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Medical Costs Bankrupt Patients; It's the Computer's Fault

nbauman writes "Don't get cancer until 2015. The Obama health reform is supposed to limit out-of-pocket costs to $12,700. But the Obama Administration has delayed its implementation until 2015. The insurance companies told them that their computers weren't able to add up all their customers' out-of-pocket costs to see whether they had reached the limit. For some common diseases, such as cancer or heart failure, treatment can cost over $100,000, and patients will be responsible for the balance. Tell me, Slashdot, how difficult would it be to rewrite an insurance billing system to aggregate a policyholder's out-of-pocket costs? 'A senior administration official, speaking on condition of anonymity to discuss internal deliberations, said: "We knew this was an important issue. We had to balance the interests of consumers with the concerns of health plan sponsors and carriers, which told us that their computer systems were not set up to aggregate all of a person's out-of-pocket costs. They asked for more time to comply."'"

8 of 637 comments (clear)

  1. Re:A cynic's view by gander666 · · Score: 5, Interesting

    This.

    The mess is deep and wide, and likely still has some duct tape applied to cover up the Y2K transition. Many/most of these systems are ancient, and creaking under their own mass.

    --
    Suppose you were an idiot and suppose you were a member of Congress ... but I repeat myself. - Mark T
  2. Just curious by Trailer+Trash · · Score: 5, Interesting

    By what legal authority did Obama delay this implementation?

  3. Re:A cynic's view by cusco · · Score: 5, Interesting

    The last time I had to deal with the insurance programs they were nothing more than a web GUI hiding a dumb terminal interface. Most are still on mainframes.

    --
    "Think about how stupid the average person is. Now, realise that half of them are dumber than that." - George Carlin
  4. Re:A cynic's view by AK+Marc · · Score: 5, Interesting

    Sadly, the reason we can't comprehend the problem is that nobody will make intelligent decisions. With "only" 300,000,000 records, and probably not more than 100 q/s (which should be restricted to UID, as privacy is important), the thing could run on any of a number of cheap and ubiquitous databases. Use off-the-shelf querying programs for reporting. Standards-based interfaces, and require other systems connect in standards-based ways. Instead, we have ancient systems built in the '70s and such on unusual languages with proprietary interfaces, and everything new needs to connect back with the old interface. When 30% of your systems are big-endian and 30% little endian, and 30% some bastardized undocumented middle endian (just making up a worst case, hopefully it's wrong), integration costs are large.

    Burning the place to the ground and starting over would be cheaper. The problem is they never figure that out until after the first hundred billion dollars are spent. And the bigger problem is when they do burn it all down and start over, the never remember to lock the politicians in first.

  5. Re:A cynic's view by i.r.id10t · · Score: 5, Interesting

    Which is funny, because my health policy company (whatever BCBS in Florida is called this month - FloridaBlue I think?) sends me a statement every month of what was charged, what was paid, what I paid. And at the end of the year they send a nice summary for tax filing purposes. Heck, hte pharmacy the family uses - Publix - has a "year to date" on each receipt we get for prescriptions.... so, it obviously isn't impossible, or even too hard....

    --
    Don't blame me, I voted for Kodos
  6. Re:A cynic's view by dkleinsc · · Score: 5, Interesting

    In most polls on the subject, including some internal studies by the Republican Party, younger voters don't exactly like the Democrats, but think the more prominent Republicans are so insanely dangerous that they won't even consider them. I mean, running down the list of everyone who has made it onto the Republican presidential ticket in the last decade:

    - George W Bush: Flat-out incompetent, with policies that: bankrupted the US treasury, gutted FEMA and then stood by while a major American city was destroyed, started 2 wars on false pretenses, willfully broke at least 5 of the 10 amendments in the Bill of Rights, ignored counterterrorism until it smacked him in the face with the biggest intelligence failure in US history, and caused the greatest economic mess since the Great Depression. The Republican Party has done its best to minimize his influence on the current campaigns.
    - Dick Cheney: Admitted war criminal, and the architect of many of the bad policies of George W Bush.

    - John McCain: In his first key decision as a would-be president, chose Sarah Palin. If he'd wanted a woman, he could have gotten someone at least competent like Christine Todd Whitman.
    - Sarah Palin: She was stumped by the question "What magazines and newspapers do you read?" Enough said.

    - Mitt Romney: Didn't know where Iran is, which I would think is kinda important if you're president. Announced that he didn't care about the fate of half of the citizens of the country.
    - Paul Ryan: Produced budget after budget where the numbers, based on ludicrous assumptions (like 20% economic growth), fail to add up. And that's his area of expertise.

    As for the last round of Republican primary candidates:
    - Rick Perry and Newt Gingrich: Both at least appear to be racists, whether intentionally or not. That's a big deal to the growing percentage of young people who aren't white, and also to the significant percentage of white young people who oppose racism.
    - Rick Santorum and Michelle Bachmann: Both have made it quite clear that their religious beliefs will trump scientific or statistical or factual evidence where the two conflict.
    - Herman Cain: Had no actual factual understanding of any of the issues, as anyone who listened to an extended interview figured out pretty quickly.
    - Ron Paul: Insightful about some stuff, also nuts about some other stuff. By all appearances, he believes the US government should not be in the business of issuing money.

    So who is this Republican that is not going to be seen as incompetent, corrupt, or crazy?

    --
    I am officially gone from /. Long live http://www.soylentnews.com/
  7. No so much by rsilvergun · · Score: 5, Interesting

    Obamacare is really an attempt to create the sort of socialism that Americans can stomach. I got a good buddy with some serious health problems who relies on gov't health care (got several actually, because if you have a health problem it isn't long until you die or need help from the gov't unless you're an Heir/heiress).

    Anyway, I started asking him what he was gonna do. How would he use private insurance. Wouldn't they insurer just keep raising his rates. He said that would be wrong, and so somebody should do something 'bout that. I asked who, and how and he said there should be a law that the insurance companies could only charge so much.

    Basically he, like most Americans, deep down want single payer health care. But we're been taught from cradle to grave that socialism is bad. We're indoctrinated. It's called cognitive dissonance. He knows he needs socialism to live. He knows he needs help, and he knows it's his right (as a human) to live. Not just to have some blind dumb chance at good luck, but to actually have a life. But he's been taught, over and over, lied to and lied to. So he breaks down.

    Obama recognized that there's lots of people like that. So he's giving them what they need (socialized health care) but doing it in the only way he can. He's letting the devil have it's due, and he's going to give billions and billions to parasitic insurance companies who's only purpose is to make us feel better about getting something that's a basic human right.

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    1. Re:No so much by Maxo-Texas · · Score: 5, Interesting

      I get your point if we were talking about a million dollars a year to keep them alive.

      But in many cases it's as simple as getting a colonoscopy now if you have money vs in january if you don't (true story - and yes in america).

      It may be as simple as $6000 worth of pills a year to stay alive and healthy.

      In a country as wealthy as america is, you have to ask how we can let people die.

      It's not about suckers- it's about if you are willing to chip in a couple grand a year to make sure everyone in the country does well vs letting 40% of the country die an average of five years sooner. It's really appalling.

      I guess if it were 60%- we'd already have decent health care. But talk radio has done a lot of damage. I listened to a guy on the local conservative talk radio.

      He was 59-- his unemployment was about to run out- he wouldn't be eligable for social security until he was 62. He was going to lose his house-- his wife was divorcing him.

      He couldn't get a job. And being conservative- you know he tried. And he was railing against unemployment. Saying we shouldn't extend it to 99 weeks.

      He was literally slitting his own throat- he was so brainwashed.

      --
      She was like chocolate when she drank... semi-sweet at first and then increasingly bitter.