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The infrastructure that sends information from the healthcare.gov is still not functioning properly. Insurers say that they need an error rate of 1% or lower (preferably much lower) in order to ensure good service; currently the error rate is stuck at 5%, according to Wonkblog. Earlier, I had predicted that this issue would prevent a surge of enrollements since I assumed that the Obama administration wouldn't want to throw millions of Americans into a Kafkaesque bureaucratic nightmare where they didn't know whether they were insured or not.

As you can probably tell by the fact that there are now 2.1 million enrollees, I was wrong. Mea culpa. I should have known Obama cares far more about optics and messaging than he does about reality.

Reality, though, always ends up rearing its head, as this article in the New York Times shows.

Paul D. Donahue and his wife, Angela, are among more than a million Americans who have signed up for health coverage through the federal insurance exchange. Mr. Donahue has a card in his wallet from his insurer to prove it. But when he tried to use it to get a flu shot and fill prescriptions this week, local pharmacies could not confirm his coverage, so he left without his medications.

Similar problems are occurring daily in doctors’ offices and drugstores around the country as consumers try to use insurance coverage that took effect on Jan. 1 under the Affordable Care Act.

The issues are widespread:
A spokeswoman for WellPoint, whose plans are being sold on exchanges in more than a dozen states and include Anthem Blue Cross, said the company was “experiencing an unprecedented level of questions from our members,” with one million calls to its customer service centers last Thursday and Friday alone. The centers typically receive a million calls in a month, said the spokeswoman, Kristin E. Binns.
And they are costing people real money:
In Los Angeles, Hilary Danailova, who is almost eight months pregnant, said she had to pay $630 for an ultrasound on Thursday after failing to get an ID card or any confirmation of coverage from her new insurer, Anthem Blue Cross. Ms. Danailova, 38, said she signed up just before Christmas and sent her first month’s premium of $410 by overnight mail on Jan. 3. She has repeatedly tried to reach Anthem to see whether the company has processed her payment.
Going back and fixing these errors will take more manpower, cost more money, and cause more harm than if the Obama administration had done the right thing and closed enrollment until the Exchanges actually worked. $630 is a lot of money, even if Danailova eventually gets her money back from Anthem (a big if, IMO, since insurers are Scrooge-like in their miserliness). What if she hadn't had that kind of money to spend out of pocket, and had to go without necessary prenatal care? What if she was visiting an oncologist instead of an obstetrician?

Public private partnerships like the ACA don't just suck because they allow corporations to socialize costs and privatize profits, they're also, in direct contradiction to neo-liberal orthodoxy, horrifically inefficient and stuffed to the gills with waste, graft, and incompetence. They bring together the worst aspects of both the state and the market.

Obama, whose plan to address income inequality is to set up Special Economic Zones, doesn't understand that. He's solidly indoctrinated in the same political ideology that brought us Thatcher and Reagan: neoliberalism, an ideology that remains hegemonic despite delivering us to the brink of economic oblivion in 2007, which we've remained teetering on the edge of ever since.

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