How Kentucky Built the Country's Best ACA Exchange 333
Hugh Pickens DOT Com writes "Dylan Scott writes at TPM that Kentucky, with its deeply conservative congressional delegation, seems like an unlikely place for Obamacare to find success. Instead, Kentucky's online health insurance exchange has proven to be one of the best, and shows that the marketplace concept can work in practice. Kentucky routinely ranks toward the bottom in overall health, and better health coverage is one step toward reversing that norm. It started with the commitment to build the state's own website rather than default to the federal version. On July 17, 2012, a few weeks after the U.S. Supreme Court upheld the Affordable Care Act, Democratic Gov. Steve Beshear created the exchange via executive order, over the objections of a Republican-controlled state legislature, which sought other means — including an effort to prevent the exchange from finding office space — to block the site's creation. ... Testing was undertaken throughout every step of the process, says Carrie Banahan, kynect's executive director, and it was crucial because it allowed state officials to identify problems early in the process. ... From a design standpoint, Kentucky made the conscious choice to stick to the basics, rather than seeking to blow users away with a state-of-the-art consumer interface. It 'doesn't have all the bells and whistles that other states tried to incorporate,' says Jennifer Tolbert. 'It's very straightforward in allowing consumers to browse plans without first creating an account.' A big part of that was knowing their demographics: A simpler site would make it easer to access for people without broadband Internet access, and the content was written at a sixth-grade reading level so it would be as easy to understand as possible."
Hey rest of the country.... (Score:3, Insightful)
Kentucky did better than you did. One of the most ass-backwards hillbilly clueless groups of people around. And they beat you. Completely.
That's... Very very sad.
Re: (Score:2, Informative)
And they play a mean banjo too. I saw "Deliverance".
P.S. A widely used technique in American humor has long been to have an outwardly unsophisticated character who is actually more insightful than the superficially sophisticated characters. In the spirit of the Appalachian-American(1) stereotype, it looks like Kentucky has brought humor to real life.
(1) Bo Duke said that this term was now preferred to "hillbilly".
Re: (Score:3)
And they play a mean banjo too. I saw "Deliverance".
P.S. A widely used technique in American humor has long been to have an outwardly unsophisticated character who is actually more insightful than the superficially sophisticated characters. In the spirit of the Appalachian-American(1) stereotype, it looks like Kentucky has brought humor to real life.
(1) Bo Duke said that this term was now preferred to "hillbilly".
You obviously didn't pay much attention to Deliverance or Dukes of Hazzard. Both are set in northern Georgia.
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His geography levels test out at under sixth grade level.
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So was Hazzard County.
Re:Hey rest of the country.... (Score:5, Insightful)
We Kentuckians aren't all ass-backwards anymore than all Californians are LA gangsters or all New Yorkers are mobsters.
If you want to say "an economically depressed state with generally fewer technological resources than others beat you" then fine. But try to avoid stereotypes mmmkay?
KY gets it (Score:5, Insightful)
Subject pun intended.
What is with all the websites which launch with a bunch of stupid bells and whistles? Just get the core functionality working, and then worry about the pretty pretty. Most sites never really make it that far, but they implement the gewgaws and glitter anyway.
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>> and then worry about the pretty pretty
For that matter, most sites can forgo pretty altogether.
Google, Zillow, Amazon, Wunderground were all more usable and useful when they were simple.
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Re:KY gets it (Score:5, Informative)
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The bells and whistles in those cases are perhaps more to generate buzz among non-nerds. If I go to say university website and it has all the information (like address) I need in plain black text on plain white background, and I can ctrl+F and get on with my life in a second, I appreciate that. However, for every one person like me who doesn't want any frills, there are a dozen sill
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The bells and whistles in those cases are perhaps more to generate buzz among non-nerds. .
I don't believe that for a second. Non-nerds want an attractive page to look at and a design that works well. Most AJAX I see looks to me like someone is padding his or her réumé.
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Re:KY gets it (Score:4, Insightful)
In fact, perhaps it is time to repost this on Slashdot for today's fresh audience of developers, lest our classics be forgotten:
The Rise of Worse is Better [jwz.org]
I and just about every designer of Common Lisp and CLOS has had extreme exposure to the MIT/Stanford style of design. The essence of this style can be captured by the phrase ``the right thing.'' To such a designer it is important to get all of the following characteristics right:
I believe most people would agree that these are good characteristics. I will call the use of this philosophy of design the ``MIT approach.'' Common Lisp (with CLOS) and Scheme represent the MIT approach to design and implementation.
The worse-is-better philosophy is only slightly different:
Early Unix and C are examples of the use of this school of design, and I will call the use of this design strategy the ``New Jersey approach.'' I have intentionally caricatured the worse-is-better philosophy to convince you that it is obviously a bad philosophy and that the New Jersey approach is a bad approach.
However, I believe that worse-is-better, even in its strawman form, has better survival characteristics than the-right-thing, and that the New Jersey approach when used for software is a better approach than the MIT approach.
Let me start out by retelling a story that shows that the MIT/New-Jersey distinction is valid and that proponents of each philosophy actually believe their philosophy is better.
Two famous people, one from MIT and another from Berkeley (but working on Unix) once met to discuss operating system issues. The person from MIT was knowledgeable about ITS (the MIT AI Lab operating system) and had been reading the Unix sources. He was interested in how Unix solved the PC loser-ing problem. The PC loser-ing problem occurs when a user program invokes a system routine to perform a lengthy operation that might have significant state, such as IO buffers. If an interrupt occurs during the operation, the state of the user program must be saved. Because the invocation of the system routine is usually a single instruction, the PC of the user program does not adequately capture the state of the process. The system routine must either back out or press forward. The r
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Its called the iterative process. Make small thing test it run it verify it, make small test it run it verify it... Do it in small chunks so you can at least have a shot at having your integration work worth a damn.
I worked on one project totally hit all the marks. Hit all the performance, memory, blah blah blah... Nice simple iterative project. Just continue iterating and the project would have new features every 1-3 weeks. Another group took over didn't like the 'style' (naming) thought it was 'too ha
Attn: Slashdot Socialists!! You Are Screwed. (Score:2, Interesting)
Something Bad is going to happen, because Obama called upon his Bottomless Well of Executive Power to delay the Employer Mandate unilaterally, fearing political fall-out for the 2014 elections should millions upon millions of previously-covered workers be dumped into the exchanges.
Will this happen? I don't know. But here's what I do know: Obama sufficiently feared this possibility to violate the Constitution and delay his own beloved pet boondoggle to avoid the possibility of it.
Right now we are talking abo
Re:Attn: Slashdot Socialists!! You Are Screwed. (Score:5, Insightful)
I agree with your criticism of Obamacare. The answer is to have real "socialism", like in Canada, Japan, Australia, and most of Western Europe. Then we could save a third off the top. Total US healthcare expenditures are 50% greater as a percentage of GDP than any other country, for no more care and no better results.
I'm too much of a cheap bastard to worry about ideology.
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Re:Attn: Slashdot Socialists!! You Are Screwed. (Score:4, Insightful)
Good theory, but do you have an example of that working in the 21st century? If not, I'll stick with facts and empiricism, and go with what works in dozens of countries around the world.
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Good theory, but do you have an example of that working in the 21st century?
I see you chose to exclude the 20th century where health insurance did work.
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For who?
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And I see you chose to ignore my question. Stop living in (a largely imagined) past Golden Era. It was cheap when they couldn't do much for you.
Re:Attn: Slashdot Socialists!! You Are Screwed. (Score:4, Informative)
That is simply not true. Life expectancy. [gapminder.org] Infant mortality. [gapminder.org] Deaths from burns. [gapminder.org] Drownings. [gapminder.org] Deaths from falls. [gapminder.org] Deaths from poison. [gapminder.org]
Pick any metric that you like and you'll see similar results. The reality is that the U.S. paying FAR more than virtually all other countries for health care and getting demonstrably poorer results than many, including most of Europe. (We're tied with the Marshall Islands with Tuvalu and Niue close behind. Everyone else spends far less than we do.)
Worse, if you set any of the graphs in motion it becomes blatantly clear that for the past several years, we have been spending ever more on health care and seeing next to no improvment. It's most blatantly obvious in the case of infant mortality but the same trend is clear for virtually all variables. Meanwhile, country after country following more 'socialist' models are seeing far better results from the dollars that they spend.
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There are some of us in other parts of the civilized world that just go WTF at the total mess that is the US Healthcare System. To say it is Fucked Up would be generous.
Thank god the politicians on all sides got together towards the end of WW2 and gave birth to the UK's NHS. Paid for out of general taxation and free at the point of delivery to everyone. I pay approx $200/month out of my earned income but even that ends when I reach official retirement age. from then on it is free. No loss of benefits if you
Hello? (Score:2)
Health exchange sabotage (Score:5, Insightful)
In effect the deliberately obstructionist Republican governors put the entire project at risk, and now the Republicans are screaming that it doesn't work. They are sick manipulative bastards who will do anything to get their way.
By the way, a friend of mine just signed up through the California exchange, and it was not a big deal. If the people in charge want it to work, they can make it work. If they want it to fail, they can make it fail. The Republicans want government to fail, so it does. By analogy, it's like going to a doctor who thinks medicine is bunk, and he proves it by having his patients die. In both a literal and figurative sense, Republicans are happy to see Americans die.
Re:Health exchange sabotage (Score:5, Interesting)
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New York did a damned poor job advertising its own exchange... this is the first I've heard of it. Most people in states with their own exchanges are still probably trying to get on the Federal site, which certainly won't help the current issues.
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I couldn't get the federal site to work long enough to get that far. Ended up Googling it and went directly to the NYS site. The cheapest insurance option offered was only $10/mo less than I have now and the whole thing was a huge pain in the ass if you're looking for anything remotely specific (hearing aid coverage in my case), but it's workable if you have patience.
On the bright side, I already had an ID and didn't need to re-register thanks to using the surprisingly decent NYS DMV website in the past.
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I think you are cutting the Republicans too much slack. The current crop of faux Republicans want to destroy trust in government. That way the voters will decide on less government. The Tea Baggers (and I include that Svengali, Grover Norquist) are even worse than that. They want to destroy the rest of the world's trust in the U.S. so that there will be no "foreign entanglements". Their belief is just the same as it was in the 1930's, that if the U.S. leaves the rest of the world alone, it will leave the U.
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You mean the whole bit where the United States decided to embargo Japan instead of leaving them the fuck alone which prompted Japan to contemplate an attack on Pearl Harbor?
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Wow, somebody really wasn't paying attention in History class when covering 1933-1941. Newsflash, the US didn't embargo Japan just to be dicks, they did it b/c the Empire of Japan had spent the previous years fucking up Manchuria.
Ironic (Score:5, Insightful)
I found it amazingly ironic that the states which take the hardest stance on wanting to do everything their own way because the federal government can't possibly know the nuances of their state needs nearly all chose to let the feds make the ACA website for them.
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More like "the Feds want an Exchange, let them pay for it".
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Yes, it's amazing that the states led by people who don't believe the law is Constitutional don't want to have a hand in ripping the Constitution to shreds.
What hypocrites!
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The Republicans want government to fail, so it does.
So true! Ideally, it would also fail in a manner to generate business for the 1%.
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If the people in charge want it to work, they can make it work.
So, what you are saying is that the Obama Administration wanted this to fail, because they are in charge of healthcare.gov. Not only that, but they were able to get this law written however they wanted. They chose to have the law written so that it would be their responsibility if the states did not choose to build their own exchanges. They thought they were blackmailing the states into setting up exchanges. The Republicans governors said, "Our voters don't want this system. You are insisting in forcing thi
Comment removed (Score:3)
Different states = experiments (Score:5, Interesting)
A point I've read in The Economist, and has really stuck with me, is how one of America's strengths is the somewhat loose federation of the states, which allows for different approaches to any given problem. Each state can try its own approach to the ACA, or education, or taxation laws, et cetera. Eventually the "better" approaches should become clear, and the country as a whole will adopt them.
Now in practice it doesn't always work like that, but I think we see it in action right now with marijuana legalization and gay marriage.
Of course, the federation also means that, in cases where the "best" approach is known a priori, we lose efficiency when some states fail to adopt it. I don't consider that a big problem, because I think politicians are rarely capable of identifying and engendering quality programs right from the start, especially at the national level.
Let's hope the rule proves true here, and that other states copy Kentucky. (Maybe Kentucky can even share the code?)
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A point I've read in The Economist, and has really stuck with me, is how one of America's strengths is the somewhat loose federation of the states, which allows for different approaches to any given problem. Each state can try its own approach to the ACA, or education, or taxation laws, et cetera. Eventually the "better" approaches should become clear, and the country as a whole will adopt them.
And that's one of the biggest weaknesses as well. Confederacy was tried twice and both failed.
Look at the struggles of the US building infrastructure like broadband - a loose organization of municipalities and states means thousands of separate jurisdictions to deal with.
Corporations can exploit various differences and form in one state, do business in another - to avoid or partially avoid laws, etc.
Answer's in the question (Score:2)
weeks after the U.S. Supreme Court upheld the Affordable Care Act, Democratic Gov. Steve Beshear
There's your answer right there.
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Well the Democratic leaders of Healthcare.gov sure didn't manage to make a usable site. So party affiliation has less to do with it than you think.
Testing and feature prioritization? (Score:5, Insightful)
So with so many projects you have too many cooks who have their own internal priorities and the result is the wonderful British expression, A Dog's Breakfast.
Did the article author actually attempt to apply? (Score:5, Interesting)
Because I'm on my fourth online application and kynect had me in some sort of infinite loop purgatory (in which I wasn't allowed to complete the application process) for the past three weeks. This morning, I finally got a message asking me to upload additional documentation.
For what it's worth, the Cabinet for Health and Family Services is in charge of Kentucky's exchange. The same Cabinet which is responsible for child welfare and has a history of hiding information [kentucky.com] about child fatalities which occur under their watch.
World flipped upside down (Score:4, Interesting)
US about to be the world's biggest oil exporter.
NSA shutting down foreign surveillance while maintaining domestic surveillance
Kentucky is a model for a government-run IT project done right
Did Hell [gotohellmi.com] freeze over or something?
Comment removed (Score:5, Insightful)
Re:Wow. (Score:5, Insightful)
Re:Wow. (Score:5, Informative)
To quote wikipedia.
"The study, the most comprehensive study of literacy ever commissioned by the U.S. government, was released in April 2002 and reapplied in 2003 giving trend data. It involved lengthy interviews of over 90,700 adults statistically balanced for age, gender, ethnicity, education level, and location (urban, suburban, or rural) in 12 states across the U.S. and was designed to represent the U.S. population as a whole. This government study showed that 21% to 23% of adult Americans were not "able to locate information in text", could not "make low-level inferences using printed materials", and were unable to "integrate easily identifiable pieces of information." Further, this study showed that 41% to 44% of U.S. adults in the lowest level on the literacy scale (literacy rate of 35 or below) were living in poverty.[2]
A follow-up study by the same group of researchers using a smaller database (19,714 interviewees) was released in 2006 that showed some upward movement of low end (basic and below to intermediate) in U.S. adult literacy levels and a decline in the full proficiency group.[3]"
The less literate seem likely to be over-represented in the users of these exchanges.
Re:Wow. (Score:5, Insightful)
Re:Wow. (Score:5, Insightful)
From a rational standpoint, the incentive is to wean those adults off of govt programs,
When you "wean" a baby off milk, you don't do it by starving them to death. You do it be introducing desirable alternatives. Yet the "wean" usually discussed is more like a drug treatment plan cold turkey. That's not a wean. If it is a wean, please specify the alternative they are being weaned onto, and how it's more desireable for the person being weaned than what they are on now.
It is extremely difficult to reintroduce the shame and stigma of receiving charity once a generation of children have grown up in families almost wholly dependent on govt programs and it is only that reintroduction which will cure the disease.
What are you, Catholic? We need to control people through guilt and shame? Really? That's a US view that's not seen elsewhere. And, having been to places where being on the doll/benefit isn't looked down on the way it still is in the US, the US has the worse system and still more "shame" to it. Yes, kids in school get picked on for having discount lunches. I've seen them beat up for it. And you want to make life harder on them because you feel there's insufficient "shame".
Shame and guilt are a sign of a conscience which is what keeps people from misbehaving without the need for the use of police force.
Doesn't work for corporate executives. They show shame and guilt when ordered by their lawyers, and yet offend at a rate greater than any minority slums (they just have legal representation to get the charged dismissed/reduced)..
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So your idea of reforming welfare is to humiliate the recipients, remove children if there's any failure on weekly drug tests, and throw them off on a fixed schedule. I fail to see anything positive, like trying to help them get useful skills and become employable.
Last I looked, most people got on welfare because they hit a hard spot, and stayed on welfare for an average of three years (which means a lot of people on for a year or two for every welfare queen). The large majority are trying to get off w
Re:Wow. (Score:5, Insightful)
I can't believe I'm responding to an AC.... but I hate this ideological shit.
I'm a progressive. I believe capitalism can build good things if government creates the basic infrastructure so that people can get on with their lives. I believe !@#$ing selfish "I got mine, fuck everyone else" Righties take that basic infrastructure for granted.
"negative effects of govt programs which have fostered dependency" You're pulling that out of your ass. I grew up POOOORRRRR... we got WIC, food stamps, lunch assistance. I got Pell grants to go to college. I assure you, I've paid back every dime and then some through my taxes. That's how the system is supposed to work, that's how it often works. You give someone a hand up, and they pay it back. Yes, there are exceptions. No, they are not the rule.
"the incentive is to wean those adults off of govt programs" Like what already happens?
"inherently destructive and dysfunctional as Obamacare" How would you know? We've barely started the damn thing. And what's so !@#$ing wrong about making everyone buy medical insurance? Where's the government takeover? What's the problem here?
"The moral hazards of charity" /eyeroll
"It is extremely difficult to reintroduce the shame and stigma of receiving charity " We're in the biggest recession since the !#$!ing Great Depression. Now is a fine time for a little charity. So fuck off. And we all know the "recovery" is fine at the top, but it's not over down here at the bottom.
"wholly dependent on govt programs" I hate this one most of all. My neighbors are Poor. 30 years old, 5 kids. They are the nicest people on the planet, they give, they have a wonderful family.... and they work HARD. Harder than me, harder than you. I grew up poor. I've seen it. Poor people work HARD. Often they have 2 or 3 jobs, they wake up early, the work late, they go to work sick so they don't get canned. Their KIDS work under the table! Fuck your myth of government dependance. If that family is getting help from the government, I'm happy for them.
If companies would pay a damn decent wage in this country, they wouldn't have to work so hard. But all those chain stores (which seems to be most of our economy these days) can pay low wages, and that's that. The companies COUNT on the government to pick up their slack with assistance.
"progressive political ideology seeks to eliminate all societal standards of behavior and the very concept of of personal responsibility" I never knew I was such a bastard. Here I thought I was for building basic infrastructure and getting the hell out of the way so everyone can make a buck and get on with their lives. I thought I wanted well regulated economic institutions, so we all can get on with our businesses without fearing undue risk with our protected money. Here I thought I just wanted justice for those that fucked our entire economy. Here I thought I just wanted the government to mind the constitution and not wiretap folks without at LEAST a rubber stamped warrant.
If progressives have one weakness, it's that we want things to be FAIR. We want a level playing field. Joe Millionaire Senator Buddy shouldn't be able to murder and hooker and get away with it just because he's rich. Rich people SHOULD pay more taxes ON THEIR EXCESSIVE wealth, because by the nature of DOING BUSINESS, they USE MORE OF THE INFRASTRUCTURE and BENEFIT FROM IT MORE than we little poeple do.
What bastards, us progressives.
The whole post above is an ideological rant that demonizes "the other guy". It's all too common, and I apologize for my own part in it above. Most Righties just want to be left alone. Everyone hates taxes. Everyone hates beaurocratic stupidity and money wasting. People feel powerless these days and it's too easy to blame "Them". But please, everyone, don't demonize the other side.
Also, I'm kind of hating how all these stories lately digress into ideological wars instead of commenting on the original topic. Kentucky built something good, to help it's citizens. Good for them! I hope it works.
Re:Wow. (Score:5, Funny)
http://xkcd.com/1133/
The only flying space car that's taken anyone to another world.
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I love that one.
Re:Wow. (Score:5, Insightful)
"[T]he content was written at a sixth-grade reading level so it would be as easy to understand as possible."
They really are setting the bar high in Kentucky.
Yes they did.
It's far more difficult to write simple and easy to understand text than it is to simply copy & paste legalese.
The target demographic of this site is every adult living in the state, so it should be accessible to every adult.
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The target demographic of this site is every adult living in the state, so it should be accessible to every adult.
You're on the wrong website. The GP is in the spirit of things, as he pretends to have a larger penis because he can read on a 7th grade level.
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There are obviously people here who [have] never read a book in their life that wasn't required by some teacher.
Re:Wow. (Score:5, Insightful)
"[T]he content was written at a sixth-grade reading level so it would be as easy to understand as possible." They really are setting the bar high in Kentucky.
What I want to know is who they had to waterboard to get insurance companies to provide information about their policies written at a 6th-grade level...
Mine alternates between issuing cryptic tomes (with pictures of happy, smiling, healthy people on the front, naturally) that alternate between dense medical-billing-and-coding jargon and EULA-like 'eh, you'll discover what we don't cover after you've had the procedure' disclaimers.
As much as I enjoy making fun of the developing world, why should we permit vital, allegedly mutually-consensual, contracts to be couched in language that a substantial portion of the people who 'agree' to them aren't capable of understanding? Without mutual understanding, much less mutual consent, centuries of contract law are reduced to a mockery.
Re:Wow. (Score:5, Funny)
What I want to know is who they had to waterboard to get insurance companies to provide information about their policies written at a 6th-grade level
They probably had someone outside of the insurance companies do the translating, though I do prefer your waterboarding approach. Oh, that sounds so harsh. Better to call it "enhanced contract interpretation".
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That's the plan.
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The cryptic stuff comes because they used techno-geeks to build the sites. The techno-geeks talked to the insurance geeks and the new Geek-O-Rama was stillborn.
It is really hard work creating good user interfaces. Skimp on that or turn it over to people who don't converse well with the regular society and we get crap interfaces we have to suffer from. And it doesn't necessarily restricted to gui elements. I especially love the Verizon phone jungle where you can go around loops which are 9 interactions long:
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"What I want to know is who they had to waterboard to get insurance companies to provide information about their policies written at a 6th-grade level..."
Arguably no one. Much of the point in the exchange was that it provides a few tiers of identical insurance levels that don't allow for dropping of preexisting conditions or much BS. This is why these plans cost a bit more than the really cheap cut rate plans, because they can't drop you for the most part. So in reality the government set the standard, whic
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What I want to know is who they had to waterboard to get insurance companies to provide information about their policies written at a 6th-grade level...
One benefit of Obamacare is standardizing insurance policies for what they will cover, eliminating many fine print items (like pre-existing conditions, age restrictions, setting standard limits for copays and out-of-pocket expenses). The only major differences are deductible, premiums, and doctor's network within an insurance class on the exchanges. This makes it much easier to make apples-to-apples comparisons and actually makes the free market of the exchanges work better for consumers.
Chicks doing birth control (Score:3)
"I'm all in favor of chicks doing birth control, but personally, the pill isn't gonna do me any good. Why should that be on MY policy?"
1. Chicks hate it when you call them Chicks. The "doing birth control" doesn't make you sound like a winner either....
2. Are you planning on having sex sometime? Then the Pill is indeed going to do you some good. I'll give you a tip (phrasing!)... Your chances of having sex will go up if you don't spout this stupid crap in front of women.
3. The whole point of insurance
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It's just a matter of facing the reality of public education in the US.
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Theoretically we could represent every number like this: 1111111 instead of 7. So why do we have any numbers other than 1? Because it's much less work to write 1234 and manipulate those four digits than to write or type one thousand two hundred thirty-four 1's and count and/or manipulate them.
Or, referring back to Randall Munroe's Up Goer Five [xkcd.com] the term "helium" is shorter and more precise than "that kind of air that makes your voice funny." When I explained this to my nephew who's in kindergarten the latter
Re:Wow. (Score:5, Interesting)
Re:Wow. (Score:5, Interesting)
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It's good to hear from you two on this. A local perspective is always a plus, even on such a common topic as a functional website.
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Common occurrence? Functional website? Are you sure you meant to use those phrases in the same sentence?
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"[T]he content was written at a sixth-grade reading level so it would be as easy to understand as possible."
They really are setting the bar high in Kentucky.
Despite per-pupil costs of public schools quadrupling over the last 50 years [ed.gov] (inflation-adjusted), mere 30% of 8th-graders nation-wide are deemed "proficient" in reading [mediamatters.org]. Kentucky did the web-site right, even though their average [ed.gov] is slightly above national.
We are now all set for our healthcare to become the same sort of dizzying success, that the public schools already are.
Re:Wow. (Score:5, Insightful)
While training to be a journalist in the 1970s we were taught to write at that level also. Reading at that level will take you through The Atlantic, National Geographic, Outside Magazine, Consumer Reports, The New Yorker, WebMD, Wikipedia, Reuters, Washington Post, New York Times. Considering the state of literacy in America, "setting the bar higher" would be stupid for a website designed to serve the public with health issues. If you happen to think this bar is too low, try walking into a classroom where kids have to learn to read, and teach them. Try teaching people to read when they grow up in poverty, a big problem in all states, including Kentucky. I've lived there. My own father had to get a GED because when he was in ELEMENTARY school he had to drop out to get a job so his family could get by. Over-privileged, over-bred, snarky people may look down at the unwashed masses. But those who grew up in comfortable homes with parents who had the time and resources to focus on their kids' education have lived soft lives. They haven't had to rise above it. In my childhood my father knew I had to graduate from high school. He told me he'd beat the hell out of me otherwise. But even though he knew the value of a high school education in the workplace, he still had no concept of the value of college. I've had to struggle to get where I am today, and many of the people I lived with in Kentucky still struggle just to make a living. I hated living there and won't do it again, but I'm damn proud that Kentucky, one of those states people laugh at, a Tea Party foothold, had the foresight to do something right that our glorious surveillance president couldn't get it right. And no, I'm not a right-winger. Just the opposite.
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Re:Wow. (Score:5, Informative)
"[T]he content was written at a sixth-grade reading level so it would be as easy to understand as possible."
They really are setting the bar high in Kentucky.
That's pretty standard for text intended for the general public. Newspapers have traditionally been aimed at a sixth-grade reading level too.
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"[T]he content was written at a sixth-grade reading level so it would be as easy to understand as possible."
They really are setting the bar high in Kentucky.
FWIW, "Harry Potter" is written at a "Sixth Grade" reading level although a number of kids start reading that book in third or fourth grade.
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The average American reads at a "Seventh Grade" reading level [wikipedia.org] so targeting "Sixth Grade" gives you a wider audience.
Re:Wow. (Score:5, Informative)
Eh, they just wanted the bar set so Rand Paul could understand the site. Mitch McConnell is SOL though.
Rand Paul graduated college and medical school, and passed certification of American Board of Ophthalmology — before running for Senate and winning.
I'd wager, his reading comprehension is above that of most people — yourself included.
McConnel has "only" a bachelor degree of formal education, but that's still well above most people... Whatever your beef with your political opponents, sneering at their education only makes you look ridiculous [usatoday.com].
Re:Wow. (Score:4, Informative)
Rand Paul graduated college and medical school, and passed certification of American Board of Ophthalmology — before running for Senate and winning.
Rand Paul isn't board certified by the American Board of Ophthalmology--at least he hasn't been since 2005. Yes, he passed his board exam in 1995, but rather than recertify (like every other doctor has to), he opted to create his own "National Board of Ophthalmology" with himself as president. (see wikipedia [wikipedia.org] if you don't believe me)
To be fair, it does take a certain amount of intelligence to give the middle finger to your accrediting board and create your own professional board "shell" company. Doesn't say much for his ethics or proficiency at ophthalmology. I guess that's why he went into politics, those traits likely serve him well.
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To be fair, it does take a certain amount of intelligence to give the middle finger to your accrediting board and create your own professional board "shell" company. Doesn't say much for his ethics or proficiency at ophthalmology. I guess that's why he went into politics, those traits likely serve him well.
Ok, what does that "say" for his ethics? Providing competition to the state-backed monopoly on a category of medical care sounds ethical to me.
Re:Wow. (Score:5, Interesting)
Here's the thing, per the wikipedia page, which is as much research as I care to do about this, he got the board certification from the ABoO, then formed the NBoO because he and about 200 other ophthalmologists got their knickers in a twist about having to recertify, let that fall apart, then reformed it right before his original certification ran out. As of now the NBoO isn't recognized by anyone. That's problematic.
Certification is incredibly important in medical fields. If the chef at a restaurant doesn't know his stuff, you're gonna eat a steak that's overdone, if your ophthalmologist doesn't know his stuff, then you're blind for life. Someone's gotta be making sure that our doctors actually know what they're on about, the price of them screwing up is too high.
If you genuinely disagree with that, then let me know the next time you need surgery, with three days notice I can be board certified by the National Board of AreYouFuckingInsane Surgery, and I'll beat anyone else's price for your surgery by 25%. Don't worry dude, I"m like, totally qualified. I saw it on TV once.
Oh, and real quick before anyone brings up the whole recertification thing, Even if you're the best damn ophthalmologist in the world, if you don't keep up with the current science, you'll fall behind in much less than 10 years. The big bad secret about medicine is that we still don't really know how the human body works, we've just got a pretty good set of guesses, but we figure out ways that we're wrong all the time. Hell, I'm a paramedic, I deal with disease processes that we understand pretty well, and I have to recertify every 2 years, including proving I've done a whole bunch of continuing education.
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"Whatever your beef with your political opponents, sneering at their education only makes you look ridiculous."
That's some pretty big talk from a person who's sig line is: "Somewhere in Chicago a community is missing an organizer."
Here's one for you:
Whatever your beef with your political opponents, sneering at their community service only makes you look ridiculous.
I'm not from Kentucky but (Score:5, Insightful)
The takeaway should be the that the KY developers properly understood that they need to make the site as widely accessible as possible.
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Re:Not all republicans are republitards (Score:5, Insightful)
Well, the democratic governor did it via executive order while the republicans tried to deny them office space to do the work. I wouldn't give the republicans too much credit. This seems more of a success in spite of them not because of them.
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Excuse me, could you clarify the color references in your post?
Specifically, "yellow dog", "blue majority", and "coal vouchers".
Thank you.
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"A fellow once advertised that he had made a discovery by which he could make a new man out of an old one, and have enough of the stuff left to make a little yellow dog. Just such a discovery has Gen. Jackson's popularity been to you [Democrats]. You not only twice made President of him out of it, but you have had enough of the stuff left to make Presidents of several comparatively small men since; and it is your chief reliance now to make still another."
-- A. Lincoln
They would vote for a literal yellow dog. Blue is the color used by news outlets for democrats. Red is used for republicans. coal is not a color. It is a resource mined in easteren kentucky.
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Actually Appalachia went "red" a long time ago, only slightly behind the rest of the South. Excellent article on it here:
http://www.washingtonpost.com/sf/national/2013/10/26/a-blue-states-road-to-red/ [washingtonpost.com]
Re: (Score:2)
Technically: Affordable Care Act in the US (or "ObamaCare") Health Insurance Exchange, where people are able to shop for and purchase health insurance that meets federal requirements.
Officially: A TLA (Three Letter Acronym) that is US-Centric and probably half or more of the folks in the US don't even know what it means, so never mind the folks outside the US who have better things to worry about than more TLAs.
Re: (Score:2)
An ACA Exchange is a joke (the joke's on you and me). Health care exchanges have been tried and did little or nothing to improve things. They're a pretense to have some sort of free market competition inside of a government mandated system, which only seems like a contradiction only because it is. Either throw everybody to the scum, or have either a properly regulated system of non-profits or the government as a universal health insurer. That works everywhere else, but we have to maintain a pretense and get
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Healthcare is full of fake non-profits. They're NP because they "donate" care to the needy - though in reality they are required to treat everybody by law, and they write off the debts which they find they can't collect though the court system. Nearly every NP hospital has a team of lawyers which clog the judicial system chasing payments from non-paying patients.
Exchanges are a purely republican idea, though not without merit if there is actual competition. I'm still baffled why the ACA didn't take the simp
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They didn't go with opening the FEHB or any other large government option to the population because the Republicans rightfully feared that given the choice people would have picked the government option, if you have to deal with a large bureaucracy anyway why wouldn't you deal with the one with a 1.5% overhead cost instead of a 20% overhead cost?
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Obviously you haven't seen the other ACA exchanges. I browsed through it and it's loads easier to figure out than the NY or federal sites.
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You haven't surfed the internet much lately. Many sites do a multiple re-direct that prevents the use of the back button from working correctly. It's annoying as hell, but it's not uncommon.
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Yeah, it did that to me too. Like so many other sites over the years that have some sort of auto-redirect function. Going back just reloads the redirect function.
So right click on the 'back-arrow' so a menu drops down, and choose the page from before the redirect page. No real reason to complain about it.
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I got rid of all of the buttons on my browser to save viewing space. For most sites, hitting the Backspace twice quickly will get you where you want, but in the case of the Kentucky site I had to hold it down to get past the redirections, so it seems while it's not unusual, it's a little more annoying than most.
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Thank you dear Drudge reader. Did you see the one about the homeless high schooler too?