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Health market performance template

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I’m from Kansas City, Missouri, where I grew up a few blocks from Rockhurst High School. So I was predisposed, for purely non-partisan, Kansas City-related reasons, to enjoy Tim Kaine’s speech Wednesday at the Democratic National Convention.

I watched bits and pieces of the speeches from my sofa, near New York, before he came on. The earlier speakers mostly seemed to have gotten their speeches out of the same speech machine. Kaine was a lot livelier, and he really won the crowd over by pointing out that Donald Trump often says “believe me.”

Kaine used repetition of that phrase, combined with descriptions of parts of Trump’s biography that Democrats generally do not like, to cast doubts on Trump’s honesty.

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Go, metropolitan Kansas City guy! (Even if, technically, he grew up in Overland Park, Kansas. Hey, we’re all Royals fans.)

But then I got to thinking about how totally awful the U.S. Department of Health and Human Services (and HHS’s child, the Centers for Medicare & Medicaid Services, and HHS’s grandchild, the Center for Consumer Information and Insurance Oversight) have been about Affordable Care Act performance disclosure.

Various convention speakers got up to talk about how great the ACA is without (surprise!) getting around to mentioning that some of the biggest ACA exchange plan providers do not think the ACA exchange system is so great.

That reminded me of the many congressional hearings on the ACA that have featured Republicans who were pretty mean, and Democrats who were pretty vague.

The HHS equivalent to the potentially credibility-sapping phrase “believe me” would be, “I’m sorry. I don’t have that information with me. I’ll talk to my staff and get back to you.”

Of course, that’s longer, and more awkward, than “believe me.” But to me, it feels as if HHS officials used that phrase about as much per hour during congressional ACA hearings as Trump uses “believe me” per hour during his campaign events.

What would be great is if Donald Trump and Hillary Clinton (and any other presidential candidates who want to play, such as Gary Johnson or Jill Stein) would get past the “I’ll get back to you” stage of ACA transparency and somehow develop an ACA World Performance report card system.

Maybe Trump could provide a list of 20 performance indicators, and Clinton could provide a list of 20 indicators, and a computer would merge the lists, with half the indicators coming from each candidate. 

The candidates would have to pledge, if they won, to post indicator numbers every quarter, or, to explain, in a mildly embarrassing way, why the numbers weren’t available, and describe the parties that might be able to help provide the desired information.

Maybe, if we had an ACA performance report template like that, we’d finally know how many people the ACA Small Business Health Options Program small-group exchange plans really have.

Maybe the candidates could drag the private sector into this and somehow get good, quick data and small employers’ use of stop-loss plans.

Maybe… Gosh, I can’t remember how I was going to end this article. I’ll have to talk to my people and get back to you.

Believe me: It will be huge. 


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