Health reform’s problems run deeper than a glitchy website

By Dr. Philip Caper, Special to the Bangor Daily News
Posted Nov. 14, 2013, at 11:49 a.m.
 

Serious problems with the websites created by the Affordable Care Act continue, and probably will for a long time. Although frantic efforts at incrementally improving them are being made by the Obama administration, and some sites are working better than others, they are a long way from working well.

As I’ve written before, the causes of the website’s problems are far more serious than poor software design. They are baked into the law by its extreme complexity.

There is growing frustration and anger at the administration in Congress from both Democrats and Republicans. Much of it is being expressed by the same people whose hypocrisy and obstructionism is responsible for a failure to do the right thing in the first place. Calls from members of Congress to delay the ACA’s implementation or to repeal it entirely will intensify.

Instead of expanding our existing Medicare program, which has been working well for almost 50 years and is our country’s most efficient and least intrusive health care financing program, the ACA creates complex new law that perpetuates and reinforces the chaos and confusion of our hodgepodge of public and private insurance programs. Coverage and financial assistance continue to depend on an individual’s employment status, income, place of residence, age, conjectures about future health status, and many other factors, some of them subject to change with little or no warning and many impossible to predict.

Smooth implementation of the ACA depends upon the ability of many parts of government and thousands of insurance companies to seamlessly communicate with one another and agree on data drawn from myriad different public and private sources. Some in the health insurance field believe such a task will be difficult or impossible to achieve.

We have to ask ourselves, who are the winners from requiring us to go through the expense and confusion inherent in trying to implement a law of over 2,000 pages? The answer is clear. It’s a health insurance industry that profits from complexity and confusion, and providers of pharmaceuticals, medical supplies, devices and services who benefit excessively from the very weak cost controls inherent in our fragmented system of paying for services.                                    Read the full article

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