invade the Solomon Islands. 27: The British withdraw all troops back into Singapore. 29: Rommel enters Benghazi, Libya in his drive east. For the next few months, the two sides will rest and rearm. 31: The Japanese take the port of Moulamein, Burma; they now threaten Rangoon as well as Singapore. : The last organized Allied forces leave Malaya, ending the 54-day battle. Considering how World War Two started for the Allies, would you guess how the war would end three and a half years later? When you seek to change people’s behavior or human events, you can’t depend on the initial timetable to stay on schedule. Stuff happens and you need to adapt and react to it. But you don’t give up. Our digital culture has evolved an expectation of immediate results that views disappointing initial results as abject failure. This impatience with perfection conflates failure to manage the building of a website with the failure of a complex, not yet fully implements change in the way healthcare is delivered and funded in America. Just because the website doesn’t work right on day one is not a reason to throw out the entire Healthcare Reform act. We all need to slow down, turn off the iPhone, stop text messaging and Twittering long enough to think, not just react. We’ve got the Battle of Midway and El Alamein yet to come in about six months. And the end of the mandatory insurance sign up period - coming in about six months. We can wait a little longer for perfection.
Posted on: Mon, 18 Nov 2013 14:25:49 +0000
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