By lambert strether of Corrente
On Tuesday, Pravda informed us that the White House was “ramping up” its efforts to market ObamaCare, and that among those efforts would be “a Google hangout Wednesday to promote its enrollment Web site,” www.healthcare.gov [sic*]. Some of us also received a mail blast giving the event details, and inviting us to submit questions via twitter to #HCgovHangout. Needless to say, many of us noted the date and submitted questions, and when the time came, we were not disappointed…. I grabbed the live stream off Google[‘s proprietary site]; here it is:
The two talking heads in the video are Julie Bataille (left), Director of CMS’ Office of Communications, and Kristin Rowe-Finkbeiner (right), Executive Director/CEO and Co-Founder of MomsRising.** (The other co-founder is Joan Blades, also a co-founder of MoveOn.org.) Rowe-Finkbeiner’s presence explains something Donna Brazile said on ABC’s This Week, working her kayfabe routines with George Will and some other Sabbath Day gasbags (clip):
GEORGE WILL: Young people, young people are not going to sign up if they can do elementary arithmetic, which they can. Second, why not just —
DONNA BRAZILE: If their mama tells them to sign up they’re going to sign up.
How are they going to organize that? I asked myself. Now I know. Mom’s Rising is the answer! (That said, though I hold no brief for Will’s viciousness, if I were young, healthy, in debt from college, and facing Obama’s brutal job market, I’d think twice about spending a dime on a defective product like health insurance.)
* * *
We’ll have a transcript of the hangout tomorrow — our transcriber took about ten minutes to do it, which gives you an idea of the depth that Bataille and Rowe-Finkbeiner brought to their “conversation” with us — which I will color code. For today, however, I color-coded the tweets themselves; the exercise yielded some interesting results. Here are the results in tabular form:
(Appendix I shows the coding for the entire stream; the colors to the left of the tweets correspond to the colors in this table.)
From a public relations standpoint, the two most important categories are Publicity (72 tweets; ) and User Confusion (15; ) combined with User Critique (15; ). Why?
Well, there were a ton of Publicity tweets, but they all looked like this, with varying degrees of chirpiness:
On Wed July 10th tweet your question to #HCgovHangout We’ll answer questions live on air. You Tube http://t.co/B4a8kT02SR
— HHSRegion7 (@HHSRegion7) July 9, 2013
Unfortunately, most if not all the Publicity tweets got the URL wrong, resulting in User Confusion tweets like this:
#HCgovHangout Where is the Google Hangout? 2:40pm. Will it go past 3pm?
— Lifelong Educator (@Consultant59) July 10, 2013
#HCgovHangout Trying to connect to the live hangout: Most unsatisfactory experience! No way to connect & no contact info listed for help!
— Fern Shinbaum (@Fernpms) July 10, 2013
And User Critique tweets like this:
wrong link, 15 minute conversation, and no correction with the RIGHT link? #HCgovHangout does not make me feel good about implementation!
— Rachel Fey (@RachelFey) July 10, 2013
@mphippsm @RachelFey Hope you're doing BetaTest of Exchanges now because this kind of thing on Oct 1st would be a disaster! #HCgovHangout
— katiebird (@katiebird) July 10, 2013
(Disclosure: Katiebird worked with me and others to develop questions for #HCgovHangout.)
The next most important set of tweets (“Question: Coverage”) was on what ObamaCare’s health insurance plans will cover (37 tweets; ). Here’s an example:
Will the health plans on the exchanges offer full range of MCH services including midwives and birth centers? @HealthCareGov #HCgovHangout.
— Melanie PhippsMorgan (@mphippsm) July 10, 2013
As we shall see with the transcript in Part II, a few of the more general coverage questions were answered, but specific questions demanding precision — as above — were not. (This is important, because ObamaCare’s mind-boggling complexity makes for a staggering number of very specific questions.)
The final important set of tweets (“Question: Exchange”) focused on how the exchanges were supposed to work, and whether they would be ready by the October 1 deadline (30 tweets; ). Here are some examples:
• #hcgovhangout which of the 50 state #obamcare exchange marketplace 100% complete and in beta testing? Can you give me a status on Ohio?
— Dave Petno (@davepetno) July 10, 2013
I've heard there are problems getting things ready for Oct. Have you started testing the system? #HCgovHangout
— lambert strether (@lambertstrether) July 10, 2013
None of these questions were answered, including other questions on the 10/1 drop-dead date.
Amazingly, a question I posted was answered; I’ll talk about that in Part II as well.
Summing up: The #HCgovHangout launch was a public relations debacle.
1. If the publicity campaign had really been a success, Publicity wouldn’t have been the category with the largest tweet count; real tweets with real questions would have outnumbered the professional PR tweets by at least an order of magnitude. Of course, the announcement appeared at the last minute, only a day in advance of the Hangout. Was this session a dry run? Lack of planning? What?
2. Embarassing technical and user experience failures — wrong URL; no help; no official corrections on the stream; nothing on the principals’ twitter profiles — cannot but give the impression of a program that’s out of control. Given that so many of the aspects of ObamaCare that raise concerns are technical — even after Obama gutted the Exchanges by descoping the employer reporting requirement and income validation — that’s an especially unfortunate impression to convey.
3. Stale videos and a Beltway-style orgy of mutual self-regard by insiders consumed most of the allotted time, giving real tweets with real questions short shrift. This cannot but convey the impression of an administration that’s out of touch.
4. Bataille and Rowe-Finkbeiner shy away from the “Will you be ready by 10/1?” questions. Curious! Or not, eh?
So: Last minute planning, out of control, and out of touch. And maybe out of time. Quite a message. I wonder what the White House will think?
NOTE * Of course, ObamaCare apologists consistently conflate health care with health insurance; the two are not the same, shown most vividly in the fact that health insurance companies profit by denying health care, not giving it. This tactic verges on disinformation.
NOTE ** Look, I’m not against Moms, OK?
NOTE Again, back in the days of steam-powered mainframes fueled with punch cards, LBJ rolled out Medicare to the entire over-65 population in a year. That shows the difference between single payer’s simple and rugged system architecture, and ObamaCare’s underwhelming complexity.
Appemdix I: Coded Tweets
So you can see the coding, here are thumbnails of the #HCgovHangout twitter stream from the first tweet ’til I turned off the recorder at 3:00PM (there are doubtless more tweets following the hangout). You can click each thumb to get a barely readable larger version; technical limitations (a tiny laptop screen) dictate the small size. These thumbnails are screen dumps from the twitter feed, cropped, pasted together, and then color-coded in InDesign; this clumsy manual process has certainly led to occasional errors, which will not substantively affect the chart. As in Twitter, the posts read from the present to the past,
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Also, pie:
49 comments
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One hopes that some day someone will start thinking and then organizing and then executing a Final Solution for Blue Dogs like Max Baucus. It is only then that these cretins will start fearing the mob. Not that Blue Dogs are the only problem – we should be more expansive in our thinking and contemplate the entire ex-Senate porcine gang and every K-Street revolving door whore. A few CEOs would definitely come in handy not to mention ex-Presidents like that man who never had sexual relations with that woman. When accountability has been legislated out then the only accountability instruments are the pitchforks and lamp posts.
Until they are grabbed by their collars and dragged into the streets Nothing will change!
It’s a lot like the old Soviet Union, with much slicker public relations. You have a large, comfortable toadying class enjoying a well heeled parasitic existence so long as they don’t breathe a word of truth. The corporate underlings sucking up to kleptocrat CEOs are essentially no different than the captive journalists prattling the big media line and the tenured academics trumping up bogus research and congratulating one another for myopic stupidities.
They all play let’s pretend and keep cashing the checks, and when the shit hits the fan, it’s who could have known?
Lenin had the obvious solution to all this. He executed everybody. It may be too early to say he was wrong.
[gee, Jake, you can’t mean that?]
I mean its one thing to kill hundreds and thousands of people by denying them access to medical attention while funneling insurance premiums into CEO chalets, but to single out cute little blonde ABC talking heads…….
Cute?
The hardworking gal I take my laundry to (but I load the washers) I’ll take any day (any may yet, if I can) over ANY of those gals.
Proverbs 31:10-31 (New American Standard Bible)
correction: “and may yet, if I can”
But, do you trust her with the quarters?
LBJ didn’t have so many hands up his posterior he felt like a B grade mule in a sex tourism designation Pron flick room appetizer.
skippy… neoliberalism = aka the art of selling your self + people are products responsible for marketing themselves… your soaking in it…
thanks skippy. i’ve always found PR for HMOs to be uniquely sickening. there you are feeling lousy waiting to go sit in the cubicle with someone who doesn’t remember your face or name to write you a scrip after a 5-minute “consultation,” and on the wall you see pictures of caring, happy, healthy patients and drs. all squeaky clean and getting along famously.
i’ve often wondered what most patients think of this dissonance. i guess most people are so used to it from TV it just goes on by them?
as you put it so succinctly, we are now each responsible for making our own PR. it’s work, but we’re not going to ever get paid for the hours we put into it. and if we forget in the process who we really are or what speaking truth looks like, all the better–at our own expense, we can become happy, useful robots always on. and speaking truth is just getting too risky, anyway.
Have family relations in executive positions residing in this industry and what do you think in their primary reasoning is[???]…. mercenary pay.
skippy… when remuneration becomes mercenary… you get… keep the advantage from what you kill… been there done that…
This thing is going to be a f*cking disaster
I’m afraid you’re right.
That inspires confidence. We may not be the brightest lights on the planet but how stupid do they think we are?
And slapping cheezy ideas of American Motherhood onto it? Oy!
shouldn’t user confusion and user critique each be 15, not 30, in the table at the beginning of this piece? they add up to 30, but this user is confused by the 30 in each.
Fixed, thanks.
Lambert, i love this blog and love your “laugh-so-you-don’t-cry” ongoing takedown of ObamaCare.. However, on practical matters, I’m lost – I am one of those “young, healthy” people you mention above – should I just endure the penalty and buy my own insurance? Hope that NYC has a decent exchange? etc. Short of privately hoping for a disaster from which medicaid will be expanded to all, what should I do, strategically speaking?
My understanding is that you can wait to buy, pay a small penalty and then purchase insurance when needed since there is no more preexisting condition exclusions. Young people who have insurance will do the math and drop their current insurance and buy when they get sick thus defeating the whole purpose of the bill of enlarging the pool and spreading the risk. This seems to be the existing meme. If I’m wrong about this, I’m not the only one who is thinking this way. If true, this health plan is DOA and can’t be resuscitated.
But what about emergencies?
Good point. Accidents being the obvious problem in the case of severe injuries. Young people may be inclined to roll the dice here since they generally consider themselves indestructible. The big numbers generally come into play with catastrophic illness or even long treatment resulting from accidental injury. Then it’s time to grab the ipad and sign up with the exchange.
Please someone disabuse me of my understanding of this bill if this is incorrect.
Is this why the Republicans have been calling for this plan to fail all along since they knew the individual mandate was a trap door? Can it really be this stupid?
You’ve stumbled upon one of the many problems with Obama-care. Our healthcare system sucks. Obama-care had two goals. One was to protect the status quo while breaking up the demand for change, and the other was to glorify Dear Leader. Do you remember Obama’s line about “an uniquely American system”? He didn’t care about a good system. He cared about protecting the profits of healthcare parasites and making a name for himself.
In the case of accidents, you will get treated regardless of your ability to pay. Without the insurance, you end up with a big bill, of course. So, the question is what you are insuring against? I would only purchase the insurance if I had a lot wealth at risk. In my opinion, anything less $50K in assets, I don’t even consider buying the policies that are going to be offered if I am under 35 years of age and otherwise healthy. And even between $50-150K, I would have to seriously calculate the risk/reward.
Please don’t give financial advice on this blog.
If you have a bad credit record, you are precluded from a lot of jobs.
And declaring BK is emotionally draining. Plus if you were earning at a decent level of income or have enough assets, like a house, you’ll have to do a Chapter 13. That means 60 months of rice and beans. I’m not exaggerating much. The whole point of a Ch. 13 is to be highly punitive, to make the borrower live as meagerly as possible and extract as much as possible for the creditors.
And as readers of this blog know, even though a BK is supposed to get rid of all your debts, a lot of junk debt is resold and has this nasty way of showing up post BK. You the borrower are broke by design thanks to the Ch. 13 and so don’t have the $ to hire a lawyer to get this fixed.
I’d suggest thinking twice about not being insured.
…exactly…having viewed as friends homes were taken by (Washington) State
for medical bills over last years of life, of uninsured…
The inference that a medical insurance policy will prevent BK due to extraordinary healthcare expenses is unworthy of you, Yves.
As you have discussed many times on this blog, over half of the bankruptcy filings necessitated by large, unpayable medical bills were filed by people who HAD medical insurance.
The craven harassment and abuse of bankruptcy filers does not change that reality. In the event of increasingly common, extraordinary medical expenses, a medical insurance policy is unlikely to prevent financial ruin. This is especially true of the bare bones coverage being peddled as part of Obamacare.
The idea that if you just buy a medical insurance policy, all your medical needs will be adequately and affordably met just ain’t so, Yves, and you know it.
You really think health insurance is a protection against declaring bankruptcy in such instances? You are part of the problem Ms. Smith.
Don’t think of it as ‘health care’. Think of it as a protection racket.
It’s another rent-extraction mechanism engineered by the FIRE sector, government-sponsored and government-enforced. Americans are now required to pay tribute to terminally-greedy owners of the insurance industry.
Banksters: “Your money or your life.”
Americans wanted the government to fix the health care system. So did the insurance industry. So they did. The fix is in.
http://www.despair.com/government.html
+100
… anti-government repubLIEcons are out in force again-so, Medicare is bad??? How about Social Security???…food stamps???…
folks-don’t be led astray by anti-government fundamentalists who wish to use a very poor program to bash government…
it’s issue by issue, program by program….each needs to be debated upon merits of…this particular problem therefore, is bushbama’s answer to bushit medicare part D…corporate $ub$idy…
Shorter Brazile: You have to live it or live with it.
You may already have won!
Wow, they can’t do any better than this? They’re (we’re) sunk.
Lambert is hitting the ball out of the freaking park, compared to the no-show MSM. At the Old Grey Meretrix of Eighth Avenue, the stenographers are still waiting for the admin-approved press release to roll off the wire.
Being ‘sent to the exchanges’ is like the threat that used to terrify English children during the V2 raids, of being ‘sent to Coventry.’
But as the Drone Laureate frequently reminds us, this IS wartime, so sacrifices are required. Some must be sent to the exchanges, in order that others may live and prosper.
“What are they going to exchange me for, Mommie?”
“Money, my child. Money.”
“Being ‘sent to the exchanges’ ” The only thing missing in the supermarket cartoon with the 1950s smiley wifey (rising mom?) is fake soapbars and a sign that says “showers over there.”
lambert sure is. superb journalism, and thanks to those you’re working with too, lambert. thanks, thanks, thanks.
I love your charts & graphs Lambert, but it’s missing the point.
As mentioned in the comments above, this is not meant to work as healthcare. Stop looking at it that way. It’s meant to provide chattel for the insurance companies, with bonus good marks for obama and to split the dissenters.
So they/obama/the D’s DO NOT CARE if it doesn’t work, looks stupid, is embarrassing. Heck most of what Obama does is embarrassing, and they don’t care. If the rent is paid, that is all that matters.
More useful to us puny humans IMO would be charts & links on what to do instead–on how to avoid being forced into medicaid–on how to stop the mandates, etc. Concrete actions & information.
For example: current medicaid guidelines reject a person from qualifying if they own two vehicles (at least in this state). Would that still be enough? Quick Gramma, buy a clunker & save the house.
If forced into medicaid, can one extract oneself?
If one has a current policy, and not much income, would dropping the policy as it soars in cost mean one could just pay the penalty and suck up any health care for the year, and start over the next year?
My insurance, which only covers me if a comet hits me on a Tuesday afternoon, just sent notice it is going up another 15%, and a threat that if I switch to a cheaper plan I will lose being grandfathered in….. to what, they don’t say.
I’m going to ask my insurer and my doc, but frankly do not expect either to tell me the truth.
Trust me, I know it’s all about rental extraction. Sometimes you go for the 30,000-foot view, sometimes one goes for close-in work with the blade….
On the “most useful to us”… Katiebird and I have tried on this; we’ve spent a lot of hours. But it’s not easy. For example, KB, who’s trained for this sort of thing, spent six hours in the library looking for regulations that, we now understand, didn’t even exist — they were part of Obama’s 600-page document dump on July 5. We continue to work on this, and post regularly, but it’s not like there are hidden gems to be uncovered with just a little digging; trying to figure out anything about ObamaCare is the hardest work either of us have ever done. Sure, the exchanges are suppposed to make it easy…
That 600+ pages of regulations really bothers me. I just DO NOT understand how the FINAL REGULATIONS for a project this huge can be delayed to within 3 months of the Go Live date.
Shouldn’t this be in Final Testing Phase at this point (Perhaps on the Congressional Employees) … Has there ever been a complex computerized system that didn’t undergo at least a year of Tests?
Thank you Lambert. Loved it. Obama’s folly turning into Obama’s karma. And all we have to do is sit back and let the entirely rotten “health care system” go bankrupt and despised all on its own power.
“It’s not just the employer mandate: Three [More] Obamacare delays you haven’t heard about”:
http://www.washingtonpost.com/national/health-science/health-insurance-marketplaces-will-not-be-required-to-verify-consumer-claims/2013/07/05/d2a171f4-e5ab-11e2-aef3-339619eab080_story.html
Well folks, we are at the point where rubber meets the road with Obamacare. Clearly, it CAN’T be implemented unless the sun, the moon, and every single star line up AND unemployment is under 5%. The largest retailers and restaurants have pledged to cut employee hours to below 30 – and they can easily do that – because millions are lined up to take part-time jobs.
Here’s the thing with healthcare: it costs more than almost anything, it’s unavoidable, and no one wants to pay for it. We stumbled into employer-funded healthcare after WWII, which works well enough, but because it’s voluntary, it leaves out millions. Obamacare tries to fix that with a number of mandates, but that makes employers try to dodge it using loopholes. Single payer deals with this problem, but good luck getting that through Congress.
“Obamacare tries to fix that with a number of mandates, but that makes employers try to dodge it using loopholes.”
Have you ever heard of cognitive dissonance? Read your sentence again. It might be more accurate to say Obama-care tries to create the illusion of solving problem, but it provides loopholes so no one with any power has to obey the new rules.
Congress merely passed what Obama decided at the earliest stage. This is has been extensively reported on. Every complaint about Congress was the Administration’s attempt to persuade the sheep the President was on their side. Yes, he has significant power over the funding of the Democratic Party and can easily support primary challengers while making certain their is no golden parachute for former Senators and Congressman by simply making sure companies that hire the former electeds less likely to win federal contracts. If those companies can’t get contracts, former Congressmen are just expensive potted plants.
Nothing was “stumbled into”. Any system that’s been in place for 60 years has institutional backing and support at the highest level. Employment based insurance would not exist if it weren’t to someone’s benefit. And it doesn’t benefit us.
As a suggestion for any future “color coding”, I suggest using similar shades for related topics. All user questions/informative type queries would be shades of green, worthless PR-speak and self congratulation in red, etc.
The color coding is interesting but so many different shades are used it’s basically impossible to extract much information from the format. It just looks like a color salad. A slight tweak would make it easy to understand at a glance.
That’s a good idea, semantic colors. The user non-question colors were light yellow to orange, but yes, I could be more systematic. Maybe I won’t forget to do this in Part II.
Fresh Air has an appoligist on right now, basicly dismissing the points raised here. His explination as to why the employer mandate was delayed? It’s not important because it dosn’t affect the employer.
Du, I am not worried about the employer… its the employee I am thinking about here.
”Fresh Air has an appoligist on right now”–
damage control.
i really hope they are reading this blog, too.
Mostly, it was “people will come to live this… in time” line. And of course he trotted out the California numbers which are already arguing a drop in insurance premiums, which I think there is good reason to remain skeptical.
And my eyes rolled into my head when trotted out the old Ragan line “slowing of growth.” The exchanges haven’t even gone on line yet and they are giving us trend data? That is a bit like declaring the winner of a race – before the starting gun gets fired. Just not very credible.
But the whole thing reminds me of the Californian Electric Crises. They trotted out estimates there too that the electric spot market would make electrical power too cheep to meter. Prices began to rise from the starting gun.
I think the low premium rates are a statistical mirage. There is a lot of scrutiny taking place here and the insurance companies are probably competing more for image than any thing else.
But it’s also possible that the decrees in premiums are genuine at this point as for a time there will be genuine competition. But once contracts get set, and regulations get worked out, the competition will quickly vanish, much as it has with part D plans. Far to much of AHA is designed to prevent competition. After all, not every one is even allowed to enter into the exchanges if your employer provides a policy or if you have other options that you don’t have control over. How much competition is even possible when you gate keepers keeping consumers out?
Along with Obamacare, wouldn’t it be just awful if the Transatlantic Trade and Investment Partnership and the Pacific Partnership talks break apart due to the increasing friction among Europeans and Asians deep concern over the widening NSA revelations?
Trust may be a dirty word to our leaders, but still means something to the general populations.
Wow, I fianly watched the video. Its a little female-centric.
The solution to the health care cost crisis is simple – Medicare for all. The infrastructure is in place, administration is modeled and innovation is not required for implementation. Of course, the insurance industry have sworn to a suicide pact, (executives throwing themselves from skyscrapers in metropolitan centers on a yet to be determined future date and time,) if anything approaching Medicare for all were to succeed. Instead of doing something as unbusiness-like as paying legitimate benefit claims, the insurance industry spends millions on negative propaganda to turn people off to practicality and humane choices.