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from the sign-this-form-and-we-can-cure-the-hemorrhage-with-a-money-extraction dept.
The Affordable Care Act (ACA) open enrollment period for US Soylentis has ended. The website was plagued by problems from its launch and even had issues on the the last day.
So, did any Soylentis actually use healthcare.gov to sign up and how has your experience been with the Obamacare system so far?
For those that don't know, from Wikipedia:
The ACA was enacted with the goals of increasing the quality and affordability of health insurance, lowering the uninsured rate by expanding public and private insurance coverage, and reducing the costs of healthcare for individuals and the government. It introduced a number of mechanisms - including mandates, subsidies, and insurance exchanges - meant to increase coverage and affordability. The law also requires insurance companies to cover all applicants within new minimum standards and offer the same rates regardless of pre-existing conditions or sex. Additional reforms aimed to reduce costs and improve healthcare outcomes by shifting the system towards quality over quantity through increased competition, regulation, and incentives to streamline the delivery of healthcare. The Congressional Budget Office projected that the ACA will lower both future deficits and Medicare spending.
(Score: 4, Insightful) by Anonymous Coward on Sunday April 06 2014, @01:32PM
There's more to healthcare than the supplier and recipient of benefits, and it's the amount of bloat that has causes healthcare prices to rise to the point where action is necessary. The pharmaceutical industry (spends more on advertising than research), hospital administrators (one of the biggest growth sectors in terms of profit, yet with no value-add compared to their role in healthcare thirty years ago), formerly marginal health-services providers like scooter manufacturers and MRI centers, and *tada* insurance companies have, in financial terms, wholly eclipsed the simple, Norman-Rockwell image of the doctor-patient transaction. The doctor gets little of what the patient pays, especially if he's a frontline general practitioner working for some healthcorp conglomerate.
The more middlemen and profit centers and gluttonous maws of corporate greed got added to the system, the more expensive healthcare became, at a rate outpacing CPI and even education inflation.
And similar things are happening in your local school district. It used to be far cheaper to build and run a school, and the old schools sufficed to produce fine statesmen and generals and all the glory of the flowering Republic. Now you need a $50M facility, loads of extraneous teachers to teach PE and wood shop instead of literacy or math or science, and a host of subsidy programs in the form of massive textbook, techno-gadget, and breakfast/lunch budgets. It's the construction and corporate-subsidy programs that are growing the most: textbooks are often over $100, even in high school, and the plethora of wholly unnecessary iPad-for-education programs that don't actually help literacy are appalling. Meanwhile, student-teacher ratios suck and the core functions of education are getting neglected.
The fire departments seem relatively less bloated, although the police are starting to bloat up with the latest MIC subsidies for new tactical gear and SWAT armored personnel carriers that never get used for anything because America is not Somalia. Still, I mind the fire and police less, because they're still focused on core functions.
Health care and education need serious reform: cutting out a ton of profits being made by players on the sides. Obamacare didn't do that for healthcare, and probably just made it far worse by forcing the young and healthy to assume some of the costs of caring for the unhealthy, socializing risk while ensuring insurance profits. Note that I didn't say anything here about paying taxes to build ICU's: actually nationalizing health care itself, not just mandating its insurance, might help build ICU's, but Obamacare won't. Nationalizing the entire healthcare industry might help, but it won't happen. Eliminating insurance and middlemen and government subsidies and letting markets determine rational and far-lower pricing for healthcare is, frankly, a pipe dream that will never happen. I don't see a way out -- all I see is a looming financial crisis in which aggregate demand for all products and services dies out as a small number of middlemen and marginal actors, most of whose profits will go to a very few people, suck the discretionary spending out of a populace that can't find adequate employment.
(Score: 1) by tirefire on Monday April 07 2014, @08:05AM
You've touched on a lot of my favorite subjects to get pissed off about, but for now I'll just focus on one. iPads, $100+ textbooks, and PE teachers only form the latest wave of "education" pork barrel spending. Read John Taylor Gatto on schooling's transformation in the post-WWII period:
"... a long-term propaganda campaign which radically redefined good education to include football stadiums with lights, band uniforms, huge cafeterias, bus systems large enough to meet the needs of a small city though used only a couple hours a day, costly standardized testing, and many similar additions which once would surely have appalled ordinary citizens with both their high cost - and bizarre irrelevance." (emphasis mine)
Source: https://www.johntaylorgatto.com/chapters/17i.htm [johntaylorgatto.com]
There's a whole book available there for free, by the way. I highly recommend it.
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Personal Story: Right around 2006, the school board in my home town in Iowa wanted a new, larger middle school. The existing building had about 24 students in each classroom when I was a student there just a couple years prior, and enrollment projections showed there would be fewer students 10 years in the future. What was their justification? It was that 6th grade was currently taught in elementary schools, and that some study from California said it was best to put 6th grade in middle school (never mind that 6th grade in the elementary schools had already been run like a middle school for a decade).
Result: A new middle school was built only a quarter mile from the city limits, at a cost of tens of millions of dollars. Nearly every student had to be bussed in or driven; no one lived within walking/biking distance except about a thousand college students in an uber-cheap off-campus apartment complex directly across the street. A lot of them liked to get wasted on their balconies every Thursday/Friday afternoon right about when the middle schoolers got out. Shortly after the new middle school was opened, perfectly good neighborhood elementary school buildings were closed because declining enrollment, coupled with the loss of 6th-grade students, put every elementary school way under capacity. The K-5 students were consolidated into the remaining elementary schools; I remember seeing a lot of shiny new school buses rolling around town soon afterwards.
Bonus: The old middle school was re-purposed into the "administrative headquarters" for the school district. Since then, I've never seen more than 20 cars in the parking lot of a building that once warehoused 500+ students at a time. On a warm day last week, I went for my first bike ride of the year, and when I rolled around the corner expecting to see the old building and maybe eight cars in the lot, I saw... nothing. The building had been demolished, the parking lot torn up, the dirt raked, ready to be seeded with grass. Until I hear otherwise, I'm going to assume that some time last winter all the administrators held a meeting where they decided to get real jobs and then left town as pariahs. It's easier for me to bear than checking the local newspaper to see a photo of the groundbreaking ceremony for the NEW! PEDAGOGICALLY-SOUND! COMMON-CORE-COMPLIANT! ARCHITECTURAL-MASTERPIECE-ERRMAAGUUUUD! building that is no doubt under construction somewhere else.
(Score: 0) by Anonymous Coward on Monday April 07 2014, @09:38PM
We'll, the ACA does put a ceiling on how much of revenue can be spent on non-care-giving activities: 20%. That means that slice of the pie is going to wind up being squabbled over between administrative salaries and owner/investor profits, instead of growing unbounded at the expense of care and/or premiums.