30 September, 2013

New York State Strikes with Stupidity (Again), Moreso Than Just That of the ACA

NYS is ludicrous (well, that's not news, but I digress). I just thought I'd look in on what I theoretically could pay for NYS "marketplace" health insurance, at http://www.nystateofhealth.ny.gov/PremiumEstimator. What do they have there? They have an Excel workbook. So let's see...they were too lazy (or too pressed for time) to put up some HTML forms and have a server give me some answers. No, instead I'm expected to buy proprietary software (or subscribe to Office 365) to find this information. Let's not forget that any time the State wants to update anything in this workbook, a new workbook must be (re)published, thus leaving potentially thousands if not millions of people with outdated information ("well...what are you talking about? I downloaded the file, and running the file told me this is what companies are there and what the premiums will be"). Heck, the file name itself contains "9-23-13 update". OKOKOKOK...don't say, "but Joe, there's ((Star)|(Open)|(Libre))Office."  I know about the free/libre *Office suites.

When I opened this "wonderous" workbook with LibreOffice, it (rightfully so) complained that the file contained macros, and that they would be disabled, and to run them, I had to go into a specific place in the settings.
Are you going to tell me seriously "normals" are going to understand what's going on, let alone how to run these macros appropriately without compromising the security of their LibreOffice installation? Besides, this advice does not completely describe the things which need to be selected (they missed the name of the button "Macro Security"). I mean, being a computing professional, I know exactly how to handle this and remain safe.

OK, take two: I'll just use Google Docs, and import it into a spreadsheet, like I've done on numerous occasions with other workbooks. "This file could not be imported. Supported formats: .xls, .xlsx, .ods, .csv, .txt, .tsv, .tab."  Ummm....OK, so I fibbed a little, and renamed it from a .xlsm file to a .xls file, and retried.  "The uploaded file is password-protected and could not be imported. Please remove the password and try again."  As I didn't put the password there to begin with, I obviously can't remove it.

As if this workbook monstrosity wasn't bad enough, after going into the macro security and setting the level to "medium" (prompt to run macros, but don't turn them off entirely), I discovered I have to enter in my county.  I'm sorry; what's that?  I thought the whole underpinning of a national health care law (combined with Amendment XIV) was that I should be able to get health insurance just the same as someone in LA, CT, CA, MO, MT, NJ, or any other state for that matter, let alone some subdivision of NY such as a county.  I also thought a major principle behind this law was to break down the state border barriers when it comes to selling health insurance.  Why am I going to NYS?  Why am I not going to some federal entity (HHS?) for this?

As I really don't want to spend any money at all on health insurance at this point, but my nation tells me (theoretically) I must, I selected the "Catastrophic" option, figuring that's lowest on the list and will probably have the cheapest premiums.  This "wonderous" workbook then informs me "This plan is only available if every person in the household is under the age of 30."  Again, ummm....sorry, what?  So just because I was born in 1965, I cannot simply insure myself against catastrophic illnesses and injuries?  Hello!  Amendment XIV?  Or how about 10 CFR Part 1040, Subpart E?  As a 48-year-old, I feel denied and limited as an individual for the opportunity to participate in an insurance program which receives federal tax subsidy as financial assistance.

Let's just put all this NYS silliness aside for a moment.  I'd like to know just how our "salescritter" (BHO) could think he was not lying.  (Well, we know now quite well he was, but we're stuck for another 3.5 years or so.)

I want to know, what is the magic pixie dust which is supposed to fix insurance magically?  After all, this law was "sold" to the American public as reducing premiums substantially, while at the same time adding roughly 30 million more people to the health (insurance) system, not all of them necessarily paying people, insuring "kids" until they're 26 years old, total exclusion of denial based on preexisting conditions, with no mention of tort reforms.  I suppose the slice of the American public who supported this law figured it was just the cruel, heartless, greedy insurance companies which could take the money they were all receiving with the system before law enactment and offer these incredibly enhanced services just because they have been so incredibly "greedy."

Look, don't get me wrong.  There are some areas in health insurance which could be improved which would parallel other laws in the respect that noone should be discriminated against based on what they are.  We have many such laws, such as against discrimination based on color/race, gender, age, and so on...what we are, something about which we can't really do anything.

For example, preexisting conditions is a really tough nut.  I'm talking about Crohn's disease, diabetes, lupus...any number of conditions/diseases which are caused totally or partly by genetic factors; again, it's what those affected are, often nothing to do with what they do or did.  If for example one develops adult onset diabetes, as long as one has had insurance, it's covered.  But some poor schlub who, for whatever reasons, has some sort of lapse in insurance coverage is either denied or must pay sky-high premiums?  It makes no rational sense to me.  I'm also not saying they shouldn't pay something additional, just that they shouldn't be denied, and there should be some sort of limit on the premium differential.  I mean, as many have pointed out, making everything the same is unfortunately not a workable solution, because all someone has to do is not buy any insurance at all and then waltz in after something happens and say, "hey, I need this."  A good analogy people often cite is going to buy homeowners' insurance right after one's house burns.  There needs to be some disincentive against doing that sort of thing, so maybe disallowing denial plus some percent cap on premium differential would suffice.

Tort reform could go a long way towards curbing lavish, arguably unjust malpractice awards.  Malpractice premiums could potentially be reduced substantially, therefore prices charged for medical services, therefore the amount insurance companies have to pay out on claims.

Do we really need 50 different health insurance regulatory jurisdictions?  Just like the NYS Do Not Call registry got subsumed by the national DNC, couldn't some laws be passed which trump individual States' insurance laws so that insurance companies can sell in all states and eliminate the compexities of selling in all 50 States?  This is a noted exception to States' rights, simply because the larger the pool of people served, the more inexpensive the system becomes, by combining the risks over a much wider area.

It's all so much hooey. I hope it somehow gets repealed and completely rewritten.  Moreso, I would like to see a NYS law passed which states open standards must be used for all externally accessible media...meaning no Microsoft anything, no Flash, nothing proprietary.


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