Every Saturday from 1:30 p.m. to 5:30 p.m., the abandoned Pinckney Community Public Library in the rural town of Pinckney, Michigan flickers to life. Two caravans bearing young professionals in white coats roll up to the parking lot. Once inside, they loop stethoscopes around their necks, shuffle color-coded forms around the front desk, and smooth out paper bed covers on mattresses. One of them swings a sign stamped with the words "Clinic Open" toward the front door. In the cramped back room, a senior medical student is giving a crash course to a second-year on the essentials of heart pharmacology.
By 2010, the United States, with about five per cent of the world's population, was consuming ninety-nine per cent of the world's hydrocodone (the narcotic in Vicodin), along with eighty per cent of the oxycodone (in Percocet and OxyContin), and sixty-five per cent of the hydromorphone (in Dilaudid). As narcotics prescriptions surged, so did deaths from opioid-analgesic overdoses?from about four thousand to almost seventeen thousand. Studies have shown that patients who receive narcotics for chronic pain are less likely to recover function, and are less likely to go back to work. The potential side effects of prescription narcotics include constipation, sexual dysfunction, cognitive impairment, addiction, and overdosing.
Some major health insurers are so worried about the Obama administration?s ability to fix its troubled health care website that they are pushing the government to create a shortcut that would allow them to enroll people entitled to subsidies directly rather than through the federal system. The idea is only one of several being discussed in a frantic effort to find a way around the technological problems that teams of experts are urgently trying to resolve. So far, the administration has resisted the idea, partly because of concerns about giving insurance companies access to personal data.
Initial reports suggest that fewer than 50,000 people successfully navigated the troubled federal health-care website to enroll in private health insurance plans as of last week, two people familiar with the matter said Monday. The early tally falls far short of internal goals set by President Barack Obama's administration in the months leading up to the opening of the HealthCare.gov site Oct. 1, and the low number has worried health insurers that are counting on higher turnout. Technology problems and design flaws have blocked many users from completing insurance applications or creating accounts to use the site, which serves consumers in the 36 states where the federal government oversees the new health-insurance exchanges. [Subscription Required]
Problems with the federal health insurance website have prevented tens of thousands of low-income people from signing up for Medicaid even though they are eligible, federal and state officials say, undermining one of the chief goals of the 2010 health care law. The website, HealthCare.gov, is primarily seen as a place to buy private insurance with federal subsidies, but it is also a gateway to Medicaid, which generally provides more benefits at less cost to consumers. That door has been closed for the last six weeks, with the federal government unable to transfer its files to state Medicaid programs as it is supposed to do.
People trying to sign up for health insurance aren't the only ones confused by Obamacare. Doctors say they don't know what to expect, due to the problems with the federal and state websites. Like many American physicians, Dr. Brigit Britton expects to see a rush of new patients when the Affordable Care Act begins in January. But because of the enrollment problems, she doesn't know who they are, or how many. Britton said she's not sure what challenges doctors will face after Jan. 1. She said, "We are prepped to anticipate large numbers of patients and sicker patients, but beyond that ... we aren't sure what's going to happen."