5 ms·

I'm not from the US. I wonder, isn't this overly dramatic? So it takes a while to fix the web site. People have presumably been waiting for health insurance for

I'm not from the US. I wonder, isn't this overly dramatic? So it takes a while to fix the web site. People have presumably been waiting for health insurance for decades, what is one more month? Also, really, people get worked up about government processes that are difficult to use?

ceejayoz 13y ago
> People have presumably been waiting for health insurance for decades, what is one more month? If you're going to have to go outside the exchange for coverage, the open enrollment period is probably closing very soon. My work ones have traditionally needed a decision made by mid November. By now, I'd have had to tell my employer yes/no on his healthcare - regardless of whether I'd been able to log in to shop around.
- SilasX 13y ago
  Why did they even set up the exchanges that way? "Well, employers traditionally have retarded deadlines and signup windows, so when we fix healthcare, let's make sure to carry that part over!"
  - nickff 13y ago
    These exchange requirements are set up to avoid "free-riders", a problem caused by the mandatory disregard of pre-existing conditions. The logic is quite interesting, as the regulations create problems which must be solved by further intervention; this causes ever-increasing levels of interference in the market.
    - SilasX 13y ago
      No, that's unrelated and handled by the mandate. Note that the exchanges still have to take newcomers in the future; making people do it during arbitrary windows does nothing about the free rider problem.
      - nickff 13y ago
        I think the idea is that restricting the enrollment period will cause uncertainty (or fear) that the citizen may 'miss out' on the opportunity to save money on treatment throughout the year. Restricted enrollment periods also make government oversight and regulation simpler. As far as I can see the mandate has a separate goal, and was intended to penalize non-consumption of insurance, as well as broaden the customer base, while not being so high as to be a potentially unconstitutional compulsion. I do not think this is system is well thought-out or particularly good, but this is the only explanation I can find.
        SilasX 13y ago
        So, in other words, the enrollment window restrictions have nothing to do with the free rider problem, and can't be justified on that basis?
        nickff 13y ago
        From my last post: >the idea is that restricting the enrollment period will cause uncertainty (or fear) that the citizen may 'miss out' on the opportunity to save money on treatment throughout the year. I believe this logic shows that enrollment periods are reasonably related (, Supreme Court language for constitutionally permissible,) to the free rider issue. Whether it is a sufficient justification for government intrusion into independent decision making by citizens is a completely different, and entirely normative judgement.
nswanberg 13y ago
I think the article's tone is breathless and find the problems with the website predictable and boring (it also helps that I have insurance and barely need it). But lots of people are angry about the new health care laws and are linking the laws with the excecutive branch's ineptness at website building, and trying to imply the two are related. Others just like reading about conflict and struggling against a problem, and getting "insider" information. The way this article is written helps both groups get that entertainment. I can't see anything useful about the article though. It's not clear what the website is trying to do, how it interacts with the insurance companies, or to get anything else out of the set of metaphors the author is using to try to describe a website. Has anyone found any good articles detailing the problems or, better yet, any description of how governments can create or have created successful websites, or how future administrations might approach creating a highly visible website?
- sanderjd 13y ago
  For what it's worth, I completely disagree. I think this episode has been incredibly interesting, as it's the first time that I've seen major news reporting about the realities of software engineering, which in turn means that it's the first time all the people I know outside the industry have had any insight into this sort of thing. Of course the article isn't useful, that's not what it's for. As a description of a problem that has affected people in terms that they may actually understand, I think it works pretty well. Hopefully we'll get some good detailed post-mortems eventually, but they certainly won't be in the newspaper.
kevingadd 13y ago
If your previous policy was cancelled due to ACA and you can't get a new one because the enrollment processes for the exchanges are broken, you get to enjoy a gap in coverage. That is never a good thing.
- d23 13y ago
  That's nonsense. All of the previous ways to sign up for health insurance are still around, and the policies that were cancelled basically didn't give any coverage anyway (that is, they didn't cover medication or hospital visits and allowed insurance companies to drop the owners of those policies at any time).
  - Estragon 13y ago
    It's more complex than that. For instance, I was on student health insurance which (a) jumped substantially in price and (b) required upfront payment of 12 months of premiums, with no possibility of reimbursement if something better coming along. Since I'm expecting things to be significantly cheaper under the new regime, I've taken interim insurance, which ends (i.e., product will no longer exist) on January 1. It's been a huge hassle, and it will be an even bigger one if I can't arrange ongoing coverage after that.
  - zaroth 13y ago
    What's nonsense is to claim "the policies that were cancelled basically didn't give any coverage anyway." The ACA added several minimum requirements to private insurance plans, such as maternity and prescription drug coverage, which people could reasonably choose to forgo in exchange for the lower premiums. FYI, not having "prescription drug coverage" does not mean insurance does not cover any medication. It is a pharmacy benefit, in other words, over-the-counter medication. In my personal experience, I pay significantly less without the coverage than with it. I also don't have to worry about formularies, prior authorization, or generic swap-outs. To give you a specific example, in 2013 I paid $107/mo for a private individual policy with a $2,700 deductible, $5,250 max out-of-pocket (inclusive of the deductible) and unlimited lifetime benefits. Next year under ACA I'll be paying $283/mo for a policy with a $4,500 deductible and $6,350 max out-of-pocket (inclusive of the deductible) and unlimited lifetime benefits. The most important clause in the ACA is limiting the rating factor due to age to a maximum of 3x. That clause alone makes it the single largest tax increase ever passed on young middle class families with children. By my estimates, it will cost families like mine about $50,000 in increased insurance premiums over the next 10 years, because the least we can now pay is 1/3rd the rate of unhealthy 64 year-olds.
downrightmike 13y ago
That is the mindset, put off doing anything important until the media tells you that you MUST do it now.

ceejayoz 13y ago

> People have presumably been waiting for health insurance for decades, what is one more month? If you're going to have to go outside the exchange for coverage, the open enrollment period is probably closing very soon. My work ones have traditionally needed a decision made by mid November. By now, I'd have had to tell my employer yes/no on his healthcare - regardless of whether I'd been able to log in to shop around.

SilasX 13y ago
Why did they even set up the exchanges that way? "Well, employers traditionally have retarded deadlines and signup windows, so when we fix healthcare, let's make sure to carry that part over!"
- nickff 13y ago
  These exchange requirements are set up to avoid "free-riders", a problem caused by the mandatory disregard of pre-existing conditions. The logic is quite interesting, as the regulations create problems which must be solved by further intervention; this causes ever-increasing levels of interference in the market.
  - SilasX 13y ago
    No, that's unrelated and handled by the mandate. Note that the exchanges still have to take newcomers in the future; making people do it during arbitrary windows does nothing about the free rider problem.
    - nickff 13y ago
      I think the idea is that restricting the enrollment period will cause uncertainty (or fear) that the citizen may 'miss out' on the opportunity to save money on treatment throughout the year. Restricted enrollment periods also make government oversight and regulation simpler. As far as I can see the mandate has a separate goal, and was intended to penalize non-consumption of insurance, as well as broaden the customer base, while not being so high as to be a potentially unconstitutional compulsion. I do not think this is system is well thought-out or particularly good, but this is the only explanation I can find.
      - SilasX 13y ago
        So, in other words, the enrollment window restrictions have nothing to do with the free rider problem, and can't be justified on that basis?
        nickff 13y ago
        From my last post: >the idea is that restricting the enrollment period will cause uncertainty (or fear) that the citizen may 'miss out' on the opportunity to save money on treatment throughout the year. I believe this logic shows that enrollment periods are reasonably related (, Supreme Court language for constitutionally permissible,) to the free rider issue. Whether it is a sufficient justification for government intrusion into independent decision making by citizens is a completely different, and entirely normative judgement.

nswanberg 13y ago

I think the article's tone is breathless and find the problems with the website predictable and boring (it also helps that I have insurance and barely need it). But lots of people are angry about the new health care laws and are linking the laws with the excecutive branch's ineptness at website building, and trying to imply the two are related. Others just like reading about conflict and struggling against a problem, and getting "insider" information. The way this article is written helps both groups get that entertainment. I can't see anything useful about the article though. It's not clear what the website is trying to do, how it interacts with the insurance companies, or to get anything else out of the set of metaphors the author is using to try to describe a website. Has anyone found any good articles detailing the problems or, better yet, any description of how governments can create or have created successful websites, or how future administrations might approach creating a highly visible website?

sanderjd 13y ago
For what it's worth, I completely disagree. I think this episode has been incredibly interesting, as it's the first time that I've seen major news reporting about the realities of software engineering, which in turn means that it's the first time all the people I know outside the industry have had any insight into this sort of thing. Of course the article isn't useful, that's not what it's for. As a description of a problem that has affected people in terms that they may actually understand, I think it works pretty well. Hopefully we'll get some good detailed post-mortems eventually, but they certainly won't be in the newspaper.

kevingadd 13y ago

If your previous policy was cancelled due to ACA and you can't get a new one because the enrollment processes for the exchanges are broken, you get to enjoy a gap in coverage. That is never a good thing.

d23 13y ago
That's nonsense. All of the previous ways to sign up for health insurance are still around, and the policies that were cancelled basically didn't give any coverage anyway (that is, they didn't cover medication or hospital visits and allowed insurance companies to drop the owners of those policies at any time).
- Estragon 13y ago
  It's more complex than that. For instance, I was on student health insurance which (a) jumped substantially in price and (b) required upfront payment of 12 months of premiums, with no possibility of reimbursement if something better coming along. Since I'm expecting things to be significantly cheaper under the new regime, I've taken interim insurance, which ends (i.e., product will no longer exist) on January 1. It's been a huge hassle, and it will be an even bigger one if I can't arrange ongoing coverage after that.
- zaroth 13y ago
  What's nonsense is to claim "the policies that were cancelled basically didn't give any coverage anyway." The ACA added several minimum requirements to private insurance plans, such as maternity and prescription drug coverage, which people could reasonably choose to forgo in exchange for the lower premiums. FYI, not having "prescription drug coverage" does not mean insurance does not cover any medication. It is a pharmacy benefit, in other words, over-the-counter medication. In my personal experience, I pay significantly less without the coverage than with it. I also don't have to worry about formularies, prior authorization, or generic swap-outs. To give you a specific example, in 2013 I paid $107/mo for a private individual policy with a $2,700 deductible, $5,250 max out-of-pocket (inclusive of the deductible) and unlimited lifetime benefits. Next year under ACA I'll be paying $283/mo for a policy with a $4,500 deductible and $6,350 max out-of-pocket (inclusive of the deductible) and unlimited lifetime benefits. The most important clause in the ACA is limiting the rating factor due to age to a maximum of 3x. That clause alone makes it the single largest tax increase ever passed on young middle class families with children. By my estimates, it will cost families like mine about $50,000 in increased insurance premiums over the next 10 years, because the least we can now pay is 1/3rd the rate of unhealthy 64 year-olds.

downrightmike 13y ago

That is the mindset, put off doing anything important until the media tells you that you MUST do it now.