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As someone who investigates consumer life and health insurance complaints for a living, I can vouch for Lance's assertion that people do not read their insurance policies. Nor do they read the annual statements insurance companies send to them. They rely on what reps or ads told them, or what they *think* ads or reps told them.


Insurance is complicated... But I'm not sure the rolling into ACA is quite the fine tuned machinery you say it needs to be. As has been pointed out a lot, for many people nothing will change - Medicare, veterans, most people employed by large companies. It's the uninsured, and as we've seen, people in special situations like the individual market who face the hardest choices. And yes, some of them may find it complicated... But I don't know that it needs to be; the whole exercise has been envisioned (not necessarily executed) as what most corporate workers see- choices among similar plans, all of which should give good basic coverage. The larger problem as you point out is that most people don't understand or think about the complexities around health insurance. That's why stories about problems stick and why anecdotes are driving our discussion rather than sound policy. Everything will likely unfold fine for most people; but if that's not the story that gets told, people will likely assume and accept the worst. Massachusetts did not have an entirely smooth rollout; that's not crucial. How people perceive their experience and their ability to obtain care matters more. And that part is, I think, where the Obama people are struggling.

Lance Mannion

weboy, good points. And it's definitely not a fine-tuned bit of machinery. I don't think it can be fine tuned. Too many moving parts. It's going to need constant attention, constant supervision, constant tinkering, constant repair. It's over-designed, over-engineered. (Help! I'm getting carried aay with by my own metaphors.) It can only work the way the great machines used to work in the late 19th and early 20th century worked, with mechanics stationed at every step in the process with wrenches and oil cans.

mac macgillicuddy

Here's something not surprising, but still frustrating. The MSM does not seem to want to cover what is going on in the states that did what they were encouraged to do: expand their Medicaid, and create their own, state-based insurance exchanges. I can't recall the exact numbers, but somewhere in the neighborhood of 26 states elected NOT to do this and to rely on the Federal exchange. In CT, which is one of the states that DID expand its Medicaid and create its own, state-based insurance exchange, there does not seem to be a major issue with roll out. Or is there? Who knows, because no one is covering the story this way, although it is a major part of the story.

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