Monday, July 22, 2013

Confusion Reigns Over Health Exchanges
With ruin upon ruin
Rout on rout, confusion
was confounded.
John Milton (1608-1674), Paradise Lost
It is safe to say implementation of health exchanges confuse and confound us all,  except, of course, President Obama and Kathleen Sibelius.   They insist  the exchanges will be ready on October 1, 2013, come hell or high water.  We do not know yet which will come first, if at all.
Sibelius has  accused Obamacare critics of spreading “misinformation and fears, “ but the truth may be  closer to “lack of information and uncertainties," since  nobody knows what going to happen. Obamacare supporters are long on predicting success and short on details necessary for individual and business planning.  Missing deadlines and delays seem to be the order of the day.
Most of us -  doctors, patients, state governments, employers, the media, Obamacare supporters, government computer nerds – are confused.   There’s a growing feeling that Paradise Found, Obamacare,  may become Paradise Lost. 
Even CNBC, that staunch Obama backer,  seems to be backing off.   Today it released an article entitled “Doctors Are Skeptical and Confused about Obamacare, Study Finds.” conducted the study among 479 Independent physicians for the  survey, which had a 95% confidence level.
Doctors, those on the care frontlines.   are short on information, and long on uncertainty.
·         Just 11 % of doctors believe health exchanges will open on October 11.

·         Of those doctors  responding to the survey,  these percentages were “not at all familiar” with these aspects of the exchanges:

-          56% with how exchanges would effect their patients

-          65% with  health exchange payment rates

-          67% with cancellation policies and grace periods

-          70% with the claims process.

-          89% with how well  their patients had been informed or educated

-          Another 89% didn’t expect enrollment to begin on time.
Due to lack of information from the Obama administration and  uncertainty whether exchanges will come to pass, doctors are not expending  energy pursuing information that is not yet available from a secretive, and perhaps unknowing, government.  Therefore, says Shane Jackson, president and COO of, the organization that conducted the survey, “I think it’s logical to say they’re not necessarily seeking out all the relevant information,” he said of the large percentage of doctors unfamiliar with many aspects of the exchanges.
Why should doctors not be confused? The Obama administration  yet to  release details of plans. CMS does not know what health plans will even be in  most  exchanges or whether they will be part of the final networks offered.  How mnay how many patients will sign up for the exchanges remains a mystery.   More than half the states have opted out of the exchanges.  Most employers and their workers are clueless of what to expect.  The federal government has yet to get its act together in forming a computer “hub” that will coordinate and gather data from 7 other federal agencies whose data is necessary to see who qualifies for federal subsidies.  The government seems confused how the exchanges will actually work,  saying only  they expect “glitches” and “bumps in the road.'  
Familiarity, Aesop said, breeds contempt.  In the case of health exchanges,  unfamiliarity breeds skepticism, distrust, and confusion.
Tweet: A survey of 479 doctors reveals confusion and lack of familiarity about health exchanges and what they portend for doctors and patients.

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