Kokomo Tribune; Kokomo, Indiana

Columns

November 3, 2013

MICHAEL HICKS: The ACA into the future

Website must work for more than 30 million homes.

It is far too early to call the rollout of the Affordable Care Act a failure; most new programs have rocky starts, but this one has most of the signs of inevitable failure. If the situation doesn’t remedy itself quickly, the complete redo of the law (which I predicted some weeks ago) will be hastened considerably. Let me explain.

Anyone who has participated in a large-scale technology overhaul knows how long they take and how many elements perform dismally with the first tests. I managed one and participated in two others over the past 25 years, and the best of them, which is still ongoing here at Ball State, has consumed three years and many tens of millions of dollars, many of which are not captured by cost estimates. This is for an organization of fewer than 30,000 people. The ACA requires a less complex technology, but one that must work for more than 30 million American households — one-third of whom are functionally illiterate, and another third of whom have no home computers or Internet access. That is beyond the scope of the technology.

As the president rightly notes, the failure of the website does not mean a failure of health care, but what he will shortly acknowledge is that unless the website works really well, much of the rest of the legislation will fail.

One admirable feature of the ACA that any future health care law will wrestle with is that it is designed to pull everyone into the health care insurance marketplace. The goal of this is to spread risk across the entire population and so reduce premiums. In the coming months insurers will set premiums based upon the actual health risk of participants. If the folks registering for the ACA are all young healthy folks, then premiums could fall while Medicaid costs will rise. If those who register are in the most need of insurance (the older and sicker of the 30 million households), then premiums will rise. Simple economics suggest that if premiums drop, and the website improves, more will sign on. If premiums rise, many will drop coverage, leading to increasingly higher premiums and even more dropping coverage. This “death spiral” will cause the ACA to fail, and expedite serious reforms to the law. So here are my predictions.

Text Only | Photo Reprints
Columns
  • DAVE BANGERT: Indiana's new chief justice and court's 'mom question' Two years ago, as Loretta Rush ascended from Tippecanoe Superior Court 3 judge to the state’s Supreme Court, I dropped this line in a column celebrating someone who had earned her place.“Across the state, the headline will be: ‘[Mitch] Daniels Choose

    August 14, 2014

  • JEFFREY McCALL: POTUS promises of transparency fail to materialize The United States system of government relies on citizens having full access to information that can be used in self-governance. Journalists and other First Amendment advocates were enthused when the Obama administration came into office with convinc

    August 14, 2014

  • Rob Burgess House of Burgess: RIP Robin Williams

    I was re-watching the 2006 movie “Little Miss Sunshine” Monday when I heard my phone buzz. After the credits had rolled, I looked at the screen and found myself shocked.It was a news alert that Robin Williams had died that morning at the age of 63 of an apparent suicide.

    August 13, 2014 1 Photo

  • ANDREA NEAL: 'Paddle Your Own Canoe' is a Hoosier inspiration

    Editor’s note: This is one in a series of essays leading up to the celebration of the Indiana Bicentennial in December 2016. James Whitcomb Riley was the most acclaimed, but he wasn’t the first Hoosier poet to gain national fame. Sarah T. Bolton dese

    August 13, 2014

  • DAVE BANGERT: Rokita, illegal immigration, Ebola outbreak and context At first listen last Monday, there was something so unsavory about our congressman, Todd Rokita, whipping up two full-fledged crises — Central American children at the U.S. southern border and the African scourge of Ebola — into one pungent sound bit

    August 12, 2014

  • DAN COATS: Let's give nonprofits relief from IRS delays A flurry of scandal has recently surrounded the Internal Revenue Service.Over the past few months, we have learned about missing emails from IRS employees and revelations of clear bias and hostility by a top IRS official towards organizations with ce

    August 12, 2014

  • BRIAN HOWEY: Pitchforks and pikes in our summer of discontent Congress is ... embarrassing. Our political system is failing us. On an individual basis, many of us have respect for members of our delegation. We can have a common sense conversation with a senator, congressman or congresswoman, and then they go ba

    August 11, 2014

  • DICK WOLFSIE: Enough reminders to forget It began with a simple phone call to my friend, Auri, a computer geek I asked to help me with my very successful website, which right now is attracting up to three visitors a month. To have a strong online presence, you have to spend several hours a

    August 11, 2014

  • ED VASICEK: Outsourced jobs, health crises in foreign lands The other week, my Internet was giving me trouble. I called the support number, and — to my surprise — I spoke to a representative who sounded as American as apple pie. It turned out the technical problem was an oversight on my end and fixed quickly.

    August 10, 2014

  • MICHAEL HICKS: Dodging corporate taxes Corporations are among our oldest institutions. Something like a joint stock company probably triggered the earliest formal written communication — the accounting ledger. It should be unsurprising that the early traders of Mesopotamia used a corporat

    August 10, 2014

Latest news
Featured Ads
Only on our website
AP Video
Okla. Policeman Accused of Sex Assaults on Duty Raw: Egypt Bus Crash Kills at Least 33 Two Bodies Found in Adjacent Yards Dominican Republic Bans Miley Cyrus Concert Raw: Israeli Air Strike in Gaza Raw: Rescue Efforts Suspended at Japan Landslide Raw: Bodies of MH17 Victims Arrive in Malaysia Raw: Smaller Marches in Ferguson Marathon Suspect's Friend Pleads Guilty Attorney: Utah Eatery Had Other Chemical Burn Farm Resurgence Grows With Younger Crowd Microbrewery Chooses Special Can for Its Beer Ky. Firefighters Hurt in Ice Bucket Challenge Federal Investigation Will Look at Use of Force Community Deals With Michael Brown Aftermath US: We Do Not Pay Ransom to Terrorists Ferguson Teachers Training to Deal With Trauma Jon Hamm on the Unrest in Ferguson Tit for Tat? McDonald's Shuttered in Moscow Life on the Professional Video Game Circuit
Parade
Magazine

Click HERE to read all your Parade favorites including Hollywood Wire, Celebrity interviews and photo galleries, Food recipes and cooking tips, Games and lots more.
Obituaries
Poll
Kelly Lafferty's video on Tom Miller