Information Technology and Obamacare, an Encounter in an Elevator, A Story from Sid and an "ASP"

When Information Technology Harms Rather than Helps

Folks in the information technology field seem to think that everything should be done by computer, and woe to those who would prefer to do it in person, on the phone or by mail.  It works for Amazon.com, so why shouldn’t it work for everything else.  I think not.  Our dependence on technology should not be taken for granted.  We have not gotten there yet.

Before my recent trip overseas, I planned on having my smart phone adjusted so that I could use it in foreign countries.  The Verizon Wireless website promised that I could take care of doing this entirely on line.  I tried, but I only got so far as the question asking what kind of phone I have.  I couldn’t it since the drop down screen showed several models of the phone I have, each with varying amounts of gigabytes.  I looked at my phone, at the box it came in and fiddled around with it for about 20 minutes, but I couldn’t come up with anything to match the drop down screen choices.  So I went to a Verizon Wireless store where a human being arranged everything in about two minutes.  Lesson learned.

I recently put a “vacation hold” on my newspaper delivery while I was out of town.  I did this entirely on line with the paper’s web site.  It had worked for me this way in the past.  This time, however, the paper stopped when it was supposed to but delivery was never resumed.  I corrected this by speaking to a human being at the newspaper.  I repeat, a human being.

Only last month I received a letter from the Social Security people saying the benefit they had been paying me for the past year was incorrect and they were adjusting it for the coming year.  Some techie screwed up.  So what’s new?

Which brings us to some of the problems the Patient Protection and Affordable Care Act’s web site is having enrolling people.  Let me ask you some questions.

If you are of Medicare age, when you first became eligible for it, did you apply for it on line, by mail or by telephone?  Same question regarding the Medicare Prescription benefit.  And when you first registered for Social Security, how did you do that?  And how did you apply for homeowners or renters insurance, or automobile insurance, if you have those coverages.  Did you do so online, by mail, by phone or in person with an agent?  And if you have health insurance from your employer, did you sign up for it online or on a piece of paper your company handed to you?  Or if you have your own private health insurance, how did you get that?  Ever wonder why there are long lines at Motor Vehicle Bureau offices everywhere, even though almost everything people go there for can be done on line?  I would wager that most of you answered that you had made minimal or no use of the internet in performing these tasks and opted for a more “human” approach.

People are not as computer literate as the techies would have us believe they are.  But techies are smart enough to know that it’s in the interest of preserving their jobs to pretend that everyone knows a “cookie” is more than just something you nibble with coffee or tea. (I still really don’t understand what they are.)

   You see where I am heading with this, of course.  If the Affordable Care Act is to succeed in enrolling millions of presently uninsured people, a much greater emphasis should have been put on non-internet pathways to enrollment.  Perhaps the government should universally distribute an instruction booklet, like the one the IRS puts out each year for the folks who like to do their own taxes manually, running through all of the questions presently asked by the ACA’s web site and providing a worksheet to be completed and mailed in.  Then, techies can input the worksheet data into their systems and come up with specific alternatives available from different insurance companies for the applicant, and return them by old fashioned mail with an application to the submitter.  Techies would know better how to input what is really complex data than individuals sitting at home.  

I understand such an alternative is now available but it should be the primary method of applying, not just a sideshow second choice to the web site. 

 

If understanding how to do this is a problem for an applicant, they should be directed to the nearest Social Security office, where trained personnel should be available by phone or in person, to assist them. In fact, the “navigator” program which was intended to do this but was hampered in many states by anti-ACA politicians, should have been installed in these established Social Security offices rather than run independently.
  

This is the “old fashioned” established way most people secure insurance, not on the internet.  People deal with people. Recall your personal experiences in that area.  Even if you started searching online, didn’t you end up talking to a human on the phone?  This is the way the Patient Protection and Affordable Care Act should work, at least at its startup phase.

Once the ACA is up and running properly, and the insurance companies’ systems have kicked in for the individual policyholders, the techies and can devote their time seeing that the online system operates efficiently for future online enrollees and managing existing policyholders.  Still, however, the most effective way to enroll individuals and families initially in Obamacare would seem to be the old-fashioned way as described above in connection with other kinds of insurance, even though it may not be the most efficient way.  It is one of those occasions where efficiency should take a back seat to effectiveness.  (Effectiveness involves doing the right things; Efficiency involves doing things right.  There is a difference.)

Meanwhile, of course, enrollment in the sixteen states (and D.C.) which have their own systems is proceeding better than the stumbling Federal online system, designed for those states too stubborn or uncooperative to develop their own local systems. By the end of November, however, this may be remedied.

 

But once “old fashioned” manual enrollment procedures are fully and not just marginally operational,  you will see the Patient Protection and Affordable Care Act take root and flourish, not only for the benefit of those who purchase private insurance through it, but for the benefit of the country in general.   

If, however, Obamacare remains dependent on "on line" enrollment of policyholders with individual insurers, it will continue to struggle.

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A Footnote:  Those who feel that they have not been able to keep their existing insurance should not be blaming Obamacare and the President for that.  I believe that the fault rests with (1) employers who have used the introduction of the ACA as an excuse to change or eliminate the health insurance benefit they had been previously providing or (2) with the insurance companies involved which have, again with the ACA as an excuse, chosen to change or eliminate existing coverages provided in individual policies.  (Such complaints have been magnified a hundred-fold by a TV News network which is devoting almost half of its air time to undermining the Affordable Care Act.) 


Jack Lippman

                                               

Sid’s Corner

Community Service

Sid Bolotin   (Inspired by a Frank Cerebino column in the Palm Beach Post)

                                                           

Myron, the President of the Board of Directors of the retirement community, greeted the three residents who had decided to volunteer for the new project.

“Gentlemen, I want you to meet Gus Morgan who’s agreed to lead this new squad for implementing our new program. He just moved here from Los Angeles and was with LAPD for thirty years; so he’s more than qualified for the task at hand.”

Gus stepped forward to face the three volunteers seated in a semicircle before him. At six feet in height, athletically built, and still sporting his gray hair in a close-cropped military style he was an imposing figure.

“Gentlemen,” he began in a strong, vibrant voice, “I was a captain in LAPD’s Scientific Investigation Division (SID) and bring years of crime-scene expertise to this new enterprise for improving life in our community.”

“As you know our Board of Directors has become fed up with the scoff-laws who continue to fail to obey the regulations of our beautiful community. It’s going to be up to us to provide the board with scientific data that will enable fines to be levied and legal action taken as necessary. It’s no different than what SID did for LAPD. You three are the spearhead for our success, and I’m your guide.”

Jack, the middle volunteer, who seemed a tad cowed by Gus’ forcefulness, asked, “Exactly what will we have to do? My wife says that if I have to confront our friends and neighbors, she won’t let me volunteer.”

Immediately the other two piped up in unison, “My wife says the same. What are the details of the duties?”

 

Raising both his hands in a calming gesture Gus soothed, “Don’t fret guys. No confrontation is required. You’ll just collect evidence of transgressions and its location. You’ll then deliver it to Gus who’ll record it and send it to the lab for analysis. The results will come back directly to the board of directors, or maybe the Property Manager for their action. Piece of cake.”

Mort, sitting to Jack’s left then asked, “Will we have to go on patrol in a car like the COP’s (Citizens on Patrol) guys, our bikes, or just walk around? Will we get to wear uniforms like they do?”

“No cars.” Gus assured him. “Just stroll around or ride your bike. And you’ll get reports from residents who come upon evidence. No uniforms for now, but maybe in the future.”

Myron then announced that he appreciated their participation and concluded the meeting with, “You’ll each get a sampling kit with Q-tips, latex gloves, and evidence bags. Be sure to not cross-contaminate the samples. You’ll begin operations as soon as all the dogs in the community have been swabbed, and their DNA registered with our sub contractor, Doctor Wang Poo’s Veterinary Laboratory. And by the way, why not think up a snappy name for yourselves? Poop Squad ala Geek Squad, Poop Brigade, and Pooper Scoopers are all possibilities. Maybe I’ll get the Board to spring for embroidered shirts.”

                                                   
A Lasting Impression

While in Israel on my recent vacation, I encountered two young men in a hotel elevator.  Obviously, they were among the many Christian pilgrims who come to Israel to visit the many religious sites there.  They wore T-shirts proclaiming them to be members of the Menorah Christian Community.  I asked them where that organization was and they told me they were from Indonesia.  "Jakarta?", I inquired.  "Yes," they replied, almost elated that I knew the name of their country's capital.  As the elevator was reaching my floor, I chose to quickly ask them if it was difficult being a Christian in Indonesia, which I seemed to recall was a aggressively Islamic nation.  "Yes, very much," they replied. This very brief encounter left a lasting impression with me.   

Meanwhile, I have determined that in Islamist Indonesia, which strongly supports the Palestinians, yet purchases weapons from Israel, there is a remarkable amount of religious tolerance, such that the largest menorah in the world is located in that country!  It isn't a Chanukah menorah, but none the less, it still is a menorah in an Islamic nation.  This menorah is  62 feet high, almost twice the size of the Chanukah menorah erected each year by Chabad near Central Park in New York City.  Perhaps it is preferable to be a Jew in Indonesia than a Christian.
JL

                                                                       Menorah in Indonesia


                                                               

Trading an Elephant for a Snake

                                                       

The Republican Party ought to change its emblem from an elephant to a snake, specifically an asp (that's the species that bit and killed Cleopatra.).  Why? Simply because the letters A, S and P stand for the basic principal underlying everything the G.O.P. does.  It is the Anti-Spending Party!   If additional revenues (i.e., taxes) are needed to fund "spending" for any program whatsoever, however important or non-partisan it might be, Republicans will oppose it.  That's because the big money donors, the ones who would be hurt most by tax increases, call the shots for the G.O.P.  It has always been that way and it will never change.

JL 

                                                                         

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