Why Obamacare Web site crashes; a modest proposal to end the shutdown crisis; and more on the healthcare dilemma.

View 794 Monday, October 14, 2013

“Transparency and the rule of law will be the touchstones of this presidency.”

President Barack Obama, January 31, 2009

 

Christians to Beirut. Alawites to the grave.

Syrian Freedom Fighters

What we have now is all we will ever have.

Conservationist motto

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This is still pledge week for KUSC which means that it’s also the Chaos Manor subscription time week. I don’t regularly bug you about subscribing to this site, but when KUSC does a pledge drive I gently – well usually gently – remind you that this site runs on the Public Radio plan: it’s free, and I don’t have advertisements, but it remains open only if it gets enough subscriptions to make me want to keep it open. It has done so for years. If you have not subscribed, now would be a great time to do it. Unlike KUSC I don’t ask for a hundred a month, or anything like that. The information is at http://www.jerrypournelle.com/paying.html or you can get there from the stuff over on the right on this page. If you do subscribe and haven’t renewed in a while, this would be a great time to do that. Now, I’ve bugged you.

I was on TWIT this week, and you can find the broadcast at http://twit.tv/show/this-week-in-tech/427.  I was on with Rob Reid and Larry Magid, and of course Leo LaPorte.

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This from Forbes today:

Obamacare’s Website Is Crashing Because It Doesn’t Want You To Know How Costly Its Plans Are

clip_image004Avik Roy, Contributor

A growing consensus of IT experts, outside and inside the government, have figured out a principal reason why the website for Obamacare’s federally-sponsored insurance exchange is crashing. Healthcare.gov forces you to create an account and enter detailed personal information before you can start shopping. This, in turn, creates a massive traffic bottleneck, as the government verifies your information and decides whether or not you’re eligible for subsidies. HHS bureaucrats knew this would make the website run more slowly. But they were more afraid that letting people see the underlying cost of Obamacare’s insurance plans would scare people away.

HHS didn’t want users to see Obamacare’s true costs

“Healthcare.gov was initially going to include an option to browse before registering,” report Christopher Weaver and Louise Radnofsky in the Wall Street Journal. “But that tool was delayed, people familiar with the situation said.” Why was it delayed? “An HHS spokeswoman said the agency wanted to ensure that users were aware of their eligibility for subsidies that could help pay for coverage, before they started seeing the prices of policies.” (Emphasis added.)

http://www.forbes.com/sites/theapothecary/2013/10/14/obamacares-website-is-crashing-because-it-doesnt-want-you-to-know-health-plans-true-costs/

I haven’t had time to analyze this, but the fact that Forbes is publishing it is significant. It makes sense: the cost of Obamacare for younger middle class employed is going to be dramatically higher than what they are paying now – this as a consequence of the rise in premiums due to having to accept older people with pre existing conditions – as those who have managed to sign up have discovered. Whether this was a factor in the web designs I do not know. But it is interesting.

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‘When a government shutdown falls in the forest, Americans should listen very carefully. The government is telling you something profound and important about how it understands the power relationship between them and you.’

<http://www.nationalreview.com/node/361057/print>

Roland Dobbins

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A Modest Proposal

I will repeat my suggestion: restore the debt limit and pass a continuing resolution in which the baseline budget for every department is 99% of what it spent last year. Each and every budget item can then be increased in a normal budget but by a separate vote: the default is you get 99% of what you got last time. This I think can be absorbed without disaster;p and it turns the budget directive in the right direction. Critical programs can be increased as needed; in fact make it easy to restore them to the full 100% of last year by a simple voice vote – but no more than twenty items on any vote, and restoring them to the 4% base line increase would take a separate, one item per vote, vote.

I know it won’t happen but it would seem to me a way out of the dilemma.

More later. And remember this is subscription drive week. If you haven’t subscribed, this is the right time to do it.

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A West Coast practicing cardiologist on the Obamacare web crashes:

 

I’m bemused by the Forbes article.

One may go to the state sites, which is where one should be looking for prices anyway and where healthcare.gov directs you. If you hit the apply button on healthcare.gov, it directs you to pick a state. I tried both California and Oregon and they worked.

I’ve not signed up as I have insurance coverage through work. I’ve had multiple patients tell me they have signed up in the last week. No idea if they really did.

The prices in Oregon, at least, are quite reasonable.

Give it a try…you can log into the site, fill out no information and get accurate prices.

http://www.coveroregon.com/

or pick any state:

https://www.healthcare.gov/what-is-the-marketplace-in-my-state

I worked with Oregon,

If I pick a 31 year old male with a 30 year old wife and a 10 year old child making 40,000/year, they would choose from 48 plans ranging from a low of 312/month to a high of about 738/month with a monthly credit of 185. Thus the low cost was 312-185= 127/month to 738-185=553. I’d suggest those prices are fair.

I did the same info with BC/BS and got prices that ranged from 157 to >900.

I had to apply on the BC/BS site with my personal information.

* * *

To continue my earlier message, once you get to an income level above what the AKA covers, you are in the range of "normal" insurance…..which you get from a business or from an individual purchase.

That purchase should not have much to do with AKA, unless you presume that the insurance companies are all raising prices to "compensate for the AKA". That has not been our experience with our corporate insurance plan, but that is a sample of one. I’d find that a bit difficult to believe with 42 plans competing in Oregon for AKA business.

Or am I not understanding something Mr. Roy is saying in the Forbes article…that’s certainly possible.

 

M

My own thoughts on this have led me to wonder how it makes political sense, and remind myself of Napoleon Bonaparte’s maxim. 

Talk show hosts have been saying you have a better chance of finding Bigfoot in your back yard than actually signing up for an ObamaCare package and purchasing it. 

I spent the day taking Roberta to Kaiser and getting our flu shots, and waiting for her at her appointment. I was reminded once again that it is certainly possible to have a medical organization that is efficient, pleasant, charges enough in co-payments to discourage frivolity but not so much that you simply can’t pay it – and do all this in a pleasant environment where the employees do not all seem as if they wish they were somewhere else. This generates an atmosphere of civility and everyone is polite.  If they could clone Kaiser I would think that might be the solution to the health care problem.

About thirty years ago I did a symposium with the senior medical faculty of a major medical school/teaching hospital on why the cost of medical education was so high. The position of the school medical staff was that good medical school professors are hard to find and they have admitted about as many highly qualified students as they can manage; admit more and the quality of education would suffer. They were worried about the steeply rising costs. Most of them are certainly retired by now, but it would be interesting to have a new symposium on the subject.

I have also noted that the Army is very good at taking educated young ladies out of social science majors and turning them into very good operating room technicians often equal in skill to physicians in many of the other countries of the world. Once again they are using officer class students with high adaptability but the program works. In the case of my daughter she qualified but then was sucked up into a line officer candidate school, but it was pretty clear that the Army machine worked quite well; of course an operating room technician is not an emergency room physician, but many of those in the military would be damned good candidates for the post and I doubt it would take the Army as long as it does medical schools.  That, however, is hypothesis and generalization from a few cases.  I do think that if part of the TARP funds had been invested in raising the quantity of those going through health care training, many of our health care problems wouldn’t exist.  Of course if some of it had been used for roads and bridges and other of those ‘shovel ready’ jobs we wouldn’t be having so many infrastructure problems.  God knows there was enough money shoveled out the door on the Keynesian theory that if the government spends money it helps the economy.  If some of that had been invested intelligently in infrastructure and health care professional education – but then that is asking a bit much of politicians, isn’t it?

And that, of course is the real debate here.  If the US health care system all worked as well as Kaiser does, we would have other things to talk about;  but our experience is that governments only know how to build armies and bureaucracies, and even there the bureaucracies then to crepe in and take over the armed services from the top – and Pournelle’s Iron Law of Bureaucracy always prevails.  http://www.jerrypournelle.com/reports/jerryp/iron.html

 

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Moving toward space; Pledge Week

 

View 794 Sunday, October 13, 2013

“Transparency and the rule of law will be the touchstones of this presidency.”

President Barack Obama, January 31, 2009

 

Christians to Beirut. Alawites to the grave.

Syrian Freedom Fighters

 

What we have now is all we will ever have.

Conservationist motto

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Still recovering from whatever I picked up in San Diego. The afternoon was taken up with doing a TWIT broadcast http://twit.tv/show/this-week-in-tech/427 which was interesting. Since it’s pledge week I have to remind you that this would be a great time to subscribe to this site http://www.jerrypournelle.com/paying.html or just use the subscribe button over here on the right.

I continue to be depressed about the crazy state of things in Washington. I do wonder why the Democrats didn’t take the life buoy thrown to them by the Republicans in the offer to put Obamacare off for a year; given that they had three years to bring out this center piece of the Obama administration and enrolling in the new plan is so difficult, the chance to put it off a year and blame the delay on the Republicans seems irresistible, I must have missed something.

I do have this good news

Grasshopper

Dr Pournelle

You’re gonna get your DCX and SSTO. http://www.newspacejournal.com/2013/10/12/grasshopper-flies-again-sets-new-altitude-record/

Live long and prosper

h lynn keith

Which is to say that private enterprise is taking mankind to space. After all that’s how the airlines were built.

I had meant to do a full mail tonight but it would have been short shrift, and much of the mail deserves comments. Apologies but I am recovering.

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This is Pledge Week at KUSC which is when I traditionally annoy you about subscribing or renewing to this site. This place operates on the Public Radio model, free to all but it stays open only if enough subscribe to keep it open. It has always been that way and we have always had enough subscriptions and renewals. I run my subscription drives in the weeks when KUSC the Los Angeles good music station runs its public radio pledge drive, and they have started their pledge week.

I do things this way so you won’t be continuously annoyed with commercials for the site and of course I don’t take advertisements here.

So if you have not renewed your subscription for a while, this would be a good time to do that. And I hasten to add, if the economic times are getting to you, I am not after eating money. Just some of your beer and wine money. Paying for this place…

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Climate and Health Care

View 793 Saturday, October 12, 2013

“Transparency and the rule of law will be the touchstones of this presidency.”

President Barack Obama, January 31, 2009

Christians to Beirut. Alawites to the grave.

Syrian Freedom Fighters

What we have now is all we will ever have.

Conservationist motto

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I have been much under the weather to the extent that I will have to miss an old friend’s birthday party tonight and have had little energy. Apologies, particularly since this is Pledge Week when I traditionally annoy you about subscribing or renewing. This place operates on the Public Radio model, free to all but it stays open only if enough subscribe to keep it open. It has always been that way and we have always had enough subscriptions and renewals. I run my subscription drives in the weeks when KUSC the Los Angeles good music station runs its public radio pledge drive, and they have started their pledge week.

I do things this way so you won’t be continuously annoyed with commercials for the site and of course I don’t take advertisements here.

So if you have not renewed your subscription for a while, this would be a good time to do that. And I hasten to add, if the economic times are getting to you, I am not after eating money. Just some of your beer and wine money. Paying for this place…

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I will try to get more up tonight, but Mike Flynn has sent me an excellent essay summarizing discussion on the Climate Debates.

It tends to be a bit wordy, but this comes as close to my view as anything I have seen:

A physicist on climate science

Readers may find this interesting:

http://judithcurry.com/2013/10/12/a-physicist-reflects-on-the-climate-debate/

MikeF

Here is an extract. There is a great deal more.

The climate science debate is something that matters, it cannot be simply neglected or ignored. Whether or not there are reasons to be alarmed is beyond the point. The point is that many people are getting emotionally alarmed with economical and geopolitical consequences that are enormous. Under such panicking pressure, and the stronger pressure of financial interests, gigantic sums are invested in wind-mill farms and electric cars, just to quote two very controversial initiatives. Decisions are taken on nuclear energy, on fracking, on deep-sea drilling, etc. Not to mention crazy geo-engineering projects that are being contemplated.

I naturally should like to be well informed of the bases on which such decisions are taken. I am prepared to adhere to some precaution principle and accept that we should be careful with injecting CO2 in the atmosphere at the scale of what it already contains when we do not know enough to be sure that it is reasonably harmless; I understand that answering many of the open questions in climate science may require more time than we can afford to wait. But I find it difficult to find a good summary document where I can read what I need. The IPCC report was not written with this in mind and it makes statements on the probability, or level of confidence, of model predictions that are not scientifically acceptable. The way they quantify their ignorance of many parameters and phenomena of relevance, as if they were arguments governed by statistics, or worse by voting, makes no sense to me.

 

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Re: A Disturbing Thought

Jerry,

I note that since I wrote last, Treasury Secretary Jack Lew has testified to the Senate about missing his October 17th debt limit deadline.

http://www.washingtonpost.com/politics/running-transcript-jack-lews-testimony-on-debt-ceiling/2013/10/10/3edc0122-31b0-11e3-9c68-1cf643210300_story.html

Among the obligatory parroting of White House talking points (the sky will fall, it’s already starting to, the President is a paragon of reasonableness who’s always been willing to negotiate, we’ve always been at war with EastAsia – oh, and broadly hinting that if you think they’ve made the shutdown gratuitously painful, just wait until they’re deciding whether to cut checks for veterans or retirees) he did make one seriously convincing point:

The Treasury Department may simply not be competent to handle what any struggling business routinely does, dealing with limited cash flow by prioritizing bills. They may simply not have the IT expertise to tell the massive computer systems involved to cut only selected fractions of the usual torrent of checks without causing things to collapse into chaos.

Given the IT magnificence that is Obamacare, I find this argument far too plausible.

A further thought: On top of my previous reasons why he might be willing to steer straight into a head-on collision, there’s the President’s recent negotiating record – getting snookered on the Sequester domestically, inspiring a fake(?)-but-accurate Putin "playing chess with a pigeon" quote internationally. He may well see that his best chance of coming out of this still wearing his pants is to stonewall all the way.

Assuming nobody has meanwhile provided a convincing argument that I’m

(excessively) paranoid about all this, I conclude that the Tea Party Republicans need to back down fast, save what face they can, then set about the serious business of taking the car keys away from Harry Reid next fall and away from the White House two years later.

Anger and pride may make it hard to swallow this, but what’s more important – short-term pride, or saving the country from short-term and long-term disaster?

It won’t be easy regardless. We’ll have to do this despite the worst the (by then desperate) Dems and their partisan Federal apparat can do.

And despite the usual ongoing can’t-beat-’em-lets’-join-’em lemming urge of the country-club set…

But consider, by next fall, Obamacare in all its magnificence will have hit tens of millions of voters, and I don’t expect most will like it any more than I do so far. Long after the current shutdown is forgotten, the fact that it was the Tea Party that stood up and tried to stop this disaster will be remembered. Build on that.

courage to us all – we’re gonna need it

Porkypine

Peggy Noonan has something of the same sort to say in today’s Wall Street Journal. She points out that good or bad, Obamacare was not ready for prime time although they had three years to prepare for its opening; it needs to be delayed long enough to fix the obvious flaws so that people can get in on it before it is brought out.  We will see.

 

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I now have to go do grocery shopping. We have interesting mail and a short dialogue of value. And of course the shut down continues. Later. And thanks to those who subscribe.

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Dr. Pournelle

You’re gonna get your DCX and SSTO. http://www.newspacejournal.com/2013/10/12/grasshopper-flies-again-sets-new-altitude-record/

Live long and prosper

h lynn keith

It is sort of marvelous. I discussed VTOL vs. wings and horizontal with Elon Musk when I spoke at a fund raiser in the Space X headquarters a couple of years ago, and he didn’t like the idea;  I wonder if I had anything to do with persuading him.  I’ll have to ask when next I see him.

Progress. Slow, but progress.

http://www.nbcnews.com/science/must-see-video-spacex-grasshopper-rocket-makes-half-mile-hop-8C11380772

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Disturbing thoughts

View 793 Thursday, October 10, 2013

“Transparency and the rule of law will be the touchstones of this presidency.”

President Barack Obama, January 31, 2009

 

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I am a bit under the weather today.

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A Disturbing Thought

Jerry,

The thing about playing Chicken is, both drivers get into the contest assuming that the other doesn’t actually want a head-on collision.

The game changes fundamentally if one driver believes he’s immortal and doesn’t really like his old clunker anyway. This by way of introducing a truly disturbing thought about the upcoming debt-limit deadline.

It seems universally agreed that an actual default on US debt instruments would be a disaster, likely precipitating a worldwide financial crisis and greatly diminishing the US’s international economic clout.

The Republicans are explicitly acting on the assumption that the President would, on hitting the debt limit, continue making payments on US debt instruments while cutting elsewhere the approximately 20% required to keep overall Federal spending within current revenue absent new borrowing. At some point, they assume, he’ll come to the table.

The President and Democrats in general are obfuscating for political advantage the difference between hitting the debt limit and actual default, and also asserting that ALL government spending (that they

like) is sacred and that the current Congress MUST do whatever it takes to fund everything (that they like) passed by a previous Congress.

This is of course nonsense on stilts, but serves the purpose of motivating their partisans and terrifying the ignorant. The rest of us just shrug and assume it’s politics as usual, and that the two sides will come up to the brink then draw back and reach a compromise, business as usual.

Indulge me in an apparent digression… President Obama’s foreign policy arguably is built around the assumption that the US’s post-WWII preeminent status in the world is an historical error that needs correcting. He pays the necessary public lip-service to the US being Number One, but both his actions and his appointments arguably point toward a chastised and diminished US.

Suppose, now, for the sake of argument, some mix of:

– genuine belief ALL their programs are sacred

– genuine contempt and disdain for their opposition

– belief that their opposition would certainly take the blame

– cynical conviction that they could then increase their power in the resulting crisis, however diminished the country might be

– and an underlying ideological conviction that diminishing the US is good for the world in any case

should later this month cause the White House to say, what the hell, They Made Us Do It, and instruct the Treasury to start missing debt payments.

I’d really like to be able to believe that this administration’s obvious ongoing fundamental respect for the law, the Constitution, American tradition, and the American people instantly rules this scenario out as ridiculous paranoia. Alas, I’ve been paying attention these last five years.

cynically

Porkypine

I would like very much to dismiss this as ridiculous paranoia. If someone has good evidence to show this is ridiculous paranoia, I would welcome receiving it.

 

I’ll try to have more later tonight.

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‘The National Park Service has every man, woman, and child in America on its enemies list.’

<http://www.weeklystandard.com/print/blogs/park-police-part-deux-hot-cops_762387.html?page=2>

—–

Roland Dobbins

Nasty and vindictive. Public servants.

The Servant When He Reigneth

"For three things the earth is disquieted, and for four which it cannot bear. For a servant when he reigneth, and a fool when he is filled with meat; for an odious woman when she is married, and an handmaid that is heir to her mistress." — PROV. XXX. 21-22-23.

Three things make earth unquiet And four she cannot brook The godly Agur counted them And put them in a book -- Those Four Tremendous Curses With which mankind is cursed; But a Servant when He Reigneth Old Agur entered first. An Handmaid that is Mistress We need not call upon. A Fool when he is full of Meat Will fall asleep anon. An Odious Woman Married May bear a babe and mend; But a Servant when He Reigneth Is Confusion to the end. His feet are swift to tumult, His hands are slow to toil, His ears are deaf to reason, His lips are loud in broil. He knows no use for power Except to show his might. He gives no heed to judgment Unless it prove him right. Because he served a master Before his Kingship came, And hid in all disaster Behind his master's name, So, when his Folly opens The unnecessary hells, A Servant when He Reigneth Throws the blame on some one else. His vows are lightly spoken, His faith is hard to bind, His trust is easy broken, He fears his fellow-kind. The nearest mob will move him To break the pledge he gave -- Oh, a Servant when he Reigneth Is more than ever slave!

 

 

 

 

 

 

Rudyard Kipling

 

And Eric found this gem:

http://www.breitbart.com/InstaBlog/2013/10/10/Nevada-Health-Exchange-A-Case-Study-in-What-Went-Wrong

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