The "Glitches" In Our Healthcare System Pre-Obamacare

In the first 36 hours, the primary website for Obamacare enrollment hit 6.1 million unique visitors. Predictably, the Republican Party’s talking points had nothing to do with what was an extraordinary rush of Americans looking to take advantage of affordable healthcare, but everything to do with, “Look at all the glitches.” It begs the question: have Republicans forgotten how bad actual healthcare “glitches” had become in this country?

In the 8 years that preceded Obama’s presidency, insurance premiums doubled, which led to individuals dropping their coverage, and to employers dropping coverage for their employees. That’s a bigger glitch than an overwhelmed IT server. In the year that the Affordable Care Act was signed into law, medical bills were responsible for 60 percent of all bankruptcies. That’s a bigger glitch than a slow loading web page.

Despite being notorious for turning budget surpluses into budget deficits, it was the Republican Party’s ceaseless wailing against big government spending that spawned the Tea Party. Evidently, their rabid like lust for repealing Obamacare, no matter the cost, and to then not replace it with a single alternative healthcare reform is further demonstration of their collective cognitive dissonance and/or know-nothingism. In fact, not only has health spending quadrupled in the past two decades, the nation’s rising health costs threatens to bankrupt the Treasury. In the year Obamacare was signed into law (2009), 17.6% of GDP was spent on healthcare. The Congressional Budget Office warned that if current trends continued through 2050, federal spending on Medicaid and Medicare alone would explode from 4 percent to 12 percent of GDP. That’s a bigger glitch than an error message.

According to the World Health Organization, the United States spends more than 2.5 times more on health care per person than most developed nations in the world, but our $8,233 per person expenditure was not buying us particularly good health. In terms of life expectancy, the citizens of 32 countries are living longer than us. In terms of infant mortality, the newborns of 33 countries have a greater survival rate.

To repeal or defund Obamacare is to tell the 129 million non-elderly Americans who have some type of pre-existing health condition that they must return to the pre-Obamacare days of being denied coverage altogether. It will mean ending coverage for millions of Americans who are for the time enjoying coverage through the expansion of Medicaid. That’s a bigger glitch than a broken hyperlink.

Less than half of U.S. medical treatment was supported by solid evidence of what works. To get a drug approved, pharmaceutical companies merely had to prove it worked better than a placebo. Studies by researchers at Dartmouth found that as much as 30 percent of healthcare was unnecessary, but nobody knew which 30 percent. In a New York Times op-ed titled “How to Take American Health Care from Worst to First,” then Senator John Kerry and Speaker Newt Gingrich wrote, “Remarkably, a doctor today can get more data on the starting third baseman on his fantasy baseball team than on the effectiveness of life-and-death medical procedures.” That’s a bigger glitch than a long live chat queue.

On Tuesday, the Affordable Care Act rolled out what was a complicated and unprecedented IT project, and certainly glitches were caused by a crush of consumers seeking information, enrollment or both. Ultimately, the glitches will not mean much when the exchange software is quickly fixed. The government also has the option of extending the enrollment process as a backstop. But the millions of Americans who are persisting through these early IT glitches are likely those who have been the victims of the moral and economic glitches that have plagued the healthcare system for the past three decades – the ones who haven’t been able to obtain coverage for years.

 

CJ Werleman can be followed on Twitter at @cjwerleman

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