The train, plane and car wreck that is and Obamacare

If the ACA and were Boeing or Airbus aircraft–they would have been grounded on 3 October.

Wherever you reside in the over 150 countries TTA is read in, if you need more convincing that the US Government is unable to be successful (and Editor Donna is being restrained and charitable) at 99 percent of everything contained in this misbegotten Act, all one needs to do is read our previous coverage and this latest update in the Daily Mail along with their links to their own previous coverage. Are you sure it’s going to be fixed within weeks, Mr. President? This is Obamacare website riddled with garbled messages today

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Except in the minds of White House and HHS planners, the obvious solution would be to STOP: halt the enrollment process, suspend the ACA implementation, restore the right to current coverage for the millions who have been blocked from renewing their current individual coverage and take the entire website down. Rethink all the elements including the coverage structure and the website, send it back to Congress for relegislating and implement a program that works sometime in 2015 IF a way can be found. But no, Americans get piecemeal fixes on a website and system that increase the vulnerability of personal information to hackers and identity theft–and coverage they cannot afford. (And this is only in the individual and small group market. Wait till it applies to large employers–other than unions which have been exempted.)

If the goal of Obamacare (the signature act of this president) was to provide a certain baseline of acceptable, affordable coverage to those uninsured or marginally insured, and to contribute to the Triple Aim which HHS has trumpeted for years–it is a complete, utter, break-the-bank failure. Editor Donna is one of the millions who has been notified that her individual coverage (highly regulated by her state, BTW) is no longer acceptable under new regulations–no, I didn’t get to keep it–and my premium will likely increase for coverage I do not need. (There are 19 million individual policies in the US–80 percent or more will be canceled.) Moreover, I will be restricted to a narrow network of physicians and hospitals and have no choice to go out of network except at 100 percent pay.

It has been described as ‘Medicaid and Medicare on steroids’ which are not compliments. The subsidies are only a papering over of reality–the whole scheme is unaffordable and unworkable, was horrible legislation from the start, and worse, it has been known it would be this way from the start. If the truth is best seen at the edges, read this article by a Stage 4 cancer survivor in the Wall Street Journal (open access): You Also Can’t Keep Your Doctor: I had great cancer doctors and health insurance. My plan was cancelled. Now I worry how long I’ll live. The president’s mealy-mouthed apology [here on MedCityNews] and the strangely timed resignation of CMS’ CIO are not acceptable. Apologies are only words, not actions. It is long past time for this administration and this Congress to ground this aircraft and admit that the wings cannot be fixed with gallons of Krazy Glue.

A personal reflection: As a college (university) student, I had the most valuable experience of a semester in London devoted to study of the British parliamentary system. One of the highlights to me was Question Time to which Ministers are subjected during the week and the PM weekly. To Americans used to the normal hush and strict order of the large US Congress, PM Question Time resembles a braying crowd at its quietest and a street fight when it really gets going (and is a popular twice-weekly broadcast on C-SPAN). It does one great thing. The Government’s Ministers–not subordinates or legal counsel–must answer Members’ business and policy questions on the floor then and there, with minimal preparation and in detail, nearly every day, and the PM weekly. Britons learn where your Members stand as well. If there was one thing I wish our Founding Fathers had taken from the British parliamentary system, it is this. Had we Question Time, where department heads and the president must be questioned on and defend policy weekly, this discipline would be good for both Congressional members and the Government. Someone might have brandished the (metaphorical for us) Mace, but a brawl on the floor would a great improvement on bad law. Close, regular questioning of the Government, and making Cabinet members and department heads show up regularly for questions, might better the chances of stopping this and many other misbegotten laws and policies now inflicted on the citizenry.

This is a signal failure of more than a website, it is a FAIL of governance. Now, where do we in the US go from here?

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