- Yssup Rider
- 12-06-2013, 03:02 PM
Don't forget dick nose...
- IIFFOFRDB
- 12-06-2013, 03:38 PM
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All Posts
http://thebullelephant.com/it-cant-be-fixed/
News
11/8/2013
It Can’t Be Fixed
By Alexis Rose Bank | 1 Comment
It Can’t Be Fixed
why Obamacare may be the biggest IT project failure ever
11/9 note: Follow-up here, Son of It Can’t Be Fixed.
Introduction: A little-known but highly significant piece of IT history
During the middle years of the housing bubble, quasi-private mortgage giant Fannie Mae undertook an ambitious – and fantastically expensive – information technology (IT) effort called the CORE Infrastructure Project.
Obamacare
The aim of CORE, in layman’s terms, was to create a new data backbone that could accommodate all the various computer programs at Fannie Mae, allowing them to share information in ways the old mainframe systems couldn’t. The main business driver of the project was the change in the way mortgages were being produced; the old mainframe systems were reliable, but were designed for the 30-year mortgage era, rather than the era of option-ARMs and interest-only loans.
On its surface, it was a very exciting project. It used then-leading-edge Java technology and modern data interchange formats. The funding was extremely generous – over the life of this project, $600 million was spent. The technical details would bore almost anyone, and probably did bore many of those working on the project, because this project was the single most expensive disaster in IT history.
CORE was a complete failure; it never saw production. One can measure the extent of this failure by the fewness of references to it, on the occasional resume, or as a legacy in an old subcontractor’s website marketing copy. In the IT world, CORE was the resume stain.
I mention CORE because without it, healthcare.gov would have no competition whatsoever as the “worst IT project ever”.
Garbage In, Garbage Out
GIGO – “garbage in, garbage out” – may be the oldest colloquial phrase in computer science, having been recorded in print as early as 1963. That it is self-evident is part of its beauty; that it is a simple statement of truth and common sense is its practical employment.
The first problem in implementing Obamacare is that the law itself is garbage. It was never designed as a practical plan that could actually be implemented; it was a blend of every flavor of corruption that infests Washington, D.C.
This is a law that no one read before they voted on it. (In my opinion, this in and of itself deprives this law of legitimacy.) Nancy Pelosi famously said, “You have to pass the bill to find out what’s in it.” Well, they passed it, and what’s in it is garbage – as is evidenced by the current fiasco. It’s every faction and lobbyist vying for money, for waivers, for subsidies, for exemptions, for discretion by the Secretary of HHS which in turn would be worked for more favors, for any special rule that could be worked to one’s advantage.
A clear illustration of the GIGO concept
It’s not a system that any engineer would recognize as being a system. The number of pages of regulations alone presently exceeds 20,000. There are way too many business rules to implement, test, and operate. With the business rules still being written, how could anyone have already programmed them into the system? An honest project management consultant looking at this plan would invariably declare it to be too complex, and that radical simplification – perhaps to the point of breaking up the one project into many separate projects – was essential to successfully rolling out and operating a product.
It cannot be left unmentioned that the implementation of the law directly contradicted what the customer (the Obama administration) had been publicly maintaining since 2007 – that it would result in cheaper health plans, and nobody who liked their insurance would lose it. Which set of orders reached the programmers? I suspect we will have to FOIA to find out. What other contradictions along these lines may have also happened? With so much contradictory information, and so much shrouded in secrecy or buried in volume, this can of worms may not yet be fully opened.
Management Failures
The responsibility for IT project success always resides in its management – they are the decision-makers, and thus they always hold the primary blame for the outcome. They do the hiring and firing; they delegate the work and they in turn hold their subordinates accountable.
In the instant case, management failure is apparent in every major decision. The choice of contractors – chosen by executive selection rather than any established process such as issuing a Request for Proposal (RFP) and soliciting bids – is curious at best, serious public corruption at worst. The Canadian contractor then made the same error, choosing Indian programmers to code the project.
The Money Pit
What this process produced was an outcome where virtually no one who had a hand in performing the work would actually be affected by the law – politicos and corporations with waivers, Canadians and Indians – none of whom would have to spend a minute of unpaid time on the site for any reason, none of whom were being forced to purchase insurance through it.
Who among them had any real incentive to make this work? The entirety of skin in this game that anyone had was the maintenance of Obama’s reputation – a reputation he clearly cared so little about he was prepared to see it destroyed entirely, in order to be President until the ruse was exposed – at which point it would be too late to vote him out of office.
Being stuck with both a flawed design and incompetent management, this project is unsalvageable. Picking new managers won’t help because no manager is going to be able to implement the design produced by this law and these regulations. These high-level catastrophic failures in design and project management each in and of themselves was capable of torpedoing this project and making successful implementation and operation impossible. But these have been masking deeper technical and logistical problems as well – the results of design and management failures – which we learn more about each day as the charade of fixing the site continues.
In pure monetary terms, the $500 million reportedly spent on healthcare.gov is exceeded by the Fannie Mae CORE project. However, that number comes from someone known both to lie outright and to consistently underestimate costs. Should the final tally exceed $600 million, healthcare.gov will take the crown as the undisputedly worst IT failure ever.
Beware
Do not use healthcare.gov. Your information is not safe. You have zero guarantee that your information is protected in any way, including the answers that you use on common security questions that give access to things like your bank account and email accounts, as well as your most private financial and medical information, your Social Security number, and other information about you. Healthcare.gov is one-stop shopping for identity theft. Because of the breadth and sensitivity of the data involved, in and of itself it represents the most extreme danger possible to your personal information security.
Healthcare.gov was knowingly rolled out with high risks to information security that were specifically waived to allow the site to go live. These problems have not been fixed; healthcare.gov is still knowingly and irresponsibly operating at extreme security risk levels. You would be unwise to believe any claims made by the government to the contrary – once your information is exposed it is permanently exposed and there is no stuffing it back into a privacy box.
Stay Tuned…
In my next article I will cover some of the more technical aspects of the situation, the total inversion of standard development practices we are witnessing in real time as the government tries to fix the problem, why the code itself is unfixable even if the (literally) fatal policy, management, and best-practices issues were resolved, as well as highlight specific risks to individuals who use the system.
All Posts
http://thebullelephant.com/it-cant-be-fixed/
News
11/8/2013
It Can’t Be Fixed
By Alexis Rose Bank | 1 Comment
It Can’t Be Fixed
why Obamacare may be the biggest IT project failure ever
11/9 note: Follow-up here, Son of It Can’t Be Fixed.
Introduction: A little-known but highly significant piece of IT history
During the middle years of the housing bubble, quasi-private mortgage giant Fannie Mae undertook an ambitious – and fantastically expensive – information technology (IT) effort called the CORE Infrastructure Project.
Obamacare
The aim of CORE, in layman’s terms, was to create a new data backbone that could accommodate all the various computer programs at Fannie Mae, allowing them to share information in ways the old mainframe systems couldn’t. The main business driver of the project was the change in the way mortgages were being produced; the old mainframe systems were reliable, but were designed for the 30-year mortgage era, rather than the era of option-ARMs and interest-only loans.
On its surface, it was a very exciting project. It used then-leading-edge Java technology and modern data interchange formats. The funding was extremely generous – over the life of this project, $600 million was spent. The technical details would bore almost anyone, and probably did bore many of those working on the project, because this project was the single most expensive disaster in IT history.
CORE was a complete failure; it never saw production. One can measure the extent of this failure by the fewness of references to it, on the occasional resume, or as a legacy in an old subcontractor’s website marketing copy. In the IT world, CORE was the resume stain.
I mention CORE because without it, healthcare.gov would have no competition whatsoever as the “worst IT project ever”.
Garbage In, Garbage Out
GIGO – “garbage in, garbage out” – may be the oldest colloquial phrase in computer science, having been recorded in print as early as 1963. That it is self-evident is part of its beauty; that it is a simple statement of truth and common sense is its practical employment.
The first problem in implementing Obamacare is that the law itself is garbage. It was never designed as a practical plan that could actually be implemented; it was a blend of every flavor of corruption that infests Washington, D.C.
This is a law that no one read before they voted on it. (In my opinion, this in and of itself deprives this law of legitimacy.) Nancy Pelosi famously said, “You have to pass the bill to find out what’s in it.” Well, they passed it, and what’s in it is garbage – as is evidenced by the current fiasco. It’s every faction and lobbyist vying for money, for waivers, for subsidies, for exemptions, for discretion by the Secretary of HHS which in turn would be worked for more favors, for any special rule that could be worked to one’s advantage.
A clear illustration of the GIGO concept
It’s not a system that any engineer would recognize as being a system. The number of pages of regulations alone presently exceeds 20,000. There are way too many business rules to implement, test, and operate. With the business rules still being written, how could anyone have already programmed them into the system? An honest project management consultant looking at this plan would invariably declare it to be too complex, and that radical simplification – perhaps to the point of breaking up the one project into many separate projects – was essential to successfully rolling out and operating a product.
It cannot be left unmentioned that the implementation of the law directly contradicted what the customer (the Obama administration) had been publicly maintaining since 2007 – that it would result in cheaper health plans, and nobody who liked their insurance would lose it. Which set of orders reached the programmers? I suspect we will have to FOIA to find out. What other contradictions along these lines may have also happened? With so much contradictory information, and so much shrouded in secrecy or buried in volume, this can of worms may not yet be fully opened.
Management Failures
The responsibility for IT project success always resides in its management – they are the decision-makers, and thus they always hold the primary blame for the outcome. They do the hiring and firing; they delegate the work and they in turn hold their subordinates accountable.
In the instant case, management failure is apparent in every major decision. The choice of contractors – chosen by executive selection rather than any established process such as issuing a Request for Proposal (RFP) and soliciting bids – is curious at best, serious public corruption at worst. The Canadian contractor then made the same error, choosing Indian programmers to code the project.
The Money Pit
What this process produced was an outcome where virtually no one who had a hand in performing the work would actually be affected by the law – politicos and corporations with waivers, Canadians and Indians – none of whom would have to spend a minute of unpaid time on the site for any reason, none of whom were being forced to purchase insurance through it.
Who among them had any real incentive to make this work? The entirety of skin in this game that anyone had was the maintenance of Obama’s reputation – a reputation he clearly cared so little about he was prepared to see it destroyed entirely, in order to be President until the ruse was exposed – at which point it would be too late to vote him out of office.
Being stuck with both a flawed design and incompetent management, this project is unsalvageable. Picking new managers won’t help because no manager is going to be able to implement the design produced by this law and these regulations. These high-level catastrophic failures in design and project management each in and of themselves was capable of torpedoing this project and making successful implementation and operation impossible. But these have been masking deeper technical and logistical problems as well – the results of design and management failures – which we learn more about each day as the charade of fixing the site continues.
In pure monetary terms, the $500 million reportedly spent on healthcare.gov is exceeded by the Fannie Mae CORE project. However, that number comes from someone known both to lie outright and to consistently underestimate costs. Should the final tally exceed $600 million, healthcare.gov will take the crown as the undisputedly worst IT failure ever.
Beware
Do not use healthcare.gov. Your information is not safe. You have zero guarantee that your information is protected in any way, including the answers that you use on common security questions that give access to things like your bank account and email accounts, as well as your most private financial and medical information, your Social Security number, and other information about you. Healthcare.gov is one-stop shopping for identity theft. Because of the breadth and sensitivity of the data involved, in and of itself it represents the most extreme danger possible to your personal information security.
Healthcare.gov was knowingly rolled out with high risks to information security that were specifically waived to allow the site to go live. These problems have not been fixed; healthcare.gov is still knowingly and irresponsibly operating at extreme security risk levels. You would be unwise to believe any claims made by the government to the contrary – once your information is exposed it is permanently exposed and there is no stuffing it back into a privacy box.
Stay Tuned…
In my next article I will cover some of the more technical aspects of the situation, the total inversion of standard development practices we are witnessing in real time as the government tries to fix the problem, why the code itself is unfixable even if the (literally) fatal policy, management, and best-practices issues were resolved, as well as highlight specific risks to individuals who use the system.
- IIFFOFRDB
- 12-06-2013, 03:51 PM
http://www.zerohedge.com/news/2013-1...annot-be-fixed
Guest Post: Obamacare Is A Catastrophe That Cannot Be Fixed
Tyler Durden's pictureSubmitted by Tyler Durden on 12/06/2013 15:01 -0500
Submitted by Charles Hugh-Smith of OfTwoMinds blog,
Obamacare is a catastrophe that cannot be fixed, because it doesn't fix what's broken in American healthcare.
I just finished a detailed comparison of my current grandfathered health insurance plan from Kaiser Permanente (kp.org), a respected non-profit healthcare provider, and Kaiser's Affordable Care Act (Obamacare) options. I reviewed all the information and detailed tables of coverage and then called a Kaiser specialist to clarify a few questions.
First, the context of my analysis: we are self-employed, meaning there is no employer to pay our healthcare insurance. We pay the full market-rate cost of healthcare insurance. We have had a co-pay plan with kp.org for the past 20+ years that we pay in full because there's nobody else to pay it.
What we pay is pretty much what employers pay. In other words, if I went to work for a company that offered full healthcare coverage, that company would pay what we pay.
Kaiser Permanente (kp.org) is a non-profit. That doesn't mean it can lose money on providing healthcare; if it loses millions of dollars a year (and some years it does lose millions of dollars), eventually it goes broke. All non-profit means is that kp.org does not have to charge a premium to generate profits that flow to shareholders. But it must generate enough profit to maintain its hospitals, clinics, etc., build reserves against future losses, and have capital to reinvest in plant, equipment, training, etc.
As an employer in the 1980s, a manager in non-profit organizations in the early 1990s and self-employed for 20+ years, I have detailed knowledge of previous healthcare insurance costs and coverage. As an employer in the 1980s, I paid for standard 80/20 deductible healthcare insurance for my employees. The cost was about $50 per month per employee, who were mostly in their 20s and 30s. In today's money, that equals $108 per month.
In other words, I have 30+ years of knowledgeable experience with the full (real) costs of healthcare insurance and what is covered by that insurance.
Our grandfathered Kaiser Plan costs $1,217 per month. There is no coverage for medications, eyewear or dental. That is $14,604 per year for two 60-year old adults. We pay a $50 co-pay for any office visit and $10 for lab tests. Maximum out-of-pocket costs per person are $3,500, or $7,000 for the two of us.
We pay $500 per day for all hospital stays and related surgery; out-patient surgery has a $250 co-pay.
So if I suffered a heart attack and was hospitalized and required surgery, I would pay a maximum of $3,500 for services that would be billed out at $100,000 or more were Kaiser providing those services to Medicare.
(Yes, I know Medicare wouldn't pay the full charges, but if Medicare is billed $150,000--not uncommon for a few days in the hospital and surgery-- it will pay $80,000+ for a few days in the hospital and related charges. All of this is opaque to the patient, so it's hard to know what's actually billed and paid.)
In other words, this plan offers excellent coverage of major catastrophic expenses and relatively affordable co-pays for all services.
The closest equivalent coverage under Obamacare is Kaiser's Gold Plan. The cost to us is $1,937 per month or $23,244 a year. The Gold Plan covers medications ($50 per prescription for name-brand, $19 for generics) and free preventive-health visits and tests, but otherwise the coverage is inferior: the out-of-pocket limits are $6,350 per person or $12,700 for the two of us. Lab tests are also more expensive, as are X-rays, emergency care co-pays and a host of other typical charges. Specialty doctor's visits have a $50 co-pay.
The Obamacare Gold Plan would cost us $8,640 more per year. This is a 60% increase. It could be argued that the meds coverage is worth more, but since we don't have any meds that cost more than $8 per bottle at Costco (i.e. generics), the coverage is meaningless to us.
The real unsubsidized cost of Obamacare for two healthy adults ($23,244 annually) exceeds the cost of rent or a mortgage for the vast majority of Americans. Please ponder this for a moment: buying healthcare insurance under Obamacare costs as much or more as buying a house.
A close examination of lower-cost Obamacare options (Bronze) reveals that they are simulacra of actual healthcare insurance, facsimiles of coverage rather than meaningful insurance. The coverage requires subscribers to pay 40% of costs after the deductible, which is $9,000 per family. Total maximum out-of-pocket expenses are $12,700 per family. This coverage would cost us $1,150 per month, and considerably less for younger people.
How many families in America have $9,000 in cash to pay the deductibles, plus the $13,800 annual insurance fees? That totals $22,800 per year. If some serious health issue arose, the family would have to come up with $12,700 (out-of-pocket maximum) and $13,800 (annual cost of insurance), or $26,500 annually.
Is healthcare that costs $26,500 per year truly "insurance"? I would say it is very expensive catastrophic insurance in a system with runaway costs.
The entire Obamacare scheme depends on somebody paying stupendous fees for coverage which then subsidizes the costs for lower-income families and individuals. How many households can afford $23,244 a year for Gold coverage plus $12,700 out-of-pocket for a total of $35,944 annually? How many can afford $26,500 for Bronze coverage?
Recall that the median household income in the U.S. is around $50,000.
How many companies can afford to pay almost $2,000 a month for healthcare insurance per employee? Even if employees pay a few hundred dollars a month, the employers are still paying $20,000 a year per (older) employee.
If an employer can hire someone in a country with considerably lower social-welfare/healthcare costs to do the same work as an American costing them $2,000 per month for healthcare insurance, they'd be crazy to keep the worker in America, unless the worker was so young that the Obamacare costs were low or the worker was a contract/free-lance employee who has to pay his own healthcare costs.
Uninformed "progressives" have suggested that "Medicare for all" is the answer. Their ignorance of exactly how Medicare functions is appalling; recall that Medicare is the system in which an estimated 40% of all expenditures are fraudulent, unneccessary or counter-productive, where a few days in the hospital is billed at $120,000 (first-hand knowledge) and a one-hour out-patient operation is billed at $12,000, along with a half-hour wait in a room that's billed at several thousand more dollars for "observation." (Also first-hand knowledge.)
Medicare is the acme of an out-of-control program that invites profiteering, fraud, billing for phantom services, services that add no value to care, and services designed to game the system's guidelines for maximum profit. If an evil genius set out to design a system that provided the least effective care for the highest possible cost while incentivizing the most egregious profiteering and fraud, he would come up with Medicare.
Does Medicare look remotely sustainable to you? Strip out inventory builds and adjustments from imports/exports and the real economy is growing at about 1.5% annually. As noted yesterday in What Does It Take To Be Middle Class?, the real income of the bottom 90% hasn't changed for 40 years, and has declined by 7% since 2000 when adjusted for inflation.
Here is Medicare's twin for under-age-65 care for low-income households, Medicaid:
As I have observed for years, Obamacare and Medicare/Medicaid do not tackle the underlying problems of Sickcare costs in America. If you haven't read these analyses, please have a look:
Why "Healthcare Reform" Is Not Reform, Part I (December 28, 2009)
Why "Healthcare Reform" Is Not Reform, Part II (December 29, 2009)
Type sickcare into the custom search box at the top of the left-hand column of the main blog page and you will find dozens of essays addressing what's broken with American healthcare.
Obamacare is a catastrophe that cannot be fixed, because it doesn't fix what's broken in American healthcare. It is a phony reform that extends everything that makes the U.S. healthcare unsustainable sickcare.
Guest Post: Obamacare Is A Catastrophe That Cannot Be Fixed
Tyler Durden's pictureSubmitted by Tyler Durden on 12/06/2013 15:01 -0500
Submitted by Charles Hugh-Smith of OfTwoMinds blog,
Obamacare is a catastrophe that cannot be fixed, because it doesn't fix what's broken in American healthcare.
I just finished a detailed comparison of my current grandfathered health insurance plan from Kaiser Permanente (kp.org), a respected non-profit healthcare provider, and Kaiser's Affordable Care Act (Obamacare) options. I reviewed all the information and detailed tables of coverage and then called a Kaiser specialist to clarify a few questions.
First, the context of my analysis: we are self-employed, meaning there is no employer to pay our healthcare insurance. We pay the full market-rate cost of healthcare insurance. We have had a co-pay plan with kp.org for the past 20+ years that we pay in full because there's nobody else to pay it.
What we pay is pretty much what employers pay. In other words, if I went to work for a company that offered full healthcare coverage, that company would pay what we pay.
Kaiser Permanente (kp.org) is a non-profit. That doesn't mean it can lose money on providing healthcare; if it loses millions of dollars a year (and some years it does lose millions of dollars), eventually it goes broke. All non-profit means is that kp.org does not have to charge a premium to generate profits that flow to shareholders. But it must generate enough profit to maintain its hospitals, clinics, etc., build reserves against future losses, and have capital to reinvest in plant, equipment, training, etc.
As an employer in the 1980s, a manager in non-profit organizations in the early 1990s and self-employed for 20+ years, I have detailed knowledge of previous healthcare insurance costs and coverage. As an employer in the 1980s, I paid for standard 80/20 deductible healthcare insurance for my employees. The cost was about $50 per month per employee, who were mostly in their 20s and 30s. In today's money, that equals $108 per month.
In other words, I have 30+ years of knowledgeable experience with the full (real) costs of healthcare insurance and what is covered by that insurance.
Our grandfathered Kaiser Plan costs $1,217 per month. There is no coverage for medications, eyewear or dental. That is $14,604 per year for two 60-year old adults. We pay a $50 co-pay for any office visit and $10 for lab tests. Maximum out-of-pocket costs per person are $3,500, or $7,000 for the two of us.
We pay $500 per day for all hospital stays and related surgery; out-patient surgery has a $250 co-pay.
So if I suffered a heart attack and was hospitalized and required surgery, I would pay a maximum of $3,500 for services that would be billed out at $100,000 or more were Kaiser providing those services to Medicare.
(Yes, I know Medicare wouldn't pay the full charges, but if Medicare is billed $150,000--not uncommon for a few days in the hospital and surgery-- it will pay $80,000+ for a few days in the hospital and related charges. All of this is opaque to the patient, so it's hard to know what's actually billed and paid.)
In other words, this plan offers excellent coverage of major catastrophic expenses and relatively affordable co-pays for all services.
The closest equivalent coverage under Obamacare is Kaiser's Gold Plan. The cost to us is $1,937 per month or $23,244 a year. The Gold Plan covers medications ($50 per prescription for name-brand, $19 for generics) and free preventive-health visits and tests, but otherwise the coverage is inferior: the out-of-pocket limits are $6,350 per person or $12,700 for the two of us. Lab tests are also more expensive, as are X-rays, emergency care co-pays and a host of other typical charges. Specialty doctor's visits have a $50 co-pay.
The Obamacare Gold Plan would cost us $8,640 more per year. This is a 60% increase. It could be argued that the meds coverage is worth more, but since we don't have any meds that cost more than $8 per bottle at Costco (i.e. generics), the coverage is meaningless to us.
The real unsubsidized cost of Obamacare for two healthy adults ($23,244 annually) exceeds the cost of rent or a mortgage for the vast majority of Americans. Please ponder this for a moment: buying healthcare insurance under Obamacare costs as much or more as buying a house.
A close examination of lower-cost Obamacare options (Bronze) reveals that they are simulacra of actual healthcare insurance, facsimiles of coverage rather than meaningful insurance. The coverage requires subscribers to pay 40% of costs after the deductible, which is $9,000 per family. Total maximum out-of-pocket expenses are $12,700 per family. This coverage would cost us $1,150 per month, and considerably less for younger people.
How many families in America have $9,000 in cash to pay the deductibles, plus the $13,800 annual insurance fees? That totals $22,800 per year. If some serious health issue arose, the family would have to come up with $12,700 (out-of-pocket maximum) and $13,800 (annual cost of insurance), or $26,500 annually.
Is healthcare that costs $26,500 per year truly "insurance"? I would say it is very expensive catastrophic insurance in a system with runaway costs.
The entire Obamacare scheme depends on somebody paying stupendous fees for coverage which then subsidizes the costs for lower-income families and individuals. How many households can afford $23,244 a year for Gold coverage plus $12,700 out-of-pocket for a total of $35,944 annually? How many can afford $26,500 for Bronze coverage?
Recall that the median household income in the U.S. is around $50,000.
How many companies can afford to pay almost $2,000 a month for healthcare insurance per employee? Even if employees pay a few hundred dollars a month, the employers are still paying $20,000 a year per (older) employee.
If an employer can hire someone in a country with considerably lower social-welfare/healthcare costs to do the same work as an American costing them $2,000 per month for healthcare insurance, they'd be crazy to keep the worker in America, unless the worker was so young that the Obamacare costs were low or the worker was a contract/free-lance employee who has to pay his own healthcare costs.
Uninformed "progressives" have suggested that "Medicare for all" is the answer. Their ignorance of exactly how Medicare functions is appalling; recall that Medicare is the system in which an estimated 40% of all expenditures are fraudulent, unneccessary or counter-productive, where a few days in the hospital is billed at $120,000 (first-hand knowledge) and a one-hour out-patient operation is billed at $12,000, along with a half-hour wait in a room that's billed at several thousand more dollars for "observation." (Also first-hand knowledge.)
Medicare is the acme of an out-of-control program that invites profiteering, fraud, billing for phantom services, services that add no value to care, and services designed to game the system's guidelines for maximum profit. If an evil genius set out to design a system that provided the least effective care for the highest possible cost while incentivizing the most egregious profiteering and fraud, he would come up with Medicare.
Does Medicare look remotely sustainable to you? Strip out inventory builds and adjustments from imports/exports and the real economy is growing at about 1.5% annually. As noted yesterday in What Does It Take To Be Middle Class?, the real income of the bottom 90% hasn't changed for 40 years, and has declined by 7% since 2000 when adjusted for inflation.
Here is Medicare's twin for under-age-65 care for low-income households, Medicaid:
As I have observed for years, Obamacare and Medicare/Medicaid do not tackle the underlying problems of Sickcare costs in America. If you haven't read these analyses, please have a look:
Why "Healthcare Reform" Is Not Reform, Part I (December 28, 2009)
Why "Healthcare Reform" Is Not Reform, Part II (December 29, 2009)
Type sickcare into the custom search box at the top of the left-hand column of the main blog page and you will find dozens of essays addressing what's broken with American healthcare.
Obamacare is a catastrophe that cannot be fixed, because it doesn't fix what's broken in American healthcare. It is a phony reform that extends everything that makes the U.S. healthcare unsustainable sickcare.
- IIFFOFRDB
- 12-06-2013, 04:28 PM
- LexusLover
- 12-06-2013, 04:54 PM
Poor Baby ... ... bulldog mouth, hummingbird ass. Originally Posted by CJ7YR ... he's talking about your again. And oh,.....
I'm still waiting for my refund, plus interest/earnings check for the contributions I have made and continue to make ...
.... but since you and yours want the "government" to provide you all health insurance ...
.....I'm going to have to get back to the end of the line .... into the not so foreseeable future.
BTW, have you gotten your "policy-not effective-due-to-faulty-application-processing" notice yet.
You are about to find out what those upcoming 50 million folks are feeling like when they get their policy cancelled .............
......... so YOU AND YOURS could get better coverage!!!!!
- CJ7
- 12-06-2013, 05:16 PM
YR ... he's talking about your again. And oh,.....
I'm still waiting for my refund, plus interest/earnings check for the contributions I have made and continue to make ...
.... but since you and yours want the "government" to provide you all health insurance ...
.....I'm going to have to get back to the end of the line .... into the not so foreseeable future.
BTW, have you gotten your "policy-not effective-due-to-faulty-application-processing" notice yet.
You are about to find out what those upcoming 50 million folks are feeling like when they get their policy cancelled .............
......... so YOU AND YOURS could get better coverage!!!!! Originally Posted by LexusLover
nope, I wasn't talking about "your" , I was addressing JD..
and about those canceled insurance policies .... study up
http://www.foxnews.com/opinion/2013/...nce-companies/
- CuteOldGuy
- 12-07-2013, 01:09 AM
Poor Baby ... you're FREE to leave this country, and the government anytime you so desire, but all you do is bitch about it ... bulldog mouth, hummingbird ass. Originally Posted by CJ7Yeah. But you have never been a fan of Freedom of Speech, have you?
Hey, what did you think of the Zerohedge articles? I mean, since your Juan Williams piece was just more bullshit from the Obamatron.
- Yssup Rider
- 12-07-2013, 02:19 AM
I've paid my premium. I'm covered. Very well
No strings attached.
Eat your bitter hearts out.
I HAVE INSURANCE.
Fuck you whiny bitches.
No strings attached.
Eat your bitter hearts out.
I HAVE INSURANCE.
Fuck you whiny bitches.
- flghtr65
- 12-07-2013, 04:15 AM
So it's not as an expensive unconstitutional intrusion on personal liberty as we first thought.The Supreme Court disagrees with you. The individual mandate is constitutional, just like in Romney Care for Mass. COF, Chief Justice Roberts knows better than you.
Yippee. Originally Posted by CuteOldGuy
- flghtr65
- 12-07-2013, 04:59 AM
http://www.zerohedge.com/news/2013-1...annot-be-fixedThe author has made some good points. The author has left out one very important fact. The health insurance companies that are selling policies on the on the Obamacare government insurance exchanges must offer policies to people with pre-existing conditions. This changes everything. In the mind of the underwriter a person who has a pre-existing condition is already sick. The probability of the insured getting sick is 100% or absolute certainty. Insurance by definition is usually a bet against the chance of a rare event occurring over time. If you are already sick the event has already occurred before the insurance is taken out (policy being written). The cost of the premium for every type of policy can't be the same. Sick people will be insured now. The comparison of costs between old and new plans that the author makes is not valid to make, it's comparing apples to oranges. A family of 4 that makes less than $92,000 will get help to pay their premium. There are 50 million people who are uninsured in the USA. Obamacare will attempt to insure most of these people. The CBO estimates that Obamacare will insure about 25 million over a 4 year period. A family of 4 that makes less than 20,000 is not eligible for an Obamacare policy and will have to go on Medicaid for their state. The republicans have no alternative plan to insure the uninsured. Red state Kentucky is one of the leading states for people signing up for the Obamacare or the Medicaid expansion based on their income. If RomneyCare can work in Mass. Obamacare can work in other states, they are essentially the same thing. They both have the individual mandate, you are required to purchase health insurance or pay a fine (or as Chief Justice Roberts calls it a Tax).
Guest Post: Obamacare Is A Catastrophe That Cannot Be Fixed
Tyler Durden's pictureSubmitted by Tyler Durden on 12/06/2013 15:01 -0500
Submitted by Charles Hugh-Smith of OfTwoMinds blog,
Obamacare is a catastrophe that cannot be fixed, because it doesn't fix what's broken in American healthcare.
I just finished a detailed comparison of my current grandfathered health insurance plan from Kaiser Permanente (kp.org), a respected non-profit healthcare provider, and Kaiser's Affordable Care Act (Obamacare) options. I reviewed all the information and detailed tables of coverage and then called a Kaiser specialist to clarify a few questions.
First, the context of my analysis: we are self-employed, meaning there is no employer to pay our healthcare insurance. We pay the full market-rate cost of healthcare insurance. We have had a co-pay plan with kp.org for the past 20+ years that we pay in full because there's nobody else to pay it.
What we pay is pretty much what employers pay. In other words, if I went to work for a company that offered full healthcare coverage, that company would pay what we pay.
Kaiser Permanente (kp.org) is a non-profit. That doesn't mean it can lose money on providing healthcare; if it loses millions of dollars a year (and some years it does lose millions of dollars), eventually it goes broke. All non-profit means is that kp.org does not have to charge a premium to generate profits that flow to shareholders. But it must generate enough profit to maintain its hospitals, clinics, etc., build reserves against future losses, and have capital to reinvest in plant, equipment, training, etc.
As an employer in the 1980s, a manager in non-profit organizations in the early 1990s and self-employed for 20+ years, I have detailed knowledge of previous healthcare insurance costs and coverage. As an employer in the 1980s, I paid for standard 80/20 deductible healthcare insurance for my employees. The cost was about $50 per month per employee, who were mostly in their 20s and 30s. In today's money, that equals $108 per month.
In other words, I have 30+ years of knowledgeable experience with the full (real) costs of healthcare insurance and what is covered by that insurance.
Our grandfathered Kaiser Plan costs $1,217 per month. There is no coverage for medications, eyewear or dental. That is $14,604 per year for two 60-year old adults. We pay a $50 co-pay for any office visit and $10 for lab tests. Maximum out-of-pocket costs per person are $3,500, or $7,000 for the two of us.
We pay $500 per day for all hospital stays and related surgery; out-patient surgery has a $250 co-pay.
So if I suffered a heart attack and was hospitalized and required surgery, I would pay a maximum of $3,500 for services that would be billed out at $100,000 or more were Kaiser providing those services to Medicare.
(Yes, I know Medicare wouldn't pay the full charges, but if Medicare is billed $150,000--not uncommon for a few days in the hospital and surgery-- it will pay $80,000+ for a few days in the hospital and related charges. All of this is opaque to the patient, so it's hard to know what's actually billed and paid.)
In other words, this plan offers excellent coverage of major catastrophic expenses and relatively affordable co-pays for all services.
The closest equivalent coverage under Obamacare is Kaiser's Gold Plan. The cost to us is $1,937 per month or $23,244 a year. The Gold Plan covers medications ($50 per prescription for name-brand, $19 for generics) and free preventive-health visits and tests, but otherwise the coverage is inferior: the out-of-pocket limits are $6,350 per person or $12,700 for the two of us. Lab tests are also more expensive, as are X-rays, emergency care co-pays and a host of other typical charges. Specialty doctor's visits have a $50 co-pay.
The Obamacare Gold Plan would cost us $8,640 more per year. This is a 60% increase. It could be argued that the meds coverage is worth more, but since we don't have any meds that cost more than $8 per bottle at Costco (i.e. generics), the coverage is meaningless to us.
The real unsubsidized cost of Obamacare for two healthy adults ($23,244 annually) exceeds the cost of rent or a mortgage for the vast majority of Americans. Please ponder this for a moment: buying healthcare insurance under Obamacare costs as much or more as buying a house.
A close examination of lower-cost Obamacare options (Bronze) reveals that they are simulacra of actual healthcare insurance, facsimiles of coverage rather than meaningful insurance. The coverage requires subscribers to pay 40% of costs after the deductible, which is $9,000 per family. Total maximum out-of-pocket expenses are $12,700 per family. This coverage would cost us $1,150 per month, and considerably less for younger people.
How many families in America have $9,000 in cash to pay the deductibles, plus the $13,800 annual insurance fees? That totals $22,800 per year. If some serious health issue arose, the family would have to come up with $12,700 (out-of-pocket maximum) and $13,800 (annual cost of insurance), or $26,500 annually.
Is healthcare that costs $26,500 per year truly "insurance"? I would say it is very expensive catastrophic insurance in a system with runaway costs.
The entire Obamacare scheme depends on somebody paying stupendous fees for coverage which then subsidizes the costs for lower-income families and individuals. How many households can afford $23,244 a year for Gold coverage plus $12,700 out-of-pocket for a total of $35,944 annually? How many can afford $26,500 for Bronze coverage?
Recall that the median household income in the U.S. is around $50,000.
How many companies can afford to pay almost $2,000 a month for healthcare insurance per employee? Even if employees pay a few hundred dollars a month, the employers are still paying $20,000 a year per (older) employee.
If an employer can hire someone in a country with considerably lower social-welfare/healthcare costs to do the same work as an American costing them $2,000 per month for healthcare insurance, they'd be crazy to keep the worker in America, unless the worker was so young that the Obamacare costs were low or the worker was a contract/free-lance employee who has to pay his own healthcare costs.
Uninformed "progressives" have suggested that "Medicare for all" is the answer. Their ignorance of exactly how Medicare functions is appalling; recall that Medicare is the system in which an estimated 40% of all expenditures are fraudulent, unneccessary or counter-productive, where a few days in the hospital is billed at $120,000 (first-hand knowledge) and a one-hour out-patient operation is billed at $12,000, along with a half-hour wait in a room that's billed at several thousand more dollars for "observation." (Also first-hand knowledge.)
Medicare is the acme of an out-of-control program that invites profiteering, fraud, billing for phantom services, services that add no value to care, and services designed to game the system's guidelines for maximum profit. If an evil genius set out to design a system that provided the least effective care for the highest possible cost while incentivizing the most egregious profiteering and fraud, he would come up with Medicare.
Does Medicare look remotely sustainable to you? Strip out inventory builds and adjustments from imports/exports and the real economy is growing at about 1.5% annually. As noted yesterday in What Does It Take To Be Middle Class?, the real income of the bottom 90% hasn't changed for 40 years, and has declined by 7% since 2000 when adjusted for inflation.
Here is Medicare's twin for under-age-65 care for low-income households, Medicaid:
As I have observed for years, Obamacare and Medicare/Medicaid do not tackle the underlying problems of Sickcare costs in America. If you haven't read these analyses, please have a look:
Why "Healthcare Reform" Is Not Reform, Part I (December 28, 2009)
Why "Healthcare Reform" Is Not Reform, Part II (December 29, 2009)
Type sickcare into the custom search box at the top of the left-hand column of the main blog page and you will find dozens of essays addressing what's broken with American healthcare.
Obamacare is a catastrophe that cannot be fixed, because it doesn't fix what's broken in American healthcare. It is a phony reform that extends everything that makes the U.S. healthcare unsustainable sickcare. Originally Posted by IIFFOFRDB
- LexusLover
- 12-07-2013, 10:56 AM
I've paid my premium. I'm covered.Actually I "hope" you and your family do have health insurance ..
I HAVE INSURANCE. Originally Posted by Yssup Rider
... if I buy a lotto ticket today ... I "hope" I win the "big money"!
That's why religions do so well ... "hope" .... the "faith" in the here-after gives them something to "believe" in ... even if it is wrong.
- Yssup Rider
- 12-07-2013, 11:30 AM
Now I can afford to keep paying for yours, LLIdiot, you Medicare leech!
Are you still trying to make people,believe that the policies that have been ought and paid for don't exist? I guess when you've been sucking off the governent's dick since before most of us were born, you'd have a somewhat skewed grasp on reality.
Are you still trying to make people,believe that the policies that have been ought and paid for don't exist? I guess when you've been sucking off the governent's dick since before most of us were born, you'd have a somewhat skewed grasp on reality.
- LexusLover
- 12-07-2013, 12:08 PM
...the governent's dick ...a somewhat skewed grasp on reality. Originally Posted by Yssup RiderOnly you would know the government has a dick ...
... has that been your preference over the "tit"?
With each post of yours it becomes more painfully obvious that our public education system failed you in so far as providing you with the necessary tools to comprehend what you read and repeat what you have read in an accurate and meaningful way.
Tax dollars wasted ... or was it that all the money in the world would not help?
If it makes you feel better about your failed-self, continue. God forbid that I would desire to deprive you of pacifying your own emotionally disturbed and disrupted mind. You may not have coverage for it.
- gnadfly
- 12-07-2013, 03:41 PM
The Supreme Court disagrees with you. The individual mandate is constitutional, just like in Romney Care for Mass. COF, Chief Justice Roberts knows better than you. Originally Posted by flghtr65Good point flighty.
Given that the "business mandate" is "settled law" also, why did Obama opt to delay it a year? I mean, its "settled law!"
- IIFFOFRDB
- 12-07-2013, 08:42 PM
Now I can afford to keep paying for yours, LLIdiot, you Medicare leech!Just how fucking idiotic are you, anyway? Your stupidity is simply astonishing.
Are you still trying to make people,believe that the policies that have been ought and paid for don't exist? I guess when you've been sucking off the governent's dick since before most of us were born, you'd have a somewhat skewed grasp on reality. Originally Posted by Yssup Rider