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Posts Tagged ‘ACA’

Do Something, Mr. President

Ludicrous, Mr. President. The world is not watching. The world is scratching its head.

If you want a health plan, please stop tweeting, stop playing golf, stop wasting time and taxpayer travel money on silly campaign rallies. You are the president.

Get to work and come up with a plan, a good plan, such a good plan and so cheap, one where everybody will win, and all the Republicans and most of the Democrats will vote for it. It’s actually quite simple.

If you want to have a plan that allows people to buy across state lines, work on such a plan, and present it, and we’ll all support it. You don’t need to kick 26 million people off their health insurance to create a market that allows people to buy across state lines.

To use your own words: It’ll be great, and it’ll be so easy.

Do something, Mr. President!

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Here is the moment when Senator John McCain voted “No” on the repeal of the Affordable Care Act. Mitch McConnell, standing by with crossed arms, watching every senator vote, walked away defeated moments later. He knew he didn’t have the votes.

It has been incomprehensible to me how a government, by the people, for the people, would want to take action that takes insurance coverage away from a significant percentage of its people.

There are 243 million people in the U.S. over age 16, so let’s call them the adult population. Taking health care coverage away from 26 million people would affect 10% of the population.

Picture yourself being one of those 26 million. You may have had a pre-existing condition like diabetes, and now, by the stroke of a pen by your president, that coverage is gone and gone forever. You have diabetes, and you can’t get insurance that you can afford anymore.

Why? Because evil Obama made it so that wealthier Americans pay more taxes to fund shortfalls. Because insurance and pharma executives make millions of dollars a year and their companies are wildly profitable because their non-competitive practices are sanctioned by our laws and regulations. And because a significant percentage of our government is bought off by those individuals and organizations and they have a president who can’t think beyond soundbites on Fox News and will sign anything as long as it serves his aggrandizement.

This entire initiative to kill the Affordable Care Act is motivated not by making things right for the American people, but by political ambitions. The president has said that the Affordable Care Act is a disaster for the American people, and – by golly – many of the dumbed-down American people believe him.

Congress Republicans wanted to score a point, with the president, and with their paymasters. Now we have a White House that not only appears to have been put in place by the aid of an adversarial power, but it also actively sabotages one of the laws of the land – the Affordable Care Act. Rather than upholding the laws, the government is sabotaging the laws.

Trump says he wants to make America great again. By throwing 10% of the adult population off their healthcare? What kind of problem-solving is that? It’s oligarchy. It’s making himself and those in his orbit in debt rich. I do not understand how he can have 37% of the population is his support. A significant percentage of his own supporters would lose their healthcare coverage. Really? That’s a lot of people supporting Trump with no healthcare. Somebody help me understand that.

McCain understood that, and he listened to his constituents. Unlike dozens of his colleagues in the Senate, who also must know deep down how wrong all this is, he showed backbone and he did what is right for the American people. Too bad there isn’t going to be another opportunity to vote for McCain for president.

For more reading on McCain:

See my open letter, also sent to him in hardcopy: Here.

My book review on Faith of my Fathers. I highly recommend this book to anyone wanting to understand the man John McCain and the experiences of a prisoner of war. If you only read one chapter, read the one about “John McCain’s Towel.”

Here is an article about McCain and torture.

 

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The Affordable Care Act is not perfect. There is room for improvement. Nothing is perfect, and something this complicated will need constant and iterative improvement and updates.

But after the House voted more than 60 times over the last 7 years to repeal the law, knowing fully well that it would be vetoed, you’d think they’d do a better job getting it done this time around, with a president ready to sign.

The president said in every speech that he would repeal and replace the law on his first day. There are a few references listed above. Those are obvious and documented.

So why would the president say:

I never said repeal and replace Obamacare, and you’ve all heard my speeches, I never said repeal and replace it within 64 days.

What is this man thinking? That we’re all stupid and have amnesia? Of course he said it! He said it a hundred times or more. It’s documented.

But then, does he actually mean he never said he’d do it in 64 days? Is it the 64 days that he’s referring to? I sure hope not.

So then, what is this president saying when he makes such a statement?

I don’t like to have a president that says stuff that either:

  • makes no sense
  • is purposely misleading or obfuscating
  • is obviously wrong and can be documented as such (is that a lie?)
  • is wrong but can’t easily be proven (that is a lie)

Why does he do that? Does he think we can’t figure it out? I don’t seriously think so. I think he simply does not give a shit. He is so enamored with himself that it really does not matter to him what we all think. He is in the history books now as the 45th President of the United States. And nobody and nothing can take that away.

How does he expect us to treat him with any respect? How does he expect other world-leaders to treat him with respect? They will never know if what he is saying is true, reliable, and accurate.

No, they actually know the opposite: Whatever Trump says is mostly not true, not reliable, and certainly not accurate.

Trump is doing serious damage to his own credibility, and he is sullying the presidency.

Will the dignity and decorum of the office ever return?

 

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I think the reason why the website for ObamaCare glitched is because Controltec didn’t create it…

This is a real quote by one of our state government customers to our support center.

When I heard that I was honored. Our company has been building and hosting web-based systems for governments for over 15 years. That’s what we do. That’s what people pay us for. That’s why our company is there. Having one of our customers, even in humor, make a statement like the one above makes me feel proud.

And then it made me think about the Affordable Care Act.

Many things went wrong. The news that insurance companies are now canceling the existing policies of millions of people, no matter what the reasons, is not good for the Administration. The fact that prices for policies are higher than expected also does not help. There are many, many contributing factors that make this law controversial, and I don’t think I need to list them here. The talking heads are full of it. Just watch Fox News for a few hours on any day and you will get your fill.

With all the controversy, all the uproar about the Affordable Care Act, one thing the Administration didn’t need was a web site that didn’t work. This gives fodder to the critics, validates their claim that “the government” can’t manage anything, let alone a health care program. And I have to say: they are right.

The website fiasco, for one, was avoidable. How much better would the lives of the Administration and its supporters in Congress be if the federal website had come up on October 1 and run flawlessly?

The evidence shows that the site was put together with inferior coding, possibly based on outdated technology. Error messages relayed personal information over the Internet without secure encryption. People were able to bypass the email verification system. These are flaws that any entry-level hacker could quickly exploit and get access to private accounts to harvest personal information. The database is meanwhile riddled with mistakes and duplicated data records, resulting in multiple cancellations and enrollments. Records don’t have timestamps, so there is no telling which records are the correct ones and which are duplicates. These flaws are just some of the obvious things that made it into the news media.

The government put the Department of Health and Human Services in charge of designing and building a major web site using a host of government contractors. The Department of Health may know something about health, but it’s not equipped to build a major web site.  It also is not efficient at managing corporate entities. I am pretty sure that the contractors, for the most part, knew what they were doing, but the leadership and attention to detail at the highest project management level was probably sub-par. The result is a system based on faulty design, implemented with outdated technology, poorly tested and therefore overall not functional.

Fixing something like this is a nightmare. If the castle is built on a sandy foundation, it will sink and crumble, no matter how many reinforcements are installed into the walls.

The Administration has now put out a call for new contractors and Silicon Valley talent. I wonder what happened to the hundreds of millions of dollars paid to the old contractors? I don’t want to ask.

But Silicon Valley talent isn’t going to fix this. The only way to really make it work is tear it down and start with a new, solid foundation.

The sad thing is that this COULD have been done right from the start. There are companies that know how to build a major site that does not go down. Facebook, Twitter, Amazon and Google are some of the obvious ones. Have we ever seen those go down? When Twitter went down for just part of a day, the whole world was a-flutter. I cannot remember Facebook ever not responding when I checked in. Amazon seems to be there any time I want to buy something. This stuff does not have to be created from scratch. In this country we have the resources and know-how to make world-class sites.

It’s just that the government is not smart enough, nimble enough and flexible enough to avail itself of this talent and capability. It’s mired in stodgy procurement practices, weird contracting rules and endless delays. Things get done at a snail’s pace, and the creativity and the pride is often lacking. Bureaucrats know how to churn red tape, but they don’t know how to make competitive, slick, efficient systems.

The government should not be in the business of managing and building websites, just like it shouldn’t be building its own fighter aircraft. It should leave those things up to the people who know how to do that effectively and competitively.

Obama must be furious. At first he got away with the excuse that the site went down because of its tremendous popularity. On October 4 he said that the site was overwhelmed by volume. But by now he has given up on that story. “Nobody is madder than me about the fact that the website isn’t working,” he said.

If I ran a moving company and took on a contract to come to your house at 7:00am to start loading up, and I showed up at your house with my moving truck pulled by a tow-truck, because it was broken down, would I inspire your confidence?

This is exactly what happened to Obama with this website.

Obama didn’t need this. He should have delayed the launch by a year. This would have given the opposition more reason to decry the effort, and more ammunition and time to shoot it down, but it would have been infinitely better than this catastrophe.

Everything else could have been overcome. This website is a disaster, and it’s going to take a long time before it’s right.

Read my lips.

[attribution: some of my facts come from the article in Time Magazine of Nov 4, 2013, page 12]

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Today I attended a national government information technology conference. One of the sessions was a panel of directors in charge of implementing the websites and call centers for the exchanges which went live on October 1. The topic of the session was ACA – Open Enrollment Week One. The IT directors of three states shared their experiences and their challenges, getting the websites up and running on time and ready for the onslaught of the public.

We all know it didn’t go smoothly. We know some websites were down or crashed and some phone lines didn’t get answered. But we all know too that the exchanges were open for business and throngs of people lined up to find coverage.

When the audience asked about what the most rewarding part of their jobs was, one of the directors said that he kept hearing how grateful many customers were that they finally were able to sign up for coverage. They had been denied coverage in the past either for pre-existing conditions, or because the premiums were more than they could afford. All of a sudden the doors were open and they could sign up. Even though coverage would not even start until January, they were already ecstatic that it was coming – they just had to wait a few months.

Estimates are that there are 48 million Americans uninsured. I believe that some of these people really do not want insurance, but I also believe that those are the minority. The vast majority of those 48 million are eager and excited to be able to join the ranks of those of us who don’t even know what it’s like not to have insurance – like myself.

 

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