Obamacare Chief Defends Rocky Start on The Daily Show

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Eric Thayer / Reuters

U.S. Secretary of Health and Human Services Kathleen Sebelius at the Democratic National Convention in Charlotte, N.C., Sept. 4, 2012

Appearing on The Daily Show Monday night, Health and Human Services Secretary Kathleen Sebelius faced a friendly pro-health reform host in Jon Stewart, but even he chided the country’s top Obamacare bureaucrat for the rocky start of Affordable Care Act, which has been riddled with computer glitches and crashes.

“The Obamacare implementation has left a lot to be desired. What a great opportunity for the opposition party to offer a reasonable alternative,” said Stewart. “For those of us who are somewhat believing that the opposition right now in Washington are crazy people…it feels like it’s frustrating to defend something that is less than ideal or is functioning at what seems to be a level of incompetence that is larger than what it should be.”

Indeed, the rollout of the first major piece of the health care law has been a mess, which might have created an opening for Republicans who oppose it to argue that the Obama Administration foisted a relatively unpopular law on America and bungled its implementation. But the law’s problematic start is competing with news about the government shutdown that Americans  largely blame on Republicans. This is undoubtedly a relief to Sebelius and the Administration, who have have declined to disclose how many Americans have been able to sign up for new Obamacare-compliant health insurance.

On Monday, Sebelius, trying to explain the glitches and the health care law’s various components to Stewart—from the employer mandate to the individual mandate to new insurance regulations and coverage marketplaces for small businesses—waded into the policy weeds. At one particularly wonky moment, a confused Stewart, trying to understand the secretary’s points, said, “Let me ask you this. Am I a stupid man?”

He’s not. But the Affordable Care Act is complicated. It’s a law with a million moving and inter-connected parts built on a foundation of political compromises that are not easy to decipher or defend. Wouldn’t a single payer system (like the one in place in Britain) have been easier and more fair, asked Stewart. “That may have been a reasonable solution,” said Sebelius, explaining that given Republican opposition to the ACA’s system of subsidized private insurance, a more government-centric plan would have been unpalatable. Stewart nodded. “So this is a system that’s been Jerry-rigged to deal with the crazy people.”

As Time explained in a story in this week’s magazine, the exchanges that launched Oct. 1 depend on young, healthy people signing up for new insurance to subsidize the cost of insuring older sicker Americans. Whether they will buy in depends on many factors, including the price and quality of the insurance plans offered. Some participation, though, might also depend on ease of use. How many young people are hearing about the exchanges and visiting accompanying web sites this week, but then checking out from the process as soon as they hit error screens?

Sebelius pointed out on Monday that uninsured Americans have until mid-December to sign up for coverage than begins Jan. 1. “The good news is you don’t have to buy it today,” she told Stewart. But if, a month from now, it’s still incredibly difficult to sign up for health insurance through a state exchange web site or healthcare.gov, that could affect the balance of the nation’s insurance pool and signal that President Obama’s signature domestic policy achievement may fail to function as promised.

“It started a little rockier than we would like,” Sebelius told Stewart.

PHOTOS: Obamacare: Promise vs. Reality

26 comments
drp83794444
drp83794444

What is needed is to make care a social utility like education and restrain greedy doctors, hospitals and medicine and equipment manufactures seeking disproportionate rewards.

Romy
Romy

Jon's commentary was really uncalled for  at such a critical moment for obamacare,  Sibellius failed to shut him up with the correct answer: we need the mandate  in order for Obamacare to succeed in keeping the policies at a low cost.  If young people do not contribute  , there are not enough funds and the costs will be higher for all.  you should know this,  john, shame on you!  makiing such a stupid argument instead of encouraging young people to join instead of expecting hospitals to care for them at the expense of others!!! I watch and like your show every day its on ,  but I could not believe my ears tonite,,,making obamacare look flawed. Single payer will never get passed with the type of republicans we have inherited, and you know this,  this is the best and at least a beginning for people to get HC that never could otherwise.If it is able to survive , it can also be improved uon.

MedicalQuack
MedicalQuack

Sad and it's the same thing I said since she was nominated in 2/2009 and you can read that here that health IT will eat her up, need someone with "some" tech background in office. I used to write code so I'm one of the geeky folks that sees things ahead of others and chooses to open my mouth at times:)

http://ducknetweb.blogspot.com/2009/02/kathleen-sebelius-kansas-governor-for.html

DeParle too, both of them no contest for the extreme math models and algorithms used by insurers, duped and duped again...again from what I said in 2009...

http://ducknetweb.blogspot.com/2009/03/nancy-ann-deparle-and-kathleen-sebelius.html

Watch the Rachel Maddow interview last night, same scripts..but Rachel was nicer and I posted both.

http://ducknetweb.blogspot.com/2013/10/jon-stewart-talks-to-kathleen-sebelius.html

This is not personal as SEC has same problem with a non technologist at the top and we all suffer the Algo Dupings they incur. Don't know what Algo Duping is? Videos done by folks smarter than me explain and tell you when you might need to be a skeptic..Algo Duping 101 (insurers duped her like crazy as she was no context at all to their extreme math models and algorithms for business) and the resultant Attack of the Killer Algorithms as I see it...

http://www.ducknet.net/attack-of-the-killer-algorithms/

WalterScotten
WalterScotten

You can't delay the individual mandate because that is in part what funds the health care program. That is the basic answer Sebeliuos should have told Stewart. I hope Stewart will read this answer somewhere because it is something they both should have known. 

WalterScotten
WalterScotten

   The Secretary did a terrible job of explaining why the employer mandate was delayed and why the individual mandate was not.  By delaying the employer mandate the health care program would not lose funding. Even the people working for employers that don't provide insurance would have to purchase insurance.  Obamacare is funded by the individuale mandate. If you delayed the individual mandate then you cut about half the revenue that insurance companies receive in exchange for not denying pre-existing conditions, not cancelling people when the get sick and offering screening as part of the policy.  I was shock Kathleen Sebelious could not give this correct answer, especially at this time.   

RevDrLeRoy
RevDrLeRoy

The major concern seemed to be why it has been difficult for many people to sign up or even to open an account.  The problem she never addressed is that no matter how much a system might be tested there is no way to test it with large number of people until you get large numbers of people accessing the site at one time.  At least that is the  way it appears to me.  Even after  systems have been in use problems or bug may arise so there are people standing by to solve those problems.  I have a son-in-law and a daughter -in-law who do that.  It seems to me that what is happening is not unusual.


TakingUpSpace
TakingUpSpace

Re: "Wouldn’t a single payer system (like the one in place in Britain) have been easier and more fair, asked Stewart. “That may have been a reasonable solution,” said Sebelius...."

Sebelius obviously hasn't read such reports as these about the UK's universal healthcare system:

http://www.midstaffspublicinquiry.com/report

http://www.telegraph.co.uk/health/healthnews/8536172/Hospitals-failing-to-provide-basic-care-for-elderly.html

http://www.curethenhs.co.uk/news/bower-and-mid-staffs-inquiry/

Moreover, because Obamacare puts the cart before the horse, consider:

"People respond to incentives, although not necessarily in ways that are predictable or manifest. Therefore, one of the most powerful laws in the universe is the law of unintended consequences." -SuperFreakonomics

With that in mind, see:

"Obamacare: Making a bad situation worse" http://relevantmatters.wordpress.com/2012/05/21/obamacare-will-make-a-bad-situation-worse/



Fastgirl
Fastgirl

If Obama can't even a create a little website that works why should Americans trust him with our healthcare? Americans were sold a bill of goods by Obama.

Anon583
Anon583

You really missed the meat of the story Ms. Pickert. You write this article as if you watched a completely different interview than the one I and many other media organizations watched. "Sebelius faced a friendly pro-health reform host in Jon Stewart..." That was a confrontational interview with a cabinet member dodging questions, sticking to talking points while the opposing party, Stewart, dealt with her as a hostile witness. That does not come across in your analysis, but is perhaps the key takeaway from their conversation.

"But the law’s problematic start is competing with news about the government shutdown that Americans largely blame on Republicans. This is undoubtedly a relief to Sebelius and the Administration..." Why would that be so? The issue of the Affordable Care Act's implementation is of primary import and directly tied into the government shutdown. It's not competing with another issue. It is the single issue at the direct center of attention in all this mess. It couldn't possibly be receiving any more attention.

"At one particularly wonky moment, a confused Stewart, trying to understand the secretary’s points, said, “Let me ask you this. Am I a stupid man?" He wasn't baffled for lack of understanding the complicated nature at the law. He said that out of frustration for having to ask the same question repeatedly without receiving an honest straightforward answer from Sebelius. He was employing self-deprecation, with a surface level reading as you implied, yes. However, based on his body language and similar ways in which he has responded to other guests when he is grilling them and not getting a proper response to a reasonable line of inquiry, he was really asking her if she thought he was stupid for not buying the line she was trying to sell him.

You didn't even mention perhaps the single most important part of the entire show. Following the interview, before the show closed, Stewart gave a rare brief statement in which he again reasserted that Sebelius had failed to properly address his concerns of the controversial nature of delays in implementation for big businesses but not the individual mandate, forcing single parties and families into perhaps not being able to afford insurance under the new plan or otherwise be subject to a fine. Stewart then slammed her attempts at avoiding the question, openly wondering if perhaps she had lied to him in her non-answers. 

Hudymae
Hudymae

After a week there is confusing, it is still better than no health insurance. It will straighten itself out even though people who are against it will make it into a big deal.  The big deal is everyone can have health insurance like other civilized countries. Insurance companies get more customers, they will just have to do more for their money and our citizens will be healthier. Republicans only talk about money and don't think about people unless it is themselves, the haves. But sending our jobs overseas, supporting too many wars, crushing unions, and women's health care, forcing religious ideas on our nation and most of all never considering any of the countries problems has taken it's toll on all of America. We are a nation of people, not simply money. They had a chance to work on the Affordable Care Act and didn't take it. They could have helped but it would have been the help for all the wrong people, the ones they made poor then won't help. 

BruceStrong
BruceStrong

This is Great News, the government just saved about 100 Million with President Oblamo cancelling his Asia trip -- Further proof that the Federal Shutdown is working... Long live Boston and "taxation without representation"... Think American Revolution!

Please give it a rest, the sky will not fall and things will continue as always... Stop the hype, pleaseeeee! blah, blah, blah So let's not talk about it and maybe our CREDITORS will just go away... 16.7 Trillion and counting, boy am I glad I don't have kids! President OBlamo strikes again...

JeffBennett
JeffBennett

@Romy I'll agree that Jon was surprisingly agressive during the interview.  However, I can understand where he is coming from.  The system is showing some of it's flaws, which we knew was going to happen.  ACA isn't perfect by a long stretch but its a huge step in the right direction.  Sebelius didn't go on there to help quell fears about the rocky start.  She was there to spin numbers to make things look far less flawed than they really are.  It was a terribly implemented strategy at that as well.  Jon asked a very pointed question that should have had an answer Sebelius would know off the top of her head if she wanted to REALLY sell that the marketplace is working.  How many people have purchased health insurance through the marketplace?  This number would be readily available to her no matter if its a million or zero.  Since she didn't indicate otherwise and considering the scope of technical issues plaguing the marketplace, people will read between the lines that the truth is closer to zero than anything else.  All she had to do was produce a number that she should have immediate and constant access to.  It only shows that one of two things were happening in that moment.  Either she really didn't know (which as the administrator of the program, would be the single most important number to watch) or the number is so bad that it would be better to feign ignorance than to reveal it.  Don't get me wrong, I wholly support the ACA and I am hopeful that it'll be vastly improved as time goes on.  However, don't go on a show that has a reputation of calling out BS and expect to work solely on talking points.

Romy
Romy

@WalterScotten exactly my point! made above.  thanks for explaining it more clearly, I was too upset with Jon to worry about my typo. No edit button for these postings?

Romy
Romy

@Fastgirl any site that gets over bombarded with too many hits , crashes.! It will be fixed,   and should not be a reflection on the plan itself , its a website glitch, and most people understand this.

whjunk
whjunk

@Anon583 I agree, her inability to answer a relatively simple question was the most embarrassing part of the interview. She even approached the answer a couple of times before veering off again into what appeared to be her "script". She was completely unprepared for an interview, much less one with Stewart. (Either that or she's really easily rattled.) 

The answer, of course, is that the employer mandate is a secondary or tertiary detail that doesn't cost much to delay and doesn't affect a large number of uninsured Americans. (Many of them can simply use exchange policies for 2014 so they won't remain uninsured.) On the other hand, the individual mandate is the core element in keeping premiums low, which benefits the vast majority of currently uninsured, and would incur huge costs to the program if it did not go into effect at the same time as the exchange policies. 

She could also have pointed out that for those who can't qualify for medicaid, but still can't afford even heavily subsidized premiums, the penalty may be waived. (She probably wouldn't want to point out that the IRS has very little enforcement power to collect it other than to withhold it from your tax refund, if any.) I really think she had the answer but for some reason was completely unable to articulate it and would retreat to her talking points.

barneydidit
barneydidit

@Hudymae And the ultimate irony is that when the House was controlled by Democrats in 09, they passed a Public Option bill that was MUCH more popular than Obamacare with the general public, AND still allowed almost all Americans to obtain health care if they needed it. But Republicans in the Senate filibustered it, declaring it to be "socialist", so now they're stuck with Obamacare...which in the super ultimate irony...was a Republican idea in the first place. 

TakingUpSpace
TakingUpSpace

@ViableOp 

Yes. Before Obamacare, Democrats considered insurers to be scummy profit-mongers. Now insurers may become richer than ever.

chuck3
chuck3

@BruceStrong Your comments are not credible when you used false phrases like "100 million" and then begin name calling.

Fastgirl
Fastgirl

Excuses, excuses, excuses. You sound just like the man you worship. If Amazon, Google, Apple and Microsoft had started out this way they wouldn't be in business today. Customers deserve better. And yes they are customers even though Obama used their money to create something that doesn't work,

BruceStrong
BruceStrong

@chuck3 @BruceStrongOK how is this: Just think about it for a minute, in 2008 the Federal debt was 10.2 Trillion dollars. It is now 16.7 Trillion and we have to RAISE the debt ceiling once again! That's 6.5 Trillion more debt in just 5 years, we can no longer afford to bankrupt our kids future... Let's put the Federal credit card away and live within our means!

BruceStrong
BruceStrong

@barneydidit @BruceStrong @chuck3 let me please explain, the national debt was 10.2 Trillion in 2008, the start of President Obama's administration and now it's 16.7 Trillion, you can do the math can't you?

chuck3
chuck3

@BruceStrong @chuck3 Just gave you a bunch of facts that document how we got from 10 trillion to sixteen trillion. Which ones do you deny?

barneydidit
barneydidit

@BruceStrong @chuck3 Wait...."facts don't matter to you"?  So it's not a fact that we're paying for two unfunded Republican wars and Medicare Part D (and the interest on Reagan's tripling of the debt)?  I'm confused Bruce...help me out. 

chuck3
chuck3

@BruceStrong @chuck3 I was commenting on your false $100 million claim. As for the 16.7 trillion, we have to pay for two unfunded Republican wars, an unfunded Medicare expansion by a GOP administration, and a crashing of the economy, also under a Republican administration.


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