I just had the Secretary of Health @Sebelius "retweet" me!! #honored
— Chad Henderson (@ChadHenderson) October 3, 2013
The legions of journalists searching for a real live person who has successfully used healthcare.gov have found one. The White House has no idea how many people have signed up, by contrast. Finally, a doctor who helped Mexico revamp its healthcare has advice for Americans: dig in because reform never ends.
Incredibly lame answer from the White House about exchange enrollment
With the Rise of AI, What IP Disputes in Healthcare Are Likely to Emerge?
Munck Wilson Mandala Partner Greg Howison shared his perspective on some of the legal ramifications around AI, IP, connected devices and the data they generate, in response to emailed questions.
The White House says they have no data on how many people have signed up for coverage through the federal exchange. That certainly implies that no one has successfully created an account and applied. At least say, “The person who tracks that count has been furloughed,” when asked how many people have enrolled.
White House press secretary Jay Carney is right that we have 180 days to go in the enrollment period but come on. Even a low number is better than, “We got nothing.”
0 for 2: Worst analogy ever from the White House
A Personalized Approach to Medication Nonadherence
At the Abarca Forward conference earlier this year, George Van Antwerp, managing director at Deloitte, discussed how social determinants of health and a personalized member experience can improve medication adherence and health outcomes.
Reason magazine is right that President Obama and Secretary Sebelius have no business linking anything the federal government does to what Apple does.
President Obama is likening the glitchy rollout of his health care law to Apple products. Suggesting either a coordinated strategy or a stunning lack of imagination, Obama’s comments echo a pre-emptive call for forgiveness made by Health and Human Services Secretary Kathleen Sebelius, who hoped yesterday that when it came to enrollment muck-ups at Healthcare.gov, Americans will “give us the same slack they give Apple.”
Obamacare’s most popular (only?) customer
A college student in Georgia is having his 15 minutes of fame as one of the first people to actually enroll in the federal exchange:
Chad Henderson, a 21-year-old student at Chattanooga State University, lives across the state border in Flintstone, Ga.
Henderson is a part-time worker at a day-care center. He did not qualify for tax credits to purchase health coverage because his income is below the poverty line. Since Georgia is not expanding the Medicaid program, that meant Henderson was essentially responsible for his entire premium.
He logged onto the Web site around midnight on Oct. 1, ready to purchase coverage. The sign-up process took about three hours. Henderson purchased a health insurance plan with a $175 monthly premium.
Denial of service attacks on exchanges?
The nasty ads are to be expected as are the misleading talking points. What is hard to believe is that enemies of healthcare reform would organize a denial of service attack to make an exchange fail. This post from Salon describes what defenses IT leaders need to build:
Matthew Prince is CEO and cofounder of CloudFlare, a company that helps clients improve their services and protects them from bad actors online. … he believes the attacks will come.
“There are three reasons people launch these attacks: extortion … competition … and the third, which is almost certainly going to be the case with these healthcare exchanges and other apparatuses around the bill, is political. And because this is a politically sensitive project, it’s probably inevitable that there will be attacks intended to harm the program and embarrass the administration,” Prince said.
It might sound like a stretch to assume that Obamacare opponents will resort to breaking these portals, denying uninsured people the ability to shop for insurance. But anyone who’s covered the official and grass-roots Obamacare sabotage efforts knows how likely it is.
“In terms of the level of skill required to launch denial of service attacks, this is the equivalent of a caveman with a club. It’s not rocket science,” Prince said. “There are services that you can pay by the hour to launch the attacks. Anyone with political ax to grind, if there’s an online component, that online component is going to be subject to attack.”
What does history tell us?
Atul Gawande identifies three forms of obstructionism that enemies have used to block the Affordable Care Act: refusing to expand Medicaid, refusing to operate a state exchange and outright sabotage. Gawande sees a parallel between this reaction and what happened after the Supreme Court’s ruling in Brown v. Board of Education:
… in 1954, Virginia shut down schools in Charlottesville, Norfolk, and Warren County rather than accept black children in white schools. When the courts forced the schools to open, the governor followed a number of other Southern states in instituting hurdles such as “pupil placement” reviews, “freedom of choice” plans that provided nothing of the sort, and incessant legal delays. While in some states meaningful progress occurred rapidly, in others it took many years. We face a similar situation with health-care reform. In some states, Paul Sullivan’s fate (bankruptcy due to medical bills) will become rare. In others, it will remain a reality for an unconscionable number of people. Of some three thousand counties in the nation, a hundred and fourteen account for half of the uninsured. Sixty-two of those counties are in states that have accepted the key elements of Obamacare, including funding to expand Medicaid. Fifty-two are not.
We are in the valley of death
Julio Frenk is dean of the Harvard School of Public Health. In a former life, he was the minister of health in Mexico. He led the Seguro Popular, a comprehensive national health insurance program that enrolled more than 52 million previously uninsured persons, achieving universal coverage in less than a decade. His experience confronting special interests, making pragmatic trade-offs, and facing seemingly insurmountable challenges led him to offer this advice to all of us Americans going through this transformation:
Every health system reform in an advanced nation has gone through such valley-of-death moments. That is the nature of the political process. For a variety of reasons, the United States is coming late to the global movement for expanded health care, the only one of the world’s 25 wealthiest nations lacking some form of universal care as of last year. National reforms inevitably go through great transitions, from vision to legislation, and then from legislation to implementation. There is always a gap between the ideal vision and the ultimate design — and there are always times of fear that the whole endeavor will collapse under the weight of competing interests. Importantly, there is also no end to the reform process as every nation’s health system continuously evolves.
