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People who can't get through on the website need to use the toll-free phone number. Someone needs to tell "hollow-eyed granny starver" (don't you just love Charlie Pierce) Paul Ryan that the website may be a mess BUT ALTERNATIVES WERE PROVIDED. (Yes, I was shouting. Ryan has a propensity to selective hearing.)

Steve French

As digby points out, despite the problems with the website, people who need health insurance will persevere because they need health insurance.

And that's precisely the problem. Uninsured people with serious medical conditions will persist in signing up. But the longer this disaster plays out, the fewer young, healthy people with few healthcare needs will put up with it before walking away. And Obamacare is perversely reliant on the participation of these people (who have the lowest incentives to to participate, that grow lower every day the site is non-functional).

If too many of these young, healthy people drop out of the risk pool because the IT system that promised to make insurance easy simply doesn't work, the worse the actuarial picture for those who do enroll gets. Premiums begin to increase, which causes even more healthy people to drop out when they conclude that insurance isn't a good deal anymore. This is the dreaded adverse selection death spiral.

This is an unmitigated disaster that has to be fixed, and fixed far sooner than most people realize. If the fix doesn't come quickly (or Obamacare doesn't get delayed), it has the potential to be catastrophic for the entire insurance market.

More here: Is Obamacare in a Death Spiral?" by Megan McArdle.


Steve, is the McArdle link supposed to be funny? Honestly, by her standards, the designers can just blame gastritis or say they didn't have calculators, explain that they come from families of academics who were intellectually quite intimidating and that should be excuse enough for anyone.


Ummm...anybody here remember the rollout of the original Windows VISTA? The "beta" version? The one that wouldn't work with half the licensed apps? The one that everybody HATED..?

OK. The one that was created by Microsoft? Immense IT company? Sorta does digital media for a living? Big operating system creator, multibillion-dollar corporation?

The one that was supposed to be the disastrous clusterfuck of ALL TIME EVAH!!??

Yeah. THAT one.

The fact that a complex platform created by 55 separate contractors (OK, I'll give somebody a power-wedgie for that - who could imagine that anything could go wrong with that plan..?) is having teething problems is irritating, but WORSE THAN THE HOLOCAUST!!!???


Sweetbabyjesus, people. Get a hold of yourselves.

El Jefe


This. Thank you. While I appreciate the critiques and concerns of the younger numbers crowd (and thank god there *is* a younger "numbers crowd," we need more statistical analysis not less in US policy-making), deciding that a data set of several weeks forecasts the apocalypse doesn't actually bear up to, well, statistical analysis. Not only does it need to be compared and contrasted to the life cycles of changing modalities in different kinds of social media (Lance's example about Facebook getting "glitchy" and the public response to it is more germane than a blind terror that hip young early-adopters will turn up their noses permanently) but we should, genuinely, consider what rolling out Social Security in the digital age would've looked like, when we go back and examine all it went through in the "teething" stages. And that's not a "back in my day," remark, it's an opportunity to do some serious counterfactual consideration about two data sets.

Frankly, it's a good thing for the longer term that we now get to confront two important things about policy implementation in this field. First the thundering fustercluck of having so many different contractors is something that needs to get fixed. This is a case where fair practices have become reductio ad absurdum. Second, there are so very, very many poor Americans desperate for health insurance that, while there will be some balance of risk pools from young healthy people, this will allow Teh Mightee Markit to observe that, just like with old folks, there's not really a profitable way for them to manage costs and reduce them via better preventive care for the armies of our disenfranchised. Maybe, just maybe, it will turn out that having, oh, I don't know, some kind of publicly-managed risk pool where everyone chips in a bit in taxes so that the insurance companies don't have to carry that lead weight around with them, could work. I think they tried something like that with retirees. Medi-something. Could be wrong. Also, with a smaller pool of healthy folk looking for private policies, we might be able to winnow down the number and efficiency of private insurers to the ones who are actually good at what they do, rather than those who just soak up premiums, deny benefits, and play the tables on Wall Street. Of course that kind of rank mid-to-long-term optimism probably just means they upped my meds again ....

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