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The real battle for healthcare

guest commentary by David Potts

Editor’s note: David Potts is a certified public accountant with more than 33 years experience. Although every effort is made to provide you accurate and timely tax information, it is general in nature and not specific to your facts and circumstances. Consult a qualified tax professional to discuss your particular case. Feel free to e-mail topic suggestions or questions to davidpotts@potts-cpa.com

Opinions, commentary and other essays posted in this space are wholly the view of the author(s). They may not represent the opinion of the owners of The City Wire.

The success of Obamacare depends on my son and those in his demographic, or we have been told. He is a healthy male in his 20’s whose health insurance premium dollar is needed to finance the cost of healthcare for old people like me and women in general.

In order for healthcare to be more affordable for the biggest consumers of the healthcare dollar young healthy men need to buy insurance to help pay the bills of the old folks. Since his premium dollars are so important to Obamacare’s success, you would think they would make it easy for him to sign up for insurance through the Health Insurance Exchange. But what a battle he had to wage just to enroll.

The Friday before Christmas my son and I were driving to Fayetteville from Fort Smith. With the road construction on Interstate 540 this is approximately a one-hour drive. The previous day my son had applied for a new health insurance policy through the new health insurance exchange. I was driving so my son decided he would use this time to call and correct a piece of information that he had given to an agent the in this application process. What dog poop he stepped in when he called to correct this one piece of information.

After leaving Fort Smith we took the exit off I-540 onto I-40. Here my son dialed the exchange number and as we drove past the Chester exit he got through to speak with an agent. We speculated the “short” wait time was the result of it being Friday night. He explained to the agent he needed to correct one item on his application. Most people would agree this should be a simple matter to do. However, the agent explained the system was unable to access his previous application to make changes so he would have to start the application process all over again. So the second application form was started. What better way to spend a Friday night?

A few minutes into the process my son asked the agent a question. He was put on hold while the agent contacted his supervisor to find the answer to the question. Later in the process I heard my son answer a question asked by the agent. After a few seconds of thought I interrupted him and we discussed whether that was the appropriate answer. He told the agent he wanted to change the answer that previous question. Again, a major mistake. In order to correct the information the agent had to start another “new” application. So a third application was started.

At exit 62, the outskirts of Fayetteville, the agent’s computer froze. My son was put on hold again. The end result was another failed application and about an hour and thirty minutes wasted. Over the next few days, my son was successful in completing an accurate health insurance application. He estimated it took 3 ½ to 4 hours to get through his application process.

When January arrived, he was told he was covered by his new policy, but he hadn’t received an invoice or a copy of his insurance policy and insurance card. In the middle of January his daughter went to the doctor for a immunization shot and as customary the receptionist asked for his insurance information. He called the insurance company and all he was able to obtain was a policy number. Gratefully, the doctor’s office was understanding and accepted only the policy number.

Last week part of his insurance information arrived. He received FOUR separate packets with the exact same dental insurance policy and FOUR invoices. It appears each time they started the application process over, he was signed up for an additional dental policy each time. But it’s been a month since he completed his application, assured that he has been issued a insurance policy and is covered, but he has yet to receive a policy, insurance card, or a bill to pay the premium.

A business operating in the free market would probably not survive if they operated at the same level of efficiency as the health insurance exchanges. People complain that the government has authorized the IRS to enforce the government’s mandate that all people buy health insurance, but maybe they should turn over the application process to the IRS too. You can moan about the IRS all you want, but they are experts in processing documents. It’s when the IRS is influenced by politicians and political leanings that it gets dangerous.

There are a lot of lessons that can be learned by analyzing the implementation and operation of the health care exchanges. Business schools will be discussing case studies for decades on this event. I’ll limit my comments to a couple of lessons that could be learned.

If you are in business strictly to make money and less concerned about providing value, become a government contractor. The people who designed and implemented this system made hundreds of millions of dollars. Because it was making the proponents of the healthcare exchanges look bad, they even had congressional hearings. In these hearings, as with any government project, each company was able to dodge responsibility and blame the other companies designing or implementing other parts of the exchange. In the end these government contractors were paid a lot of money for substandard work without any real accountability.

Second, life isn’t fair. If you are a young healthy male you will pay a larger portion of the healthcare costs in this country than you spend in your own healthcare. That’s just tough. I’m in my fifties heading toward sixty. I win, you lose. Don’t whine. It makes you look like a sissy.

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Our country is better than this. Why do we allow an incompetent government, Republican and Democrat, to thrive without true accountability? Maybe it’s time for young twenty something males, and everybody else for that matter, to find an 8th grade civics book to review our duty as citizens and to start working for change, real change.

We need leaders who know how to lead and manage in a way that produces acceptable results – at all levels of government.

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Every citizen should work to make government better and there is not better place to start than at the local level. Great article Mr. potts and real change is possible if the people demand more accountable and responsible public servants.