Hey, Obamacare Complainers: Regular Insurance Has Tons of Glitches, Too

The implementation of the Affordable Care Act is hitting some bumps, but the bureaucratic snafus are no worse than traditional medical care coverage

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Mike Segar / Reuters

The nation’s new health-insurance exchanges, the online marketplaces for medical coverage that are an integral part of Obamacare, opened for business last week. Immediately the trouble began. Web pages went blank. Attempts to enroll in coverage were delayed, or altogether stymied, as sites crashed. Critics of the law pounced. “Too many unanswered questions and too many unsolved problems,” said U.S. Sen. Orrin Hatch, Republican of Utah.

Yet there’s another way to see these growing pains: as evidence not of change but of continuity for consumers of health insurance in America. With each misstep, government officials are simply catching up to the  record of headache-inducing frustrations produced by the longstanding private medical insurance system.

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Whether you’re one of the 50 percent or so of Americans who already have private health insurance (mostly through an employer, as I do) or one of those who may now turn to the exchanges to buy coverage, the bureaucracy is often maddening. Sure, the Affordable Care Act may seem opaque and unwieldy, but make no mistake: Employer-provided healthcare—which offers plans by the very same companies now on the exchanges—is equally Byzantine. No wonder that only 22 percent of American consumers reported themselves as satisfied with the health care system in a 2012 survey from the Deloitte Center for Health Solutions.

A few weeks ago I had an all-too-typical experience. My insurance company, Anthem Blue Cross, sent me a letter saying, “It has come to our attention that we have been paying for certain . . . drugs that are not covered under your existing benefit plan.” Going forward, the letter added, my doctor would need to prescribe something different or I’d have to start paying for these particular medications myself.

And when would this kick in? According to one part of the letter, January 1, 2014. According to a different part of the letter, right away.

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It concluded with the sentence I’ve come to dread most: “If you have any questions or concerns, please call the customer service number on your ID card.”

Bravely, I did. Forty-five minutes later, I had yet to talk to an actual human being. Finally, at the 50-minute mark, a customer-service representative showed up on the line. She was cheerful and peppy. I was not.

The Anthem representative was unable to clarify anything in the letter and asked if she could put me on hold while she did a little research. I said OK, but I made a special plea: to call me back if we somehow got disconnected. Just a week before, on another Anthem call—concerning a paid claim that Anthem said was unpaid—I’d gotten cut off after an hour or so on the phone. She assured me that she’d call me back, if need be.

Ten minutes later, the representative returned to tell me that the answer to when Anthem would stop covering my prescriptions was neither January 1 nor immediately. It was December 1.

Where did this new date suddenly come from? She couldn’t explain. I asked to speak to her supervisor directly. She countered with a classic chess move: I was put on hold for another 15 minutes. Then: “Thank you for calling Anthem Blue Cross. Good-bye.” The line went dead. Checkmate.

(MORE: Obamacare Chief Defends Rocky Start on The Daily Show)

Despite my plea and the representative’s promise, no one from the company called me back. I have yet to find the stomach to phone Anthem again.

Sure, the implementation of the Affordable Care Act is hitting some bumps, especially in its early days. But before critics falsely brand these as the inevitable consequence of a “government takeover” of our healthcare system, let’s remember that when it comes to medical coverage, bureaucratic snafus are hardly the province of Obamacare alone.

Randye Hoder is a Los Angeles-based writer who regularly contributes to The New York Times’ Motherlode blog. Her articles have also appeared in the Los Angeles Times, The Wall Street Journal, Slate and other publications. She wrote this for Zocalo Public Square.

12 comments
tjp77
tjp77

You cannot be serious. 

Dealing with my private insurer may not be the highlight of my day, but I know that if I call them I will speak to an actual human being within about fifteen minutes, 24 hours a day. I know that their websites work, and I know that if they do have an outage it is usually fixed within hours not weeks. I know that my records will be kept private. And I know that if I do not like the customer experience, there is always someone higher up the food chain that I can complain to, who will usually do whatever they can to make sure I'm a satisfied customer. Oh and if things get really bad, I can always find a new provider. And as a bonus, there isn't a federal agency with a gun to my head forcing me to deal with them. 

These are all things that I have never experienced when dealing with the government... particularly the federal government. I have no idea where liberals get their boundless optimism in the ability of the government to do, well, anything at all, as everything they touch seems to immediately turn to crap. 

mdlujan
mdlujan

It's complex and not meant to be fixed overnight.  It took us many years to get to this first step toward building a better a system. I am encouraged by the dialogue as more information and understanding has come to light throughout the health care reform debate.  I have been in the health insurance business for 25 years and glad to see more engagement from consumers and business owners who finally had enough. I also helped build the CA state exchange so I also have an interest in their success... I think we all do but simply have different ideas about how to get there.  (FYI - Romneycare and Obamacare are ot really that different)

The exchange websites will be fixed eventually and millions of people will get covered (via paper application or telephone if needed). The elimination of pre-existing conditions is a major achievement and will help many finally get covered - with and without tax credits. Some will simply not enroll in anything.  The tax or penalty will help offset the costs we all pay for the uninsured... we don't refuse them care and our premiums have always been loaded for this "hidden tax". 

The enrollment in exchanges will increase as we get closer to the Dec 15th deadline (for coverage effective 1/1/2014). RIght now, most folks are just getting information and no urgency to enroll and pay now.

Ydnarr
Ydnarr

I wonder if there is anyone out there who is actually waiting for REAL data to make up their minds on this. Everything up till now is, at best educated guesses. No comment on which side is right, just curious.

Also, I wonder why the right is so determined to stop this, if they really believe it will be such a disaster. Why not wait a little bit, then sweep into power next election? They would have the votes to do what they wanted, and would get far more done that way= instead of fighting this now, from a weaker position. Are the Republicans really so determined to get in the way of something that could damage the Democrats badly, or is there another concern here?


CTLiotta
CTLiotta

Randye, your argument is invalid because of an informal fallacy of logic called the "tu quoque," or appeal to hypocrisy. 

Specifically, "there are glitches with regular insurance" does nothing to truly answer or explain glitches in signing up for Obamacare.  They are two separate issues that happen to be true, like when you catch a kid smoking and his reply is "well my older brother does it, too!"  Hypocrisy may be bad, but it doesn't negate an argument.

A better article would inform us of what happened, how it's being troubleshot, and what the likely outcome will be.

The tea people, likewise, have been using a fallacy of logic known as the fallacy of composition: that because a piece of something is broken, the entire thing must be broken. So, errors in reason all around.

cloudninegirl
cloudninegirl

These so-called "news agencies" have sold their souls - and their profession - to Satan.

cloudninegirl
cloudninegirl

Another ridiculous attempt to spin ObamaCare into a good thing. HEY HODER .. SPIN ALL YOU WANT. WE AREN'T BUYING YOUR CRAPOLA.

j45ashton
j45ashton

A few points.  As to media dissection, please...all media dissect nothing these days.  That would require time, $ and work.  I haven't seen Fox News dissect anything either.  Just complain.  Saying that Obamacare solves nothing is also ridiculous.   Preexisting conditions no longer disqualify, young people can stay on parents insurance until 26 which is a big help in a tough economy and 17 million people will be able to get insurance who never had it before...which not only aids the national health but these people getting preventive care may lower hospital charges that we all have to pay to make up for these people getting treated in emergency rooms.  And it remains to be seen if health insurance will be more affordable for everybody.

And as to the perennial GOP charge that the private sector does everything better, just google the name of any health insurance providers along with the word 'complaint' and you'll see how great the private sector is.  I have worked in Fortune 100 companies.  I've seen corruption at the top firsthand and have seen mistakes made costing hundreds of millions of dollars.  Please...don't talk about the efficiency of the private sector.  You really are talking through your hats.

littleredtop
littleredtop

The problems that we've all encountered are insurance related.  Obamacare does nothing to correct those problems and doesn't even address real healthcare issues like greed driven doctors, hospitals, insurance companies and pharmaceutical companies.  Forcing everyone to buy insurance solves nothing and only perpetuates and in some cases worsens the real problems. 

Palerider1957
Palerider1957

So typical of Time (and the rest of the MSM). Instead of challenging, questioning the garbage in ObamaCare, you give it cover.
The old deflection and obfuscation of the truth.
Now, had this been a Conservative/Republican thing, you in the MSM would be dissecting it and telling us how it is going to kill people, while you IGNORE what even Obama said about it..
And what did he say? He said: " We as a culture and a society need to make better decisions within our own families and for ourselves, but what we can do is make sure that some of the WASTE that exists in the system, that's not making anybody's Mom better, that is loading up on additional tests or additional drugs that the evidence shows is not going to improve care, that at least we can let doctors know, and your Mom know, that you know what, that MAYBE this isn't going to help, MAYBE you're better off not having the surgery (that can save your life), but taking the pain killer"  - Obama
What he doesn't say is, that MAYBE IT WILL HELP!!!!
Isn't it nice to know that getting tests or surgery that may save your life is WASTE!?
Yes, I am quite sure that is something all the Insurance companies tell their customers!

And Time, could you also explain to everybody why Obama's "We've gotta have a Civilian Security force, just as powerful,  just as strong, just as well funded [as our military] for the securityobjectives "we" have set." is set up, funded and armed through the ACA?
Why does an Army that answers ONLY TO THE PRESIDENT (which by the way, is UNCONSTITUTIONAL) needed in a supposed "Health Care law? Hmmmm?

I don't know Time, with each article you publish, you become more and more irrelevant.

kennyja
kennyja

Yes.... traditional insurance does indeed have its own glitches. However... There is an assumed assurance that when one of these glitches is encountered in the traditional insurance system, that there is some sort of standard mechanism, or process in place to resolve the issue at hand.

This reassurance does not yet exist with the current implementation of the Affordable Care Act.

bill1
bill1

@kennyja Believe me, there is no standard in the private insurance industry.  Just ask your doctor how many people he has working for him just to sort out insurance issues - probably 1 per MD, PA, etc.