Big Data, Obamacare, and Us

by Admin on April 29, 2014

in Patients, Payers

The explosion of data journalism has meant we’re hearing about more polls than ever. So this morning we learned that in a new Washington Post poll Obama’s approval ratings are the lowest ever, especially when people were asked about the Affordable Care Act.  Oh, they’re also low on the economy — don’t forget that! In the next election, we’ll probably have that square dance move in which everyone ends up with a different partner.

Data’s great, but it is sometimes nice to unpack some of it to see why that might be the case. I offer you a case in point from my own extended family. I have urged the members of my family who don’t have insurance to sign up for Obamacare, and some did. What they’ve found out is that there’s a big saving on premiums — in one case almost half. However, some of them, young and uninsured, earn just too much for a subsidy and still not enough to afford the premiums. Those are still uninsured. Others have found their benefits dramatically different under Obamacare.

The saving on premiums comes with a price. The networks seem to be smaller, and contains fewer specialists.Many doctors are waiting to see what the reimbursements will be before they sign on. The co-pays, especially for meds, are higher, and certain medications aren’t covered. Compounding pharmacies do not seem to be covered. The general impression is that nothing is covered.

That’s no different from employer-sponsored health plans, whose benefits get more meager every year..

These are just data points in the sea of “big data,” but they lead a storyteller like me to some conclusions that need testing:

1)the great American cost shift is still going on. Americans with insurance are still paying for the uninsured and the poor, as well as for the administrative layers and shareholder profits of the insurance companies. Nothing has changed here; in fact the trend toward spiraling health care costs is continuing.

2)Worse, most Americans don’t care –if they are not sick. Once they are, of course, they’re forced to become instant experts and they can tell you what the hospital charges for cotton balls are this year.

3)More Americans have decided that it might be time to buy a fitness tracker or become a paleo or a vegan and try to prevent things rather than subject themselves to an apparently dangerous health care system that features sepsis, MRSA, antibiotic-resistant staph, and surgeries by residents who haven’t slept in days.

4)Last, most people aren’t informed enough about either the old or the new systems to be worth polling. Americans appear to be disgruntled with the entire political process, and respond to government in much the same way people from developing nations do: they ignore it, assuming it is corrupt and does not have their welfare in mind.

This is a big change from fifty years ago, when people still had hope for America, and a term like “The Great Society” could be introduced without derision. The last two decades of botched efforts, recessions, revelations of corruption, and self-dealing have numbed the population to most issues. Although we don’t demonstrate in the streets, we don’t pay attention anymore either. In my travels around the world, I have learned that most people feel that way about their governments — they’re not fans.

So the next time you hear about a poll that measures Obama’s approval ratings — or anyone else’s — take a moment to remember that big data is just a bunch of little stories.



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