One of my biases is that I want everyone to be happy, and to have wonderful health insurance and wonderful doctors.
I want all health insurers to exist in a universe where they report record-breaking revenue and profits each quarter, and all producers to exist in a universe in which they exceed all possible sales quotas, get to take all possible incentive trips, and generally do great.
I want all actuaries and other forecasters reading this to exist in a universe in which their predictions are all right and they can tell everyone, “Heh heh. I told you so!”
I want all people who work on HealthCare.gov to exist in a universe in which the site works well.
I can believe that it’s possible that any conceivable health reform strategy can succeed in some universe or another. I can believe that the Patient Protection and Affordable Care Act (PPACA) will fail miserably, that it will still work out perfectly, or that some other outcome will occur.
But it’s hard for me to have much confidence in people who spout talking points, especially about routine matters.
Example: I dial in to media calls organized by the Centers for Medicare & Medicaid Services (CMS), an arm of the U.S. Department of Health and Human Services (HHS) that oversees the agency that handles the HHS PPACA implementation job. It’s very nice that CMS sends me announcements about the calls, and I’m sure the people who run the call are nice, smart, dedicated people who have what, to them, seem like great reasons for saying what they say and how they say it.
But one thing I always want to know is how activity is doing. How many people are submitting applications, choosing plans, or taking some other concrete step, per hour, per day, or per week?
Today, a CMS representative started by listing HealthCare.gov glitches CMS has fixed and wonderful improvements CMS has made.
When a reporter asked about activity numbers, the CMS rep gave such a long, complicated, talking-point-intensive answer that my brain lost its ability to process sound. The gist was: We gave you numbers last week, you dirtbag. Now, scram!
On the one hand, people can be too obsessed with short-term results.
On the other hand, it ought to be easy for CMS to come up with some easy-to-produce hourly or daily activity statistic. Simply saying what the number was, whether it was high or low, without embarrassment, might help convey the idea that CMS knows how it’s doing and is confident and open enough to talk about the bad days as well as the good days.
On the third hand, maybe the inability to produce a daily activity number is a sign that CMS folks aren’t especially confident or open.