Obamacare is an approaching disaster from just about every angle. Here’s why I think so.

It’s been amazing watching the social media threads over the past week or so in the immediate run up to Obamacare. For the record, as of this moment, 3 days into the supposed enrollment availability, I have been completely unable to get the Obamacare site to function. I get a web page that says they have a lot of visitors at the moment and they’ll get me to a logon screen just as soon as possible. I left the screen up for 30 minutes at 1 stretch and got nowhere fast. The system clearly is not scaled to operate at the level of use that should have been forecast.

I’m a contractor working at a federal agency in Washington, DC. I am directly affected by the shutdown and a lot of my friends and neighbors are, too. As much as I want this to be over and to be getting back to work, I am scared of what will happen if the Republicans do what Democrats and many others want them to: throw their hands up, give up, and just let the Democrats have their way. Let me state, for the record, why that is.

From a political policy perspective, putting the federal government in charge of our health system – and that’s exactly what this program does – is simply asking for a catastrophe. Costs are going up, not down, like we were promised. Choice in healthcare is going down, not up, like we were promised. Thousands of us are being told our health plans – the ones we liked and were promised we could keep – are no longer available. As many on my side of this debate projected would occur, businesses are declining to hire people because of the costs Obamacare incurs. Businesses are converting full-time jobs into part-time jobs to avoid the mandate. The result is exactly what we said it would be – fewer employed people working lower-wage jobs and more and more people simply giving up trying.

The policies of Obamacare force insurance carriers to accept people regardless of any pre-existing condition. That incentivizes people to avoid buying insurance, simply paying the “tax” for non-compliance, and then jumping in to the insurance pool only when they know they need it. Insurance companies will attempt to pass those costs along to the rest of us and there’s only so high people can afford to pay on premiums before retired people and the poor simply can’t afford it. People will game the system of subsidies and deliberately refuse to work toward higher-paying jobs because passing a given mark on the wage scale will reduce or eliminate those handouts.

Insurance companies are having to seriously restrict the number of doctors in their lower-premium plans which will increase the patient load. At some point, a doctor is going to look at the Obamacare-mandated 3-5 minute limit on patient visits and the growing list of drugs and treatments the Obamacare boards say cannot be offered and they’ll decide to get out of the business. Once that starts happening (…who am I kidding? It’s already happening) the patient load will simply increase faster, making the problem worse. Doctors won’t be the only ones. Nurses, too, and when the patient load starts driving up, quality of care will start to slip. Patients will suffer or die because of improper care. Think not? Britian’s NHS has had cases where patients actually starved to death while in their care. That kind of thing doesn’t happen because there are too many nurses and doctors at the facility.

There are still people out there who think Obamacare is giving them insurance and healthcare. They think it’s all for free, now. When people think they can have as much of something as they want and have it for free, they don’t tend to conserve it. They’ll use more of it and that means there will be a higher load on diagnostic and lab work. And that means longer lines at those facilities and people who really, really need those services will be stuck waiting behind people who really don’t. Again, they see that in the UK and they’ve seen it in Canada. That’s why their citizens have, in the past, come here when they really need to get a medical procedure done quickly.

The federal government is rarely the most efficient organization and those inefficiencies are adding up. They’ll get worse.

Now, lay aside the political angle on this and let’s, for a moment, just view the program from an execution point of view. In order for this thing to work, they have to have a web interface capable of tens of thousands of simultaneous sessions literally around the clock. Every time a session is opened by a user, this system was supposed to direct them to their state exchange, if they had one, or to the federal exchange if not. Once there, the user has to create an account and enter all of the personally identifying information (PII) you’d expect to have to give to buy insurance. That’s social security number, date of birth, name, address, phone, medical history, income amounts… you get the drill. Once entered, that system was supposed to then validate that data against other databases, most notably immigrations (to verify that you were, indeed, eligible to apply for subsidies) and the IRS (to verify the income data you gave was accurate). When that was all done, the system would then calculate what, if any, federal subsidies you qualify for, and present you with the alleged plethora of insurance plans available to you with the aforementioned subsidy helpfully applied to the price already. Sounds wonderful, right?

Earlier this year, President Obama decided to simply delay the interface between the user’s entered income data and the IRS database, meaning that the exchanges simply take the word of the person entering it as fact. To date, there’s been no talk of how or when that capability will be brought online and how the validation will be done on the people who have already enrolled and purchased insurance. Also waived, supposedly for the moment, is the explicitly required background checks on the people who will be working these exchanges and, notably, the help lines people call when the web site doesn’t work. These 2 problems, alone, will result in massive fraud, bleeding money out of a system that’s already hideously expensive and raising the burden on everyone who’s paying to keep it working. It will also result in a huge amount of identity theft, both due to the uncleared personnel being given insider access and due to the unauthenticated design of the systems brokering the exchange connections. Both of these are entirely foreseeable issues and both are completely preventable, but the Administration has chosen to charge ahead anyway. Like others that are rushing to defend this train wreck, they just figure that things will work out eventually. Of course, most of those people are in the federal government and Congress, two entities that have magically been granted waivers that will keep them from being exposed to the problems entirely. I wonder, out of all the people claiming that these problems are just the normal bumpy start to a large-scale project, how many are volunteering to have their identities stolen and their credit ratings destroyed? Not many, I’ll wager.

Obamacare is open, although its inability to handle a completely predictable user load is keeping the number of actual customers served extremely low at present. The train wreck is in progress and regardless of what can be done to stop it – if anything – there’s damage already on the way. I have great concerns that it’s going to get worse and I’m writing this down now, at the start, to document what my stated concerns have been during these past 3 years of having it rammed down the throat of America. It’s not too late to make the changes that will mitigate these problems but that’s not going to happen so long as the defenders of this law ref
use to even discuss it.

Here we go…

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