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Tuesday, May 24, 2016
Flaws with Obamacare are more than technological
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As for the program itself, forcing insurance companies to take everyone, without regard to prior health ailments, disrupts the balance that is necessary for insurance companies to survive. Under Obamacare, the pool composition must be just right. Companies need as many healthy people as sick people in order to balance it out. If this doesn’t happen, the risk of adverse selection becomes prevalent, which could induce a death spiral and the failure of a company.

It is also alarming that no one is talking about network adequacy. Many states still have inadequate networks because health care providers are not available, or insurers are not creating deep-enough networks. Mississippi, for example, has 36 counties without network providers. People are going to be forced into networks that do not have the means to provide care for them.

Finally, after the first month of Obamacare, the number of enrollees was revealed, and a deeply concerning pattern has developed. In some places, nine out of 10 enrollees opted to enroll in Medicaid instead of Obamacare. If this trend continues, Obamacare will prove to be extremely costly for the states that are forced to help pay for the new Medicaid enrollees.

In order for Obamacare to meet its goals, it needs to have tens of thousands of people signing up each day. However, with the initial rollout of the online marketplace, only six people signed up on its first day, despite the fact that the page was visited by 4.7 million people.

As Republicans continue to attack and put more pressure on Democrats in Washington, members of the administration continue to blame everyone else except themselves. OK, point the finger at insurers or tech contractors, but at some point, the president needs to accept responsibility for the problems caused by his health care overhaul.

Confidence in that overhaul is extremely low, and I think that many people in Washington, including Democrats, must be thinking it was one big mistake.

Al D’Amato, a former U.S. senator from New York, is the founder of Park Strategies LLC, a public policy and business development firm. Comments about this column? ADAmato@liherald.com.


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Al, the Affordable Care Act may not be great (remember it was written by Lobbyists for the Health Insurance Agencies), but it is better than what your Republican party has proposed (which in absolutely nothing). You don't have to worry since you have a government pension (which is another joke), Medicare, and a full time job. For people who have no job and are not offered insurance at work this will help. As for enrolling Americans wait for the last minute to do everything, except Black Friday shopping for Christmas.

If you looked a the NY site on Long Island a single person can get a full plan for between $240 - $350 per month. If you tried to get a plan before this (or had COBRA) it was $700+ a month or the cheapest plan that only covered the emergency room (and not any services there) was $187 a month. If you look at states with Republican governors who payed the party line they did no bother to work to setup the exchanges, so talking about Mississippi is a non-starter.

What we really need is a single payer option one low price for all and the same coverage for all. But this would mean also revamping the court system for payouts in lawsuits. This will never happen in the US where our government is for sale (think of all the patronage you gave out for contributions) and controlled by the biggest contributor and not for the people.

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