By Lambert Strether of Corrente.
The Department of Health and Human Services published an “Issue Brief,” HEALTH INSURANCE MARKETPLACE: NOVEMBER ENROLLMENT REPORT. (Sorry for the ALL CAPS, but that seems to be HHS house style.) This was my call on Monday, 2013-11-11:
It’s actually OK that the numbers are low in absolute terms; the MA enrollment for RomneyCare was initially low, and built to the final deadline. There are two metrics that matter: First, the order of magnitude of the enrollees compared to projections. 494,620 vs 49,462 is just barely passing; 494,620 vs. 4,946 would be very bad or, in Washington parlance, a “concern”; and even I don’t think there will be 494 enrollees. Second, the actuarial soundness of the pool; if the entire pool has a pre-existing condition, the insurance companies can’t profit. Unfortunately, the website debacle selects for the already ill, since only they have the incentive to sit through the days and the hours it takes to sign up. So I would expect the administration PR effort to: (1) roll out the heart-tugging YouTubes; (2) conceal the actuarial soundness, to avoid any hint that ObamaCare is already entering a death spiral; and (3) Focus on Medicaid signups, which are, after all, a success. And (4) claim next month will be better…..
But before we break that down, let’s take a minute to see how the White House gamed the numbers. Basically, the headlines with numbers (not just “low”) fall into two categories: ~106,000 and ~27,000. Why is that?
First, understand that HHS, as WaPo warned they would Monday, gamed the semantics of “enrolled.” Basically, what they did would be like Amazon saying that credit card transactions + the value of everything in people’s shopping carts = total sales. Ridiculous, right? I’ve got books in my shopping cart I won’t buy except in my own sweet time, and might never. How would those books be a sale? Same deal here. Here, buried in Appendix A of HHS’s enrollment report, note 8 for the column titled “Number of Individuals Who Have Selected a Marketplace Plan (8)” (total: 106,185) is the definition HHS is using for enrollment:
(8) “Individuals Who Have Selected a Marketplace plan” represents the total number of “Individuals Determined Eligible to Enroll in a Plan Through the Marketplace” who have selected a plan (with or without the first premium payment having been received directly by the Marketplace or the issuer) during the reference period. This is also known as pre-effectuated enrollment
“Pre-effectuated enrollment.” Savor that. So the that accounts for the optimistic, ~106,000 figure. What about the 27,000 figure? That represents the 26,794 who “enrolled” (pre-effectually) through the Federal Exchanges alone (Appendix B); a fraction of the 106,185 total.
So what in the name of sweet suffering Jeebus does HHS mean by “pre-effectual enrollment”? Up to the top (page 2):
Overview of Enrollment to Date
To date, 106,185 persons have enrolled and selected a Marketplace plan — this includes those who have paid a premium and those who have not yet paid a premium.
So, just like I said: HHS is combining sales numbers (“paid a premium”) with prospective (“pre-effectual”) sales numbers (“not yet paid a premium”). I can’t be sure whether that’s according to generally accepted accounting principles, but somehow, I don’t think so. Doesn’t think come under the heading of “Don’t count your chickens before they are hatched”? After all, there are plenty of reasons why people might not take that last step and actually fork over the cash, including (fully justified) doubts about the plan selected. Or there might be no cash to fork over, after subsidy. Or they might be eligible for Medicaid. So it would be really nice to know how many people are actually paying, because the actuarial coin has two sides: Paying out (as little as possible) and raking in (as much as possible). If that breakdown exists in the report, I can’t find it. (Readers?) The closest I can come is this rather Delphic statement:
Enrollment of individuals anticipating paying a premium for coverage is expected to increase as the start date for benefits, January 1, 2014, approaches.
Well, alrighty.
So how’d I do on my call? Here it is again:
So I would expect the administration PR effort to:
(1) roll out the heart-tugging YouTubes. I don’t visit Kos a lot, so I’ll just quote from Snow Crash:
“There’s no big hurry on this delivery,” he says. “Would you like to stay and have a drink? We’ve got Kool-Aid.”
“I’d love to,” Y.T. says, “but my diabetes is acting up real bad.”
“Well, then you can just stay and be a guest of our community. We have a lot of wonderful things to tell you about. Things that could really change your life.”
“Do you have anything in writing? Something I could take with me?”
(2) conceal the actuarial soundness, to avoid any hint that ObamaCare is already entering a death spiral. We’ve already seen the two sides of the actuarial coin, and how HHS gamed the premium side. So did they game payouts, the other side of the coin? They did indeed. We have many anecdotal reports that those with pre-existing conditions are over-represented in ObamaCare’s pool at present, because only they have the drive to fight through the horrible website. But there’s nothing in the HHS’s report that would give us a hint as to the composition of their pool. The words “pre-existing condition” do not appear. There are no proxies for health, as zip code or age. The word “smoking” does not appear. So I called this one.
and (3) Focus on Medicaid signups, which are, after all, a success. From the report, far forward on page 4:
Many of the SBMs [State-Based Marketplaces] have experienced first-month enrollment-related activity [What does that mean?] with substantial numbers of Medicaid eligible individuals applying to the Marketplace. Enrollment of individuals anticipating paying a premium for coverage is expected to increase as the start date for benefits, January 1, 2014, approaches.
Ditto.
And (4) claim next month will be better. From the report, again page 4:
[T]he Department expects Marketplace enrollment will start slowly, with peaks in December (as the January 1 coverage date approaches) and March (as the close of open enrollment approaches). Based on available data for the first reporting period, the level of early Marketplace enrollment appears to be consistent with expectations based on the Massachusetts Commonwealth Care experience. Many of the SBMs have experienced first-month enrollment-related activity [Again, WTF?] that exceeds comparable Commonwealth Care enrollment for the first month of open enrollment (See Appendix C for more information).
Ditto.
In a perfect world, I’d show whether (1) through (4) are propagating in the real world, but it’s late. I would guess badly. For example, on (3), Medicaid, Jon Walker tweets:
Medicaid expansion going well.
— Jon Walker (@JonWalkerDC) November 13, 2013
However, that has the great merit of being true. Walker also tweets:
And:
Given that the public option magic zombie sparkle pony represents the quintessence of flaccid career “progressivism,” losing a public option defender like Walker is a complete #FAIL. The White House is in very bad trouble on this.
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Excellent analysis.
I have delivered many websites large and small. I can add the large websites always fell behind and went over budget. The two things that are of extreme importance when delivering a website regardless of size: competance of the coders and adhering to Change Management principles. My guess is the White House hired bad coders and did not follow proper Change Management practices.
When large websites were going to miss their target due date…. delivering bad news up the chain always produced the most anxiety since management would envitably look at you with doubt. Nevertheless, honesty was always the best way to move forward.
It seems to me the White House has taken the — Rube Goldberg approach to Obamacare. Make things more complicated than they should be to obfuscate the underlying problems.
If they’re going to award a no bid contract, why not hire the guys who designed Romneycare? Oh yeah, politics–they had to conceal the fact that this was in fact Romneycare.
until dec 1 (i think), romneycare and obamacare massachusetts state exchanges are operating in parallel:
https://www.mahealthconnector.org
the romneycare exchange is far superior. in browse mode one can find actual premiums, copays (both subsidized and unsubsidized) and even some info on things like hospital networks.
the obamacare exchange has none of that info — or at least i can’t find it in order to do a side-by-side comparison.
… another example of “transparency” from the most transparent administration ever.
Whatever tweets from Jon Walker you were quoting, I can’t see them on my screen using Opera, Firefox or IE.
Sorry, I just fixed it.
So let’s go to the scoreboard:
106,000 might have bought Obamacare
9 million have had their current health plans cancelled
Not hard to see where this ends up. He’s managed to piss off nearly everyone. Not an easy task. Call it his special gift.
He’s still got the Obots, who are just as easily tricked and deluded as their teaparty counterparts.
Yes, the Obamacare rollout has been a disaster.
It might not be that bad. When my policy got canceled, my insurance company picked a new one for me. They said they would automatically enroll me in it unless I canceled. (Since I don’t qualify for subsidies, I decided to keep their new plan… which is like the old one but includes mental health, substance abuse, a higher but harder max, and costs 10% more.)
So… those 8,999,999 other folks might be not be in such bad shape.
BTW, I know I’m starting to come off as Obamacare’s biggest apologist.
Believe me, it’s not the system I would have designed. It’s a bad hack. OTOH, as a progressive, I do believe it moves us in the right direction; in the end I believe more people will have access to health care.
The rollout has been a disaster; one that could have been easily avoided. We’re still only 6 week in. I’m willing to give it a year or so… especially when the payoff is more people having access to health care.
I keep responding because I keep seeing hyperbole, or info that only tells part of the story.
BTW, I have 2 friends who have lost partial limbs in the past 2 years because of unmonitored diabetes. Neither had health care. One is now on VA, although that was a fight and ended up losing the rest of his foot. The other simply could not get insurance… at all, but will under ACA. This crap shouldn’t happen in civilized societies.
Presumably, however, you’re not seeing any hyperbole in this post, or you would have drawn attention to it. Right?
* * *
Do note: I have consistently said that ObamaCare will bring benefits to some; a program that large could hardly help doing so. My real issue is that ObamaCare does not and cannot being benefits to ALL, EQUALLY.
And given that we’ve now got Olenick’s 165-plan spreadsheet showing suckitude and “regulatory failure (“fraud”) I think I’m entitled, based on evidence, to question your testimony that your plan is as good as you believe it to be.
So while I welcome any fact-based datapoint, I’m always curious about “I’ve got mine!” stories that don’t go on to urge that all should get the same benefits. Why this consistent lacuna, do you think?
Or even if it is as good as he thinks, how do we know it will stay that way? Let’s not forget that no one here is necessarily saying that Obamacare will fail over night – or that it will do so in such an overt or spectacular way. It also depends how exactly how you define “fail”.
The rocky startup not withstanding, Obama will surly get the bugs worked out soon enough, turning this into a cash-cow for the insurance industry.
But will it actually bring down prices? I honestly don’t see how it can. It just asserts that consumer choice will magically bring down prices. (Do note that Obama has already backed away from previous claims that it has brought down the average price of premiums. He now argues that this will start trending down next year.) As Lambert already noted, they are not disclosing the ratio of invincible to pre-existing conditions. If there are more extractors than contributors, costs will quickly spiral out of control.
And those subsidies they are so proud of are finite. Once costs go up, those subsidies will disappear very quickly. What do you think will happen when the poor, who depend on those subsides before they can even pretend to afford the premiums, but still have the mandate hanging over their heads. I can already answer that one, they will vote Republican.
I’ve never gotten why that’s your real issue, lambert. It’s true but I don’t think that’s the real issue with ObamaCare.
The real issue with ObamaCare is not the lack of equality, it’s that it makes everyone (i.e., participants in the system, not the insurance industry) in the aggregate worse off, even if some people might benefit, because the insurance industry is extracting money without adding any value overall—and, in the process, is being strengthened and entrenched. Even if the for-profit, private insurance industry extended its “benefits” to everyone equally, that net loss for everyone still exists because of the profit extracted by the insurance companies and the administrative costs involved in the complexity of the system. (Some people win a jackpot at the casino—“I’ve got mine!”—but, overall, the casino’s customers are worse off and the “house” is, invariably, better off. It’s not an equality issue so much, it’s an issue of how much the casino pays out relative to what it takes in.)
This should be easy to see: It’s class warfare, and if you have less money, you get worse care, so (on average) you’re more likely to suffer, and more likely not to get care and die earlier. That’s wrong.
If anything, ObamaCare reinforces the class system with its income buckets.
ObamaCare won’t fix it, though it may ameliorate it in some cases (and not in others, i.e., the cases the Obots are happy to throw under the bus.
The insurance mandate is not automatically a bad thing. The best and most cost effective system all have mandatory participation, usually through taxes in some form. Public education works best because participating in its funding is mandatory, with all citizens contributing.
Nor is it automatically a bad thing to make it compulsory to perches privet insurance policies. German and Japan both use privet insurance systems that are still superior to the US in many ways.
But in these cases, the system is very equitable. Every one contributes based upon their ability to contribute a fair share into the system, and every one has a right to extract from the system according to their needs, regardless of conditions or costs. Even the wealthy are not expected to pay for their healthcare as they pay there dues through taxes and other means.
The ACA however attempts to use a free market approach, which is basically every man for him self. The wealthy; who have options, get access to a better system, while the rest of us only get what we can afford, and never what is needed. It’s a system that actually promotes discrimination. Not just based on wealth, but also on race, gender, sexual orientation, and what ever bug manages to crawl up the establishment’s as that particular year.
The lack of equity is also a time-tests strategy for con artists. How do you conceal the theft of millions? You parade around the exceptions to the rule.
Thank you for a calm counterbalancing report about what is happening. I suspect, though I can’t prove, that what you have experienced is representative of the majority of these cases. People will be automatically enrolled in a new plan that will be essentially the same as their old plan and will have a premium increase in line with the typical yearly premium increase. Many plans lost grandfathered status because of high rates of churn in the individual market(in order to get grandfathered status you must have had the policy before March 23, 2010 and not have made significant changes to the policies such as increasing the deductible).
Unfortunately tv news reports and blog posts are not going to be made showing people who have had a non-melodramatic experience, received a letter, done nothing, been auto enrolled in a new plan and seen a typical yearly premium increase.
The news media, if they do pick up on these stories, will focus on the premium increase and make it sound like it is something appalling, when the reality is premiums almost always go up. I am in a grandfathered plan (i.e. will not be cancelled) but I have no doubt my premium will increase, just as it has increased by anywhere from 7-20% every one of the years of the previous decade.
Presumably, however, this post is calm, or you would have drawn attention to some aspect of it that failed to be calm.
And presumably, again, there’s nothing melodramatic about thi post, or you would have drawn attention to that as well.
So thank you for your off-point general proffer. You write: “what you have experienced is representative of the majority of these cases.” Assuming your suspicion is correct, had you given consideration to the concept of devoting energy to helping the (by assumption) minority of those not helped to avoid suffering? Or is OK with you if they go under the bus?
No, I’m not ok with ignoring the suffering of anyone but I don’t think it is possible, in a country of more than 300 million people, to make any choice that doesn’t have some detrimental effects on someone. The number of people receiving these letters represents something like 2-3% of the population of the country. In most of these cases the consequences will be pretty uneventful. In some cases the consequences will be painful. There are discussions going on to try to deal with this problem. Unfortunately options all have some down side. There is concern that if the law is changed to grandfather most of these plans in that it could fracture the individual market into two separate risk pools(a high risk pool that complies with the law and a low risk pool that is allowed to continue to not comply with significant aspects of the law). This would also have painful consequences. There is also the question of whether such a law could be implemented in the extremely short time remaining and what kind of additional confusion and complexity it would cause in the market. It’s important that we don’t do anything, at this point, that may only add additional problems for someone else so we don’t get into a pattern of making rash changes, then someone else says “but now you’re hurting me”, triggering off more changes, etc.
Maybe the best and simplest thing to do would be to simply allocate a temporary fund to buy the small number of people who are truly facing serious problems because of this a silver grade health policy, thus allowing a more deliberative process to assess and adjust policy as we learn more about how the market is playing out, how medicaid expansion will progress in 2015 etc. I haven’t thought through all the implications of this but it would probably have fewer unwanted side effects than any of the options of altering the law at this late date or grandfathering in a lot of plans that weren’t going to be grandfathered.
I don’t know what the answer is but I’m sure that if we are forced to live by the standard that no policy or decision can have any downside for anyone that there is no possible decision, in any policy question, that we could make and governance would become impossible.
That’s a long way of saying single payer is off the table. All the brow-furrowing and cogitation disappears with “everybody in and nobody out.” Why leave that out?
Single payer is a longer term solution. I thought we were discussing the immediate problem of individuals who are having their policies cancelled for 2014 and concern about their pain and what can be done about it. I think we could agree that, whatever the merits of single payer, we aren’t going to be able to abolish the affordable care act and replace it with a functional single payer system in the next few weeks to save the individuals who are facing immediate termination of their policy effective jan 1. I take your point that this wouldn’t be an issue if we had a single payer system. You are correct about that.
I don’t recall claiming that ObamaCare could be replaced with a simple, equitable, rugged, and proven system in “the next few weeks.” Why do you insist on straw manning?
What I am saying is that ObamaCare supporters who “really love single payer” (as the saying goes) would do much better to invest their energy in contrasting ObamaCare to single payer now because there will never be another better teaching opportunity. There’s no point getting down in the weeds to defend a program that ought to be replaced as soon as possibly. It’s a distraction, verging on trolling.
I was trying to address your question to me.
We started with you asking me if I considered ways to help those whose policies are being cancelled avoid suffering and suggesting that I was indifferent to any pain being caused. My point was that arguing for single payer isn’t going to protect these people from suffering as their policies are being cancelled effective jan 1.
If the goal is to have a teachable moment then I understand your point, but if the goal is to find a way to spare these people pain(as your question suggested it was) then some feasible future implementation of single payer isn’t going to come soon enough to spare these people pain and some other solution would need to be found in the nearer term. I hope, that in our zeal to minimize the pain of some(or to avoid bad political press), we don’t make decisions that will only move pain onto others and might cause more additional trouble than benefit. I would rather see some direct temporary support to those who are presently going to suffer, rather than making late changes to the law and causing a cascading range of additional painful effects.
The problem is there is no solution which can be solved in a few weeks by tweaking ACA. This is a pipe dream. The predatory nature of the health insurance and hospital cartel system is the problem.
Any effort made to convince Republicans to do the decent thing by making tweaks which might cause some improvements would be better spent actually addressing the real problems with healthcare.
ACA was a predictable disaster to anyone who wasn’t emotionally invested in the appearance of Obama’s brand success which would create a simple messaging problem.
To sit here and denounce, ACA critics for not providing answers is childish and an attempt to deflect culpability from the supporters of a right wing policy when implemented by Democrats. Every Obot is morally culpable for every lost policy, every price increase from some who can’t afford it, and for everyone who can’t get the treatment they need because they don’t understand the difference between coverage and treatment.
Yves, some press devoted to Landrieu’s bill, S. 1624, which fixes the broken promise to millions of Americans in a simple and direct way, would be welcome. Why it has attracted so few sponsors is more than a little interesting. Because they are all in the pockets of the insurance companies? Really — even on this?
‘… fixes the broken promise in a simple and direct way …’
Man, are you always this high at 9 am?
You’re going to trust the same clowns who just shit the bed to put new sheets on it?
Kinda like calling the junkie who burglarized your house to re-key the locks for you.
“Pre-effectuated enrollment.” Brilliant! Orwell would be so proud … or envious. I wonder if that’s the great O’s very own wordsmithing. When counting pink unicorns, he not only included the shopping cart as completed sales, but the wish-list as well. Perhaps this fubar fiasco and the TPP will finally scratch the great O’s super-slippery Orgreenics non-stick coating.
LOL!! Thanks for the laugh.
Nice but redundant effort. We know that Obamism is about PR and PR only. Then money flows from our pockets to the %1.
ACA at the current state doesn’t really exist thanks to the continued dysfunction of Obamism. First rumors about “all fine” at the end of November are negative. My estimate calls for March-April provided the effort is professional, which currently it isn’t. (The guy at the top is not technical.)
We should have in mind: unemployment still high 5 years in. Pipeline still in. Food stamps out. SS and Medicare cuts still on the horizon. Why assume ACA will survive?
Yves, today’s obamacare complaint from me is regarding the subsidy. I am unfortunately one of those single lower class earners who is just on the border of income that won’t receive a subsidy. Now I do receive health care from my employer but I have to pay 100% of the premiums. So that eliminates me from both the exchange and the subsidy. And also, I don’t have any major health issues that when I look at plans on the website I say “oh joy, I was paying $1500 a month before, but now i am paying $1000”. So my point is that by going to the exchange, I am actually paying more and losing benefits. When I look at the plans on the exchange for the state of Michigan, I see more of the same plans that were in existance before the passing of obamacare. BCBS already had individual plans before. And the exchange plans appear to be just those. With the same swiss cheese setup. I am not gonna drop my employer plan just to save $25 a month and yet have my deductible go up. This is bending the cost curve. This is not cutting health insurance costs. Doesn’t the wise old saying go “there is no such thing as a tax cut, only a tax shift”? So bending the cost curve really is just shifting costs from one party to another party.
Well, you could manipulate your income downward to get under the 400% level; presumably that’s another one of the services ObamaCare make a market for. That’s what moral hazard for the poor looks like, I guess.
Thanks for this analysis. My entire job focuses on studying implementation of the health insurance exchanges, so I know that you hit the nail on the head with pointing out the fact that the government’s “enrollment” numbers are garbage. I don’t know any other scenario where counting something in the shopping cart as a sale would pass muster.
Thanks. P.M. Do feel free to share any information you have.
I once bought a penny stock for a couple of dollars. Some kind of medical imaging. Cheap enough for a gamble, I figured.
Turned out most of what the Marketing VP was booking as sales was “in the shopping cart” only.
After that, the stock lived up to it’s name. It would have cost me more to sell it that I could have sold it for.
Welcome to ObamaCare.
The strategy is pretty clear by now, isn’t it: keep lying until people give up and start believing.
Channel Surfing Old Timers
If you don’t like the channel, make one of your own.
The direction of the economy will be determined by who the old timers choose to carry the flag forward. Gold may be better than money, for a global middle class, but it is not as good as skill, which is not as good as character. So far, they don’t like what they see and are not dead yet.
Let’s say you are a tobacco farmer on your death bed, and you have a choice between Monsanto, payment in gold by a developer, payment in cash by another tobacco farmer, and trust, in a young person who has completed every task, increasing quality at a lower price. Which do you choose?
It’s not rocket science. The first three choices are Monsanto, with a time delay. Funny, how the approach of death increases acuity for some, those seeking to navigate through the eye of a needle. The empire BigAgREITs are attempting to control the outcome and failing miserably, because they kill everything they touch and end eating the seed. Chart the red tide of Monsanto. The farmers have no need of gadgets, fed by a clouded spy network judgment. The one and only thing they know is that nature takes care of its own.
No small business can start up an industry in a service economy, short of self-destruction, because the entry barriers are ridiculous, and no intelligent kid goes to a tourist town to get married and raise a family, on $10/hr chasing million dollar property. Government distills out the real economy and inserts itself in between falling quality and increasing price, growing like a weed until it consumes everything.
Once the weeds take over, you are better off leaving the farm to nature. The soil doesn’t forget. City folk either dismiss God outright or pray incessantly, with pretty words found in the feminist side of the Bible. If you ever lived on a farm, dependent on the rain and surrounded by developers sucking the well dry, you know what I am talking about.
Whether you like it or not, nations are built by families, who hold onto them until death, far beyond their productive yield, with governments built for the purpose. The Thyssens, the Krupps, and all the rest are beyond bankruptcy, which is increasingly obvious to everyone not in the union cartel, paid to look the other way. And they are competing for a shrinking slave labor pool, paying the Fed to maintain treasury demand with empty promises, hoping for an exit before treasuries blow up. Labor doesn’t need Mr. Gross, his bonds, or his ducks, which is why they are all in a row.
Silicon Valley is Monsanto’s best-last-to-lose-practice, its backroom data mining company. That’s what the latest flurry of free trade agreements is all about. The spy education network is slotting middle class social event horizons globally, to create a global middle class herd, eliminating culture as a variable to increase the marginal utility of money. George Soros isn’t escaping anything.
Silicon Valley has made it easier to exploit economic slaves globally, substantially decreasing the source, because everyone not paid to look the other way is increasing their distance, especially young people not imprisoned by the false assumption of empire, that an irrational market can outlast all individuals, and its foundation, that individual faith is itself irrational. Don’t build your home on a foundation of sand and expect a happy outcome when it rains.
War is a waste of time, money and human resources, which is about all America is good at, supplying artificial demand for a world full of artificial supply, in a global supply-side economy. Congratulations Chimerica; you are last to lose, supplanting Germany as the biggest idiot on the block, potatoes and sour kraut, famine for everyone.
The individual participant grants conscience to the least common denominator herd conscious, which competes with other herds to zero. The false assumption leads to extinction. That’s why the Nazis did what they did, and why the programmers are building this machine, imprisoning themselves and their masters, always building a taller lightning rod.
Christ Mass is not about toys, and an economy is not about grown men and women chasing toys, consigning children to poverty. Money is just an accounting set of training wheels. Don’t give it more credit than it is due.
Hillarycare is not about health. The first people to get whacked were individuals expressing choice. It’s about eliminating individual thought, freedom of action, which begins with free speech. Natural rights are not subservient to a contrived constitution.
The last thing this country needs is another bureaucrat inspector with a clipboard making a punch list, to create more make-work in the rat hole. TBTF fails every time because it is insurance against nature.
This is the best and easiest time in history to improve quality and decrease cost. Just wire around German stupidity funded by Chimerica stupidity. Wire home runs to the box and leave the monkeys trapped in the shaft.
Skills are more important than money, but not nearly as valuable as character, knowing when to ignore the science. Science eliminates thought, with algebraic reduction. That is not the function of humanity; it’s a byproduct. Gravity computes itself, not the universe. The universe has much better things to do and so do you. The automatons are going to run amok, with or without you.
Automatons can only produce what they fear, because they cannot focus away. San Francisco needs the tallest skyscraper like America needs to be bled with another hole in the head (F-ing Nazi doctors).
You know, my mom was a Diane Feinstein Nazi damsel-in-distress, who destroyed everything she touched. I loved her and pulled her out of every fire she created, without jumping in, until she built one that consumed her.
A line exists, it may be adjusted, and it may be cut at will. Old timers are always on the lookout for architects, now more than ever. You don’t need capital, you don’t need money, and you don’t need government. You need to order your priorities.
Marriage is a distillation process. Place your resistors to tune in the channel, and don’t presume to judge. Children are the integral. The empire is just a derivative, always on its way back to the DNA churn pool. Adjust the I/O feedback signal. You are not so different from the bumble be as you tend to presume.
Of course the business of America is business, Murder Inc. Why would you expect anything else, and who cares?
The empire murders itself. Don’t get involved and expect the old timer to give you the time of day. And never, ever underestimate a kid that sets up on bullies. Goliath always steps over the edge of the cliff, with momentum. That’s just the nature of a bully.
…
O.M.G. Obama just threw the insurers under the bus. I want to short some Wellpoint stock, but I took margin off my account after MF Global.
At least I can stock up on some popcorn for the upcoming kayfabe festival.
Well, the average shopping cart abandonment rate is 66% so there’s that to get an idea of how many have actually purchased.
Oooh, good point.
I am not a particularly indecisive person when it comes to an online purchase, and I have over dozen unpurchased carts at Amazon alone, and at least 5 selected, but unpurchased auto insurance policies from the last several years.
A lot of online shopping sites are maddeningly configured so you have to go through right up to the final irrevocable ‘buy click’ before you find out how much the shipping will cost. That explains almost 100% of my abandoned carts.
Since so many people have been exploited by insurance companies who’s policies are cancelled when they have a serious medical condition, I wanted to believe that the ACA would make sense but was skeptical from the beginning since it was constructed as a labyrinth of concessions to corporations.
The statement that only the garbage policies will be cancelled as a result of ACA is also a falsehood.
I recently got a letter from BCBS that my grandfathered preferred plan seasoned for over 10 years would not be cancelled *this year* but all bets are off for next year according to customer service.
At which time my plan will need to include maternity even though I am 60, and I presume mental health although I have never had those medical needs either.
So they are likely cancelling my plan that covers what I need and saddling me with things I don’t at a much higher rate (they couldn’t project what that would be).
To project this fiasco out even further, the high deductibles on top of co-pays, co-insurance of the bronze & silver and even gold plans will leave a great many people bankrupt or in delinquency anyway should a major medical be needed and unable to afford their premiums either.
And emergency rooms will still be filling the gap.
If single payer was so terrifying to our congress, couldn’t they have simply prohibited insurance companies from the abuses, done more to control costs not giving big pharma a free ride etc., routing out the graft in the system, expanded Medicaid.
A health care professional reported on a power point flow chart presentation on ACA saying it was so convoluted and complicated it was obviously going to add a lot of cost to policyholders.
I think it was Nancy Pelosi who told the new Congress in 2009 that no policies would be passed which might affect donations.
Concerning your point with legislation. Legislation is often complicated which isn’t a bad thing, but for example, what does “preventative” medicine mean?
If I recall correctly, “preventative” just means the doctor will tell you about treatments which might one day prevent a heart attack. Colloquially, most people might think that’s receiving treatment to prevent a real problem.
Who makes up Congressional staffs? Idiot kids of rich donors. Do they know the difference? How many experts are there in each office?
What if the attorneys don’t know the difference, or the boss is a tyrant who doesn’t listen? ACA is 2000 pages of major additions, minor changes, simple word changes, etc. One just can’t read ACA. You need a law library, not just a law degree. One attorney can’t do that. Did they have a real team in place to organize the work?
For example, the 9/11 Commission report could be read, and judging from most of our post 9/11 “security,” no one actually read it. Spoiler alert! Bureaucratic infighting and secrecy were the primary causes of 9/11 which didn’t involve Al Qaeda. Yes, the CIA was operating on U.S. soil instead of handing over evidence to the FBI who likely would have rounded up most of the hijackers after getting the two known ones.
If the economy was better, people could complain more, but they need to shut up to protect their place. We didn’t hear complaints which would have come out in the 90’s or even ’00’s among that sector when people could still get jobs.
healthcare system without fixing the play at the line?
It’s “the best laid plans of mice and men” and cat herding. Have you ever ordered pizza with a group? What happens? Cheese and Pepperoni is ordered because they are simple and can appease everyone, but if the simple answer isn’t picked, there is a discussion over which toppings suck and people drop out. No pizza is ordered. Why would you expect 435 Congressman, 100 Senators, and the twit in the White House to behave differently over a much more complex plan?
Yes, a wishful thinking pipe dream to suggest some common sense fixes could be advanced in the current situation.
One wistfully references that Canada’s landmark public health care was established on something like 2 pages.
And whatever happened to Obama’s repeated promise during his first presidential campaign….that healthcare reform negotiations would be publically available??
Like the TPP negotiations, which IMO will be the final coffin nail for the public enslavement by corporate supremacy if implemented, it is all done secretly and the vitals are known only when it is too late…..
We were saturated with broad concept selling points of ACA but the ‘devil in the details’ slow to be revealed.
That the whole scheme is ‘hoisted on it’s own petard’ a term oft used here, is just desserts.
Ultimately the exchange policies don’t prevent many working families, young people etc on a tight budget from being bankrupted and evidently my *good* individual policy I’ve had many years is going to be screwed with. There must be millions of people like me too.