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
  • DAN COATS: New Harmony marks its 200th anniversary Situated between St. Louis and Louisville, New Harmony is a small town in southwest Indiana smaller than 1 square mile in area. Fewer than 1,000 Hoosiers call this serene Posey County community home.Despite its size, the town has monumental significa

    July 31, 2014

  • Rob Burgess House of Burgess: Let's put lethal injection to sleep

    It was only a matter of time before this happened again; and I’m sad to say I’m not surprised at all.
    On July 22, the Supreme Court gave the go-ahead for the killing of Arizona death row inmate James R. Wood III, who had filed suit requesting a delay until the state revealed the details of the drugs that would be used to end his life.

    July 30, 2014 1 Photo

  • ANDREA NEAL: Fleeting canal era had lasting impact on state Editor’s note: This is one in a series of essays leading up to the celebration of the Indiana Bicentennial in December 2016. In 1825, the Erie Canal was completed to great fanfare. Cannon fire, parades, balls and speeches celebrated the speed and ski

    July 30, 2014

  • TOM LoBIANCO: Pence, Bayh crowd field with questions In the 2016 political landscape, a pair of the state's political big dogs -- Republican Gov. Mike Pence and former Democratic U.S. Sen. Evan Bayh -- have potential candidates holding their breath and waiting on them. Until Pence says otherwise, he's

    July 29, 2014

  • JEFFREY McCALL: All things Hillary are not news, just distractions This column has nothing to do with who should or will win the presidential election in 2016. It has nothing to do with partisan politics of any flavor. This column does, however, assess how television is oversaturating the "news" agenda with countles

    July 29, 2014

  • BRIAN HOWEY: World is rising up to meet Putin's thuggery Any illusions I had about the progressive nature of Vladimir Putin’s Russian regime quickly dissipated when I returned to my Moscow Grand Marriott room in August 2007. Upon opening the door, I was greeted with the spectacle of my papers and note pads

    July 28, 2014

  • DICK WOLFSIE: A trip to end all trips My wife is planning a very exciting vacation to celebrate our 35th wedding anniversary. This was a big surprise to me. Not the vacation part, but the 35 years. I thought it was 34. Right now she is on the back porch, the patio table stacked high with

    July 28, 2014

  • ED VASICEK: Happy marriages do not just happen My wife, Marylu, and I met through a mutual friend. My wife had been involved with Campus Crusade at her university, where my friend, Norman, also attended. One Christmas break, Norman invited his friends from church (including me) to a party — along

    July 27, 2014

  • MICHAEL HICKS: Truth about inflation Almost nothing in economics seems to confuse people as much as monetary inflation. That confusion leaves an intellectual void into which some of the least credible ideas of the modern world crawl.Goods and services typically have a price dictated in

    July 27, 2014

  • RAY DAY: Some laws will do us in In my opinion, we have made laws that are contrary to what they were intended. And this writer is going to let you in on his thoughts about them. One of the things that has been processed incorrectly is the child abuse law. When you tell the parent h

    July 26, 2014

Latest news
Featured Ads
Only on our website
AP Video
Renewed Violence Taking Toll on Gaza Residents 2 Americans Detained in North Korea Seek Help US Employers Add 209K Jobs, Rate 6.2 Pct House GOP Optimistic About New Border Bill Gaza Truce Unravels; Israel, Hamas Trade Blame Raw: Tunisia Closes Borders With Libya Four Rescued From Crashed Plane Couple Channel Grief Into Soldiers' Retreat WWI Aviation Still Alive at Aerodrome in NY Raw: Rescuers at Taiwan Explosion Scene Raw: Woman Who Faced Death Over Faith in N.H. Clinton Before 9-11: Could Have Killed Bin Laden Netanyahu Vows to Destroy Hamas Tunnels Obama Slams Republicans Over Lawsuit House Leaders Trade Blame for Inaction
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