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Should the health exchanges be shut down?

Robert Laszewski
Policy
October 29, 2013
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My sense is that the biggest reason Obamacare is now in trouble is because of the top-secret way in which the administration has handled the rollout. If they had developed the computer system in a transparent way, the marketplace would have told them long ago this would not work.

No one outside the inner circle at the Department of Health and Human Services has any idea what’s really going on behind the wizard’s curtain. Hasn’t for months. Doesn’t now.

So any technical advice any of us could give would be, to say the least, uninformed.

If I were on the inside, and it were up to me, the first thing I would do is bring in a group of heavyweight information technology experts to tell me just what was really going on. The administration cannot trust the people who have been working on this because they told them to launch this mess on October 1 and almost three weeks in there has been no improvement on the website or in the backroom — they no longer have credibility.

I would ask those experts to very quickly answer three questions:

  1. Can this thing be fixed on the fly — as the administration appears to be trying to do?
  2. If it can’t be fixed on the fly — and three weeks into this that sure looks doubtful — then can it be taken down for one or two months with a high degree of confidence it can be brought back up in time to enroll people sooner rather than later?
  3. If the first two options are not possible, just how long will the computer system have to be shutdown before Obamacare can be launched in a way that there can be confidence it will work smoothly?

Then I would take their advice.

Right now the Obama administration appears to only be looking at this through a political lens: How do they minimize the political fallout?

There are two things wrong with that perspective.

First, the politics of this can’t get any worse. This is now a political joke. Republicans can make lots of snarky comments about Obamacare and they won’t be able to do more damage to Obamacare than the administration is doing to itself. Any Republican reaction to taking the system down won’t last more than a couple of news cycles. More, the president would never lose politically by making a decision about every American already knows he has to make.

Second, the Obama administration, by keeping this computer system up and so far not being able to fix it, is not only wasting people’s time they are on their way to destroying Obamacare.

As I have repeatedly said on this blog, the real longer-term threat Obamacare faces is that not nearly enough healthy people will sign-up for coverage in order for the program to be able to pay the medical costs for the sick people who enroll.

Left as is, I have to believe that the only people willing to put up with the repeated attempts and frustration with the Obamacare website and call centers are people so sick and in need of health insurance they have no alternative.

The greatest threat to Obamacare right now is a computer system the Obama administration continues to defend. And maybe their inability to understand how much damage they are themselves doing to the president’s signature domestic accomplishment.

When these computer problems are finally fixed, then we can move onto the main event: Can Obamacare work?

Robert Laszewski is president, Health Policy and Strategy Associates and blogs at Health Care Policy and Marketplace Review. 

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  • Most Popular

  • Past Week

    • Expanding the SOAP framework boosts health outcomes

      Deepak Gupta, MD and Sarwan Kumar, MD | Physician
    • The handwashing standard nobody finished. Until now.

      Bernadette Burroughs, RN | Conditions
    • Your doctor saved your life but won’t return your call [PODCAST]

      The Podcast by KevinMD | Podcast
    • Primary care access is the real problem, not the system

      Payam Zamani, MD | Physician
    • How corporate medicine is eroding truth and patient dignity

      Ronald L. Lindsay, MD | Physician
    • Why bipolar II is not just a milder version of bipolar I

      Ethan Evans, MD | Conditions
  • Past 6 Months

    • I Googled my own name and a corporate clinic I’ve never worked at appeared [PODCAST]

      The Podcast by KevinMD | Podcast
    • Rethinking the role of family physicians vs. specialists

      Ronald L. Lindsay, MD | Physician
    • How corporate health care ruined the medical profession

      Edmond Cabbabe, MD | Physician
    • Clinicians are failing at value-based care because no one taught them the system [PODCAST]

      The Podcast by KevinMD | Podcast
    • When shared decision making gives way to medical paternalism

      DeAnna Pollock, MD | Physician
    • How xenotransplantation could finally solve organ shortages

      Rafael S. Garcia-Cortes, MD | Conditions
  • Recent Posts

    • Can clonal hematopoiesis improve blood cancer screening?

      Jason Liebowitz, MD | Conditions
    • International medical graduates need real protections

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    • Why psychiatric medications often fail autistic patients

      Carrie Friedman, NP | Conditions
    • Missed claims filing deadlines threaten patient care

      Assinatha Mukantaganzwa | Finance
    • Point-of-care ultrasound transforms emergency medicine

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    • Health outcomes rely on more than just health care

      Jalene Jacob, MD, MBA | Physician

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Should the health exchanges be shut down?
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