Notes & Links: October 21, 2013

Yesterdays news today. Sorry but life got in the way of life.

Just How Bad Is That Federal ACA Health Care Exchange Problem Anyway

Tim Worstall, Contributor at Forbes hits us with the good stuff. This was written prior to the speech by Obama on ACA which for now I will allow others with an ax to grind to parse its meaning. Clearly the execution of this technology has failed. And it appears from this article and from Obama’s comments a lot of code will need to be rewritten. Worstall makes a great point and one that is at the core of this issue

It’s not just Java for the script kiddies, for sure, but the complexity is actually in the design, not the programming. That design should have been nailed down two years ago, the code written and then tested for a good 6 months. Rather than what actually happened, which was that the design itself was still changeable into September of this year. That those insiders are still misdiagnosing the problem shows quite how far out of a technical understanding they are. There is this:

This is a good article in light of Obama’s speech. But it is even more important when you consider this Poll: Majority believe healthcare website problems indicate broader issue with law.

Fifty-six percent of Americans say the website problems are part of a broader problem with the law’s implementation while just 40 percent see the website problems as an isolated incident.

The bungled rollout has not soured support for the health law overall, however. Forty six percent now support it while 49 percent oppose it. That compares favorably to a 42 to 52 percent negative split last month. 

Somewhere in this long painful road to healthcare in America is a Harvard Business School. I hope this ends with something more, better patient care, bending of the cost curve, improving outcomes, and just giving Americans a chance to live better

New Obamacare Numbers – Success Or Failure?
Dan Munro contributor at Forbes looks at the numbers from the state exchanges and talks about his experience applying. Today the administration said about 476,000 health insurance applications have been filed through federal and state exchanges. It remains a mystery on how many people have actually enrolled in the insurance markets. But to note a bit over half of those are from 36 states where the Federal Government is running the markets. The remaining half is from state run exchanges. 

Munro ends with this and keep in mind the ACA is the single biggest target on the presidents back and when those of a certain ilk are looking to be haters ACA/Obamacare is what to aim for. 

All of which suggests that rendering a success or failure verdict at this early stage (based almost entirely on the initial and poor performance of the public exchanges) seems premature. Either way, success or failure, one thing remains certain. We’re likely to see a lot more political math between now and the end of the year.

Study adds to growing recognition hat improving graduation rates can improve public health
The Pump Handle on Science Blogs has post by Kim Krisberg looking at new data showing that dropping out of high school increases the risk of illness and disability in young adulthood. Here is the open access to BMC Public Health here

Interesting to note that high school graduation was never singled out as a major public health objective. And the data clearly shows the link between morbidity and mortality. 

Among the results, study authors found that the risk difference for long-term sickness or disability between those who complete high school and those who drop out was 21 percent. And even after adjusting for the accompanying risk factors listed above the risk difference was still 15 percent. 

Krisberg shares some data regarding the US drop rate and the fact it has declined from 12% in 1990 to 7% percent in 2011 with rates declining among whites, black, and Hispanics. Now I guess the question becomes do we use a health strategy to drive getting a high school diploma or do we drive the message that a high school diploma will help you live longer?