Kokomo Tribune; Kokomo, Indiana

Opinion

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
Opinion
  • It's time to deal with crisis For five and a half years, the president has gone around Congress to ignore, defy and alter laws in a variety of areas, from Obamacare implementation to issuing excessive new labor and environmental rules to infringing on religious freedom. It is no

    August 21, 2014

  • Nation must be united On Aug. 9, unarmed 18-year-old Michael Brown was shot at least six times, including twice in the head, by a police officer. Since that time, protestors and unrest have filled the streets of Ferguson, Missouri, a town near St. Louis.A similar scenario

    August 21, 2014

  • John understands fight against mental illness Terre Haute native Tommy John understands all too well how the pain of depression can lead a talented entertainer like Robin Williams to commit suicide.Like Williams, John achieved national fame, posting 288 victories as a major league baseball pitch

    August 21, 2014

  • Letters to the Editor Former Kokomoan on FergusonI was a resident of Kokomo from 1992 to 2008. Because of the housing crisis, my wife and I relocated to the St. Louis, Missouri area, which is close to where I grew up. With the eyes of the world focused upon the St. Louis

    August 21, 2014

  • OPN - KT082014 - king What Fergusonsays about us Aug. 9 is a day that Americans lost sight of themselves. It is the day Michael Brown, an 18-year-old black teenager of Ferguson, Mo., a suburb of St. Louis, was shot and killed by a white police officer, Darren Wilson. That evening, and for all but o

    August 20, 2014 1 Photo

  • Letters to the editor Congrats on wind farm defeat Congratulations to the citizens of Kokomo and Howard County! Your officials have done you a great favor by stopping any further considerations for construction of industrial wind turbines in your area. Now, if the fede

    August 20, 2014

  • Cleaning up voter rolls Citizens should expect the voting process for electing government representatives at all levels to be efficient and of the highest integrity. Indiana's system in recent years has at times been manipulated for political purposes -- the voter ID system

    August 20, 2014

  • Rob Burgess House of Burgess: First Amendment assault in Ferguson

    Of all the outrageous and disturbing story lines emanating from Ferguson, Missouri, since unarmed African-American teenager Michael Brown was shot by Ferguson police officer Darren Wilson on Aug. 9, the targeting of journalists during the ensuing protests ranks among the most troubling.

    August 20, 2014 1 Photo

  • Moped law long overdue We’ve all seen them on the streets, and their popularity is only growing. Mopeds have coasted in a legal grey area for years in Indiana. A lack of registration, testing and licensure allowed those without other means of transport to join other vehicl

    August 19, 2014

  • HAYDEN: Craft brewers and vintners returned sprits to Indiana State Fair Brad Hawkins felt right at home hawking his beer at the Indiana State Fairgrounds last week.When Hawkins opened his Salt Creek Brewery in a converted filling station in tiny Needmore three years ago, some tee-totaling neighbors protested he was putti

    August 19, 2014

Featured Ads
Only on our website
AP Video
Tit for Tat? McDonald's Shuttered in Moscow Life on the Professional Video Game Circuit TX Gov Perry in Washington: 'Confident' in Case Hospital Releases Two Missionaries Who Had Ebola Ramen Health Risks: The Dark Side of the Noodle NYC Doctor-in-chief Seeks Community Approach Indonesian Police Fire Tear Gas at Protesters Raw: Shots Fired in Liberian Shantytown DOJ, Bank of America Reach Record Settlement Raw: Cubavision Airs Images of Fidel Castro Raw: Grief After Deadly Airstrikes in Gaza Officer Who Pointed Gun at Protesters Suspended Kathy Griffin Challenges Minaj to 'a Booty Off' Johnson: Six Arrests, No Tear Gas in Ferguson Raw: Rescue, Relief Efforts at Japan Landslide Cadavers, a Teen, and a Medical School Dream California Drought Stings Honeybees, Beekeepers Officer Who Pointed Gun at Protesters Suspended US Mission to Rescue Hostages in Syria Failed
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