Medicare had a messy rollout, too

[Cigar]

"There are rumblings that the glitches attending the rollout of the Affordable Care Act -- along with the relentless campaign to sabotage or delay it in numerous states -- mean the program is dead on arrival. But the history of an equally controversial and vast government effort, Medicare, indicates that predictions of Obamacare's demise are greatly exaggerated...

"For starters, few in the government seem to have realized that more than 45 percent of those born between 1890 and 1920 couldn’t prove their age because they lacked birth certificates. While the government accepted other documentation such as military records or naturalization records, some pretty unorthodox records ended up being used . The New York Times reported that in one case, a man “bared his chest as a last resort. Tattooed there was the date of his enlistment in the Navy and the date of his birth.” Another applicant dug up his mother’s tombstone and carted into the local office, arguing that it constituted proof of his age. This, too, was accepted.

"In the fall of 1965, millions started to enroll, no doubt aided by the reasonable ease – perhaps too easy – of proving one’s age. But ignorance of how the law actually worked became a serious problem by that time. More than 700,000 of those eligible for supplemental coverage refused to sign up in the opening months. Despite an elaborate public-relations campaign featuring celebrities such as Jimmy Durante and Bob Hope, and a door-to-door effort by canvassers who sought out the elderly at home, many older people believed that signing up for Medicare meant they would cease receiving Social Security. Others thought they couldn’t afford the $3 monthly premium, even though the law had provisions to assist low-income enrollees..."

More here: http://www.bloomberg.com/news/2013-10-15/medicare-had-messy-rollout-too.html

It's all happened before, folks.

... and today, Good Luck to the any politician who tries to take Medicare away... :laugh:

FACT: ObamaCares is here to stay .... forever :grin:

[Chris]

What do you expect from government? Efficiency? Effectiveness? Consider, without a profit motive, it's left with a power motive. Unlike a business that would win over more customers with efficiency and effectiveness, the government is in the business of creating problems with its so-called solutions so it can ask for more money and power to fix the new problems.

[Cigar]

What do you expect from government? Efficiency? Effectiveness? Consider, without a profit motive, it's left with a power motive. Unlike a business that would win over more customers with efficiency and effectiveness, the government is in the business of creating problems with its so-called solutions so it can ask for more money and power to fix the new problems.

Dude ... put the crack-pipe down.

The Government didn't design or develop shit.

This was the same Private Company the George W Bush Administration contracted. :rollseyes:

[Chris]

Dude ... put the crack-pipe down.

The Government didn't design or develop shit.

This was the same Private Company the George W Bush Administration contracted. :rollseyes:


The Government didn't design or develop shit.

What I said. Be it government under Bush or government under Obama, it's not motivated by profit (supplying others what they want) but power (self-serving).

Plato identified altruism with the collective, selfishness with the individual. As Popper showed in "The Spell of Plato," the opposite is true.

[Cigar]

What I said. Be it government under Bush or government under Obama, it's not motivated by profit (supplying others what they want) but power (self-serving).

Plato identified altruism with the collective, selfishness with the individual. As Popper showed in "The Spell of Plato," the opposite is true.

Listen ... I've been in Software and Firmware development for 30 years in both in the Private and Public Sector ...

It don't matter if you're Government "User" or a Private "User" ... the Software works the same, the product is developed the same.

President Barack Obama didn't design the ACA Website, nor did he design the F-35 Fighter Jet.

The Government doesn't design and build anything ...

PRIVATE BUSINESS DID!

[Chris]

Listen ... I've been in Software and Firmware development for 30 years in both in the Private and Public Sector ...

It don't matter if you're Government "User" or a Private "User" ... the Software works the same, the product is developed the same.

President Barack Obama didn't design the ACA Website, nor did he design the F-35 Fighter Jet.

The Government doesn't design and build anything ...

PRIVATE BUSINESS DID!


By your own words, cigar, government owned and managed it.

[Cigar]

By your own words, cigar, government owned and managed it.

Dude ... what's your argument .... ?

All Government Owned and Managed projects don't work and All Private Owned and Managed projects do?

Really ... care to support that with any data?

[Chris]

Dude ... what's your argument .... ?

All Government Owned and Managed projects don't work and All Private Owned and Managed projects do?

Really ... care to support that with any data?


My argument was in post #2. Where's your counterargument?

[Mr. Freeze]

Medicare and Medicaid were implemented over 50 years ago before we had technological and programmatic benchmarks.

[Cigar]

What do you expect from government? Efficiency? Effectiveness? Consider, without a profit motive, it's left with a power motive. Unlike a business that would win over more customers with efficiency and effectiveness, the government is in the business of creating problems with its so-called solutions so it can ask for more money and power to fix the new problems.

The Government gave the requirement and the business failed to implement those requirements adequately.

That could happen with any business ... Government or Private :rollseyes:

[Cigar]

Medicare and Medicaid were implemented over 50 years ago before we had technological and programmatic benchmarks.

That's like saying no one traveled before car navigation :laugh:

Pour excuse ... it's a Website ...

ObamaCare is not a Website.

[Mr. Freeze]

The Government gave the requirement and the business failed to implement those requirements adequately.

That could happen with any business ... Government or Private :rollseyes:

True, but it would be less likely to happen to a private business because they would have waited until it was ready to roll it out, not stick to arbitrary dates for political reasons.

I don't think people would have minded if they waited until it was ready, but they put politics over pragmatism. This is why government is a fairy tale for most people. Government providing quality service is like the Prince riding in to save the day. It looks great in your mind but never happens.

Had they been smart they would have taken an existing system and expanded it in several iterations until it was all inclusive. It would have been a single database and slowly turned into single payer. With the new system they are no closer, technologically to single-payer than they were prior to the implementation. In fact, they will make it harder with people being added to 60 new databases.

[Mr. Freeze]

That's like saying no one traveled before car navigation :laugh:

Pour excuse ... it's a Website ...

ObamaCare is not a Website.

That's not what I'm saying. The government has had over 50 years of program experience, as well as, health care experience with Medicaid and the military systems, and didn't use any of that experience to create a narrative that could be sold to the people in order to get the best possible system.

[Cigar]

True, but it would be less likely to happen to a private business because they would have waited until it was ready to roll it out, not stick to arbitrary dates for political reasons.

I don't think people would have minded if they waited until it was ready, but they put politics over pragmatism. This is why government is a fairy tale for most people. Government providing quality service is like the Prince riding in to save the day. It looks great in your mind but never happens.

Had they been smart they would have taken an existing system and expanded it in several iterations until it was all inclusive. It would have been a single database and slowly turned into single payer. With the new system they are no closer, technologically to single-payer than they were prior to the implementation. In fact, they will make it harder with people being added to 60 new databases.

Apparently you're not aware that the company used old technology and tried to rush it to make a "dead-line".

Bottom -Line, ObamaCare isn't a Website ... The Website is an order entry and enrollment mechanism

[Mr. Freeze]

Apparently you're not aware that the company used old technology and tried to rush it to make a "dead-line".

Bottom -Line, ObamaCare isn't a Website ... The Website is an order entry and enrollment mechanism

I never said it was a website.

It is the front end to a complicated system involving over 100 different databases with new and legacy information. This information is stored in servers both in and outside the United States. It involves various encryption methologies, data migration, non-medra coding, and a hundred other complications that no one considered when writing the legislation.

This is why they should not have set an arbitrary political deadline. It will take longer to fix it than had they decided to do it right the first time.

[Chris]

Medicare and Medicaid were implemented over 50 years ago before we had technological and programmatic benchmarks.

Right, before we could measure how poorly they were implemented.

[Chris]

That's not what I'm saying. The government has had over 50 years of program experience, as well as, health care experience with Medicaid and the military systems, and didn't use any of that experience to create a narrative that could be sold to the people in order to get the best possible system.



You'd think whether they followed a waterfall methodolgy or an agile one they would at least have QAed and tested and even stress tested prior to release to production.

[Chris]

Apparently you're not aware that the company used old technology and tried to rush it to make a "dead-line".

Bottom -Line, ObamaCare isn't a Website ... The Website is an order entry and enrollment mechanism



The company hired to do the work didn't set the deadline, cigar, that was government. Each post in your attempt to shift blame trips over the fact it was a government-run project.

[patrickt]

With socialized medicine, Cigar will live to see 20-year old women getting prostate surgery and 80-year old men having hysterectomies. He might also arrive at old age at the appropriate time, as in England, for him to experience death from neglect in a hospital.

[nic34]

Medicare administrative costs are about 6 to 8 percent compared to commercial insurance administrative costs of 14 to 22 percent. While there isn’t an exact apples to apples comparison, they are close enough to see that commercial costs are higher as they include 4-6% for commissions and 3-5% for profits.

[jillian]

Medicare and Medicaid were implemented over 50 years ago before we had technological and programmatic benchmarks.

ok.

[Cigar]

With socialized medicine, Cigar will live to see 20-year old women getting prostate surgery and 80-year old men having hysterectomies. He might also arrive at old age at the appropriate time, as in England, for him to experience death from neglect in a hospital.

Just Gloom and Doom Predictions and never any Facts ... :laugh:

[nic34]

In case anyone was wondering:

http://krugman.blogs.nytimes.com/2009/07/06/administrative-costs/?_r=0

[Chris]

Medicare administrative costs are about 6 to 8 percent compared to commercial insurance administrative costs of 14 to 22 percent. While there isn’t an exact apples to apples comparison, they are close enough to see that commercial costs are higher as they include 4-6% for commissions and 3-5% for profits.



...Medicare is partially administered by outside agencies

First, other government agencies help administer the Medicare program. The Internal Revenue Service collects the taxes that fund the program; the Social Security Administration helps collect some of the premiums paid by beneficiaries (which are deducted from Social Security checks); the Department of Health and Human Services helps to manage accounting, auditing, and fraud issues and pays for marketing costs, building costs, and more. Private insurers obviously don’t have this kind of outside or off-budget help. Medicare’s administration is also tax-exempt, whereas insurers must pay state excise taxes on the premiums they charge; the tax is counted as an administrative cost. In addition, Medicare’s massive size leads to economies of scale that private insurers could also achieve, if not exceed, were they equally large.

Administrative costs are calculated using faulty arithmetic

But most important, because Medicare patients are older, they are substantially sicker than the average insured patient — driving up the denominator of such calculations significantly. For example: If two patients cost $30 each to manage, but the first requires $100 of health expenditures and the second, much sicker patient requires $1,000, the first patient’s insurance will have an administrative-cost ratio of 30%, but the second’s will have a ratio of only 3%. This hardly means the second patient’s insurance is more efficient — administratively, the patients are identical. Instead, the more favorable figure is produced by the second patient’s more severe illness.

Medicare has higher administrative costs per beneficiary

A more accurate measure of overhead would therefore be the administrative costs per patient, rather than per dollar of medical expenses. And by that measure, even with all the administrative advantages Medicare has over private coverage, the program’s administrative costs are actually significantly higher than those of private insurers. In 2005, for example, Robert Book has shown that private insurers spent $453 per beneficiary on administrative costs, compared to $509 for Medicare. (Indeed, Robert has written the definitive paper on this subject, from which the above figure is taken.)

Remember these points the next time someone tries to tell you that Medicare is “more efficient” than private insurance.

UPDATE 1: Tim Worstall points out in the comments that we should also count the deadweight costs of tax collection as part of Medicare’s administrative costs (say, 20% of the amount collected).

UPDATE 2: Benjamin Zycher has also written extensively about Medicare’s administrative costs, as exemplified by this paper for the Manhattan Institute. (http://www.manhattan-institute.org/html/mpr_05.htm)

@ The Myth of Medicare's 'Low Administrative Costs' (http://www.forbes.com/sites/aroy/2011/06/30/the-myth-of-medicares-low-administrative-costs/)

[Chris]

In case anyone was wondering:

http://krugman.blogs.nytimes.com/2009/07/06/administrative-costs/?_r=0

Wasn't wondering if Krugman would stoop to ad hominem.

[Kalkin]

Let the excuses begin. It's a shit law, passed by a shit party, elected by a shit constituency. Of course it's doomed to failure.

[jillian]

Wasn't wondering if Krugman would stoop to ad hominem.

what ad homs?

you seem to think anytime anyone calls into question one of your idols that they're engaging in ad homs.

you have a very thin skin for someone who runs around the board insulting people

[Chris]

what ad homs?

you seem to think anytime anyone calls into question one of your idols that they're engaging in ad homs.

you have a very thin skin for someone who runs around the board insulting people

So you thanked nic for posting a link you didn't bother going to read. Another problem with blind partisanship.

[nic34]

Wasn't wondering if Krugman would stoop to ad hominem.

It refutes the Heritage Foundation bogus claim.

Want to call it ad hom? So what, he's still right.

[Chris]

It refutes the Heritage Foundation bogus claim.

Want to call it ad hom? So what, he's still right.

Appeal to authority.

Nic, when you post a link you ought to at least be able to summarize the argument, not just claim it's true.