Problems with Vermont Health Connect at crisis stage, lawmaker says

A legislative leader said Wednesday that ongoing problems with Vermont Health Connect have reached crisis levels in communities across Vermont.

Rep. Mike Fisher, chairman of the House Health Care Committee, said myriad issues affecting people’s health care coverage has led to frustration and uncertainty in the lives of thousands of Vermonters, a sentiment echoed by advocates and providers.

Rep. Mike Fisher, D-Lincoln, chairman of the House Health Care Committee, hears testimony at the Statehouse in Montpelier. Photo by Roger Crowley/for VTDigger

Rep. Mike Fisher, D-Lincoln, chairman of the House Health Care Committee, hears testimony at the Statehouse in Montpelier. Photo by Roger Crowley/for VTDigger

“It’s just untenable to continue to be in this situation,” said Fisher, a Lincoln Democrat facing a re-election challenge in November.

If the situation hasn’t improved when lawmakers return in January “everything is on the table” to find a legislative fix for the issues that plague the state’s online health insurance market, he said.

Thousands of people have problems with their coverage – those with commercial plans and those on Medicaid – that can take days or weeks to resolve, creating uncertainty for many when they go to the doctor or try to fill a prescription.

In addition, it was revealed that an estimated 22,000 Medicaid beneficiaries have lost their coverage in the past three months because they were unable to, or have not tried to, complete their annual reviews on the Vermont Health Connect website.

State officials announced a federally approved remedy to provide retroactive coverage to those affected, but providers say those people still show up as not covered when they obtain services.

“We are getting more and more calls from really irate people,” said Trinka Kerr, director of Vermont Legal Aid’s Office of the Health Care Advocate. Many of those calls are coming from “people that were initially really excited about their coverage,” she said.

The overall picture presented to lawmakers, who described the update as “disheartening,” was of a well-intentioned program that’s still in disarray. Despite continued work on the site, progress over the summer has been minimal.

Health Care Reform Chief Lawrence Miller said he’s not satisfied with the pace or quality of the work being done by the state and its contractors.

Secretary Lawrence Miller testifies in front of the House Appropriations Committee Tuesday. Photo by Alicia Freese/VTDigger

Lawrence Miller. VTDigger file photo

“There’s been a lot of work and no evident progress for consumers,” Miller said. “It’s nothing that needs to be scrapped, but it’s definitely something that needs some work and remediation.”

The primary problem is the same as it has been since the beginning of the year — users can’t correct mistakes they made putting information into the website and they can’t use the website to make changes in their coverage to reflect qualifying events in their lives.

Those issues must be handled through the Vermont Health Connect call center, which with the help of a recently hired contractor, has created a process to “elevate” cases in which a mistake or change is preventing someone from accessing care or is holding a medical claim in limbo.

Providers and navigators, who help people enroll and solve issues with their coverage, said that process still requires hours on the phone. Issues that don’t meet the fast-track criteria take days or weeks to be resolved. Access to care fixes that are not initiated early in the day often get pushed to the next day.

There is a backlog of more than 14,000 corrections and changes that need to be made in people’s coverage or personal information in order to ensure they’re covered.

That number has grown despite additional contractors working to reduce it. When the backlog was initially reported in the spring, there were 10,000 pending changes. Figures from the state show it has resolved close to 7,000 in that time.

Many of those changes could affect people’s eligibility for Medicaid or subsidies they’re currently using to pay for health services. That could exacerbate the poorly understood reconciliation process the users will have to complete at tax time.

MEDICAID MELTDOWN

The state is still investigating why only an estimated 45 percent of people who needed to renew their Medicaid coverage in the past three months have actually done so, Miller said. The typical rate is closer to 90 percent.

The people affected were on Medicaid before the Affordable Care Act increased the program’s income threshold and many are close to or below the federal poverty line. Many are children and families.

Medicaid eligibility is reviewed annually, a process that was previously done through a paper form mailed to beneficiaries. Now people must go onto the Vermont Health Connect website to renew their coverage.

The state took a hiatus from doing reviews last year to allow the Vermont Health Connect website time to improve. When it resumed reviews in April, state workers became concerned by the low return rate.

Providers and navigators say that for months people who think Medicaid covers them aren’t showing up as covered when they go to fill prescriptions or visit the doctor.

Instead of the paper form that people are accustomed to, beneficiaries received notices from the state asking them to log on to Vermont Health Connect to confirm their eligibility. People can also call the call center or work with a navigator to complete their review.

“It doesn’t look like noticing was done correctly,” Miller said, suggesting the notices sent to beneficiaries might not have had the proper information.

“They’re still trying to track that down,” he said.

The state apparently had not anticipated that low-income Medicaid beneficiaries might have trouble using a new Web tool to renew coverage, that they might not seek help from navigators or that they might not recognize the notice as a substitute for their renewal form.

Some beneficiaries who did try to use the Vermont Health Connect website to renew may have ended up in the “change of circumstance bucket,” if they made a mistake entering their information, Miller said.

A mistake could be something as small as using an abbreviation in an address, and must be fixed by calling the busy Vermont Health Connect call center.

Those people’s changes are now in a queue with the thousands of other changes being requested.

The federal Centers for Medicare and Medicaid Services gave Vermont permission to reinstate people who lost coverage for that reason. But if people think they’re not covered, they might not seek services, advocates say.

The state is assuring beneficiaries and providers that services will be covered retroactively and is asking that denied claims be held and resubmitted after Aug. 1 to give the state time to try to resolve the issue.

Updated 10:36 a.m. Thursday: State officials clarified the number of Medicaid beneficiaries who lost coverage because they did not or were unable to complete their annual information update.

Morgan TrueMorgan True

Comments

  1. Darcie Johnston :

    Sounds like the 2nd year of VHC could be worse than the first. So, when does someone get fired and when do we STOP wasting taxpayer dollars? This is what the legislative leaders should be demanding NOW.

    • Keith Stern :

      People will be fired when the voters wake up to the incompetence and the failed beliefs of the liberals running the state.
      It is time to return to common sense politicians who can understand simple economics and use the reality of what Vermonters must deal with every day.

      • Walter Carpenter :

        “People will be fired when the voters wake up to the incompetence and the failed beliefs of the liberals running the state.”

        For the record, Us liberals were not in favor of these exchanges:). These exchanges have gone the way they have because of their desire not to leave any insurance company behind. Us liberals saw this coming. But, because it is federal law, we had to deal with them. Us liberals want a workable system like Medicare, for example, which is not nearly so complicated as these crazy exchanges, and actually works.

        • Glenn Thompson :

          That’s funny Walter, the ACA law was written by liberals, passed into law by liberals and Democrats without the support of *any* Republicans, and signed into law by a liberal president. If my memory serves me correctly, every liberal in the State of Vermont supported the ACA law and supported the development of this Vermont Health Connect fiasco. If the state’s Liberal and Progressive politicians can’t fix it….get out of the way and let someone else fix it.

          • The Republicans in congress for political reasons wouldn’t have voted for the ACA no matter what! It was part of the Boehner/McConnell plan to unseat the President by saying “NO” to everything Obama… also don’t forget that the insurance industry lobbied hard against the “public option” thereby eliminating a choice between it and the ACA health insurance plan.

        • Keith Stern :

          You say it works but many healthcare providers will disagree.

    • Patricia Crocker :

      All of the legislators involved in passing Act 48 need to be fired..by the people in November!

      • VHC is in no way, shape or form anything like Act 48’s “single payer/universal health care. Medicare is the only comparable plan. Medicare is simple and effective and was developed before we became so dependent on IT vendors.

        VHC is an overly complicated, and expensive insurance plan as the IT mess points out…Act 48 is not.

  2. Its time to scrap this system. We’re throwing good money after bad to save face.
    Vote for me, and I will develop an immediate containment plan to get people rightfully insured.
    Concurrently, we will migrate the customers off of the failed, unreliable, unsecure Vermont Health Connect system to private insurers working, reliable systems.
    Lets consider this a lesson to be learned from.

    • Tom Pelham :

      Rep. Fisher has Chaired the House Health Care Committee for a number of years now. He has been a primary crafter and legislative overseerer of the current Vermont Health Connect he now finds “untenable”. Here he is in 2012 with a more embracing view of Vermont Health Connect and clearly excited about his involvment in its creation.

      • Eric Johnson :

        Representative Fisher’s pre-disaster comments are unbelievable… he was totally incompetent in his ability to craft a realistic and workable plan for the Health Exchange… he brags about his risky plan to “go all in” and require all Vermonters and small businesses to purchase insurance via a yet to be built website.

        Fisher’s abilities at oversight of the implementation and operation of the Vermont Exchange are equally incompetent.

        Fischer, I know you’re reading these comments… PLEASE do the right thing for all Vermonters and RESIGN from the Health Care Committee immediately, you’ve failed.

      • Kathy Callaghan :

        Mike Fisher has unfortunately been too excited about single payer too, and shows the same inability to see the forest for the trees on that one.

        One would think he could understand that the same people who brought you Vermont Health Connect and all its catastrophes, will be the same people running his favorite single payer plan.

    • “Vote for me, and I will develop an immediate containment plan to get people rightfully insured.
      Concurrently, we will migrate the customers off of the failed, unreliable, unsecure Vermont Health Connect system to private insurers working, reliable systems.” D.F.

      Does that mean returning to the days of high deductible “junk policies” that discourage routine exams and pre-existing conditions to deny coverage?

      • No, Jerry. We still have to fulfill the minimum requirements of ACA.

  3. Vote for Valerie Mullin and get rid of a Mile Fisher.

  4. Craig Powers :

    Vote Mike Fisher out of office. He is incompetent as a legislator and he is mostly to blame for this incredibly expensive mess.

    • Ann Meade :

      I doubt he would be mostly to blame if everyone was happy with how the program has gone. I don’t know Mr. Fisher but I truly appreciate the sentiment of his video. Everyone deserves healthcare. If this is the road we had to take to make it happen, so be it.

      • Craig Powers :

        Sorry Ann,

        Your comment is not reality based because you are basing it on emotion, not facts. Yes, universal coverage should be a goal but the way VT has gone about trying to make it happen is pure incompetence and folly. Rep Fisher is the chair and should be held accountable.

    • Walter Carpenter :

      “Vote Mike Fisher out of office. He is incompetent as a legislator and he is mostly to blame for this incredibly expensive mess.”

      How so?

      • Craig Powers :

        Walter,

        Do your own homework today. The facts are clearly there. You just do not like them because they contradict your hyper-partisan beliefs.

        Sorry to be harsh… try reading the article, try to sign up and make changes on our $81 million VHC website…then ask me “how so”.

  5. Carl Marcinkowski :

    Fire the Governor. What a lot of goods he sold and continues to sell his constituents. Where would he stand if not for Irene? Milne is not the answer either. What is wrong that we have so many political challenges (taxes, schools, healthcare, etc.) but no fortitude to find a governor to work on these? We badly need campaign reform so parties other than the Big II can be heard and we can elect executives and representatives that will work for us all. Yes, I can read it all now, bashing this idea because people read less than perfect opinion pieces her on DiggerVt. If there were any chance of getting heard and possibly elected the good candidates would stand up. Nationally campaign reform would be even better but it can never happen. We have been sold out and have no real voice in the matter any longer. The system is set up to give the impression that we do have choices. But we don’t. $$$ talks and if you don’t got it, it sucks to be you.

  6. Keith Stern :

    Agreed Darcie and I will add send Mark Donka to Washington to work for his plan to have realistic insurance plans for Americans by scrapping subsidized insurance with large deductibles and instead having the government provide catastrophic coverage based on income so every American can have a healthcare policy they can afford.

    • Walter Carpenter :

      “catastrophic coverage based on income so every American can have a healthcare policy they can afford.”

      But what happens to other coverage outside of catastrophic? Will that remain completely unaffordable for most Americans, like it was before the ACA?

      • Keith Stern :

        Catastrophic coverage simply means the government paying medical bills in excess of coverage. Example, $7000 in medical bills in a year with $5000 insurance coverage. The insurance company will be able to draw the $2000 from a government fund to cover it. No paperwork or hassle for the insured. Neat, simple, and effective.

  7. Ross Laffan :

    Yes, it’s unacceptable for these problems to persist but we should NEVER so back to what we had before : the immoral system of delivering health care we’ve had throughout history. Get it right and let the bloviators move on.

    • Keith Stern :

      The ACA and Vermont Health Connect have absolutely nothing to do with the quality and delivery of healthcare, only with health insurance. I think everyone agrees we should work to make healthcare more affordable but that discussion is being ignored while trying to fix the failings of those plans.

    • Craig Powers :

      What we had before worked a heck of a lot better than this piece of crapola for a large part of the VT population, Mr. Laffan. It also did not waste $81 million (and counting). Morals have nothing to do with competency. As long as you keep thinking with emotion instead of reality, it will not get any better.

      The bloviators in this instance are Rep Mike Fisher, Robin Lunge, Mark Larson and Gov Shumlin (and all the legislators who voted to FORCE individuals and small business to purchase via the VHC before it was ever tested!!!) for subjecting us to this mess when there was no need to. They continually smiled in phony press releases that “all would be ok”. Vermonters should be appalled at this complete failure and cover up.

      How can they “get it right” when they do not listen to all sides, but press on with their Progressive agenda, despite it’s unacceptable and unintended consequences?

  8. Wendy wilton :

    Mike Fischer conciously failed to provide competent oversight of VHC by squashing concerns and questions from the Republican legislators on his committee…namely Rep. Mary Morrisey and Rep. Doug Gage. Instead he ignored them and pushed ahead despite the evidence of problems and the exorbitant costs. Had he listened to their concerns and taken it seriously, we might not be in this mess. This is a clear example of how a lack of political balance is hurting Vermonters.

    • Walter Carpenter :

      “This is a clear example of how a lack of political balance is hurting Vermonters.”

      Was it not the majority of voters of Vermont who elected this legislature and governor because they wanted this make-up? And I am curious if you would say this about when the republicans had super majorities for a century or more.

    • Another question is how would the folks at Wendy’s Ethan Allen Institute provide universal, accessible, and affordable health care, assuming they think it is desirable?
      In my opinion all the criticism from EAI concerning the ACA/VHC is hiding the real reason which is to repeal Act 48’s universal health care plan in due 2017.

      • Craig Powers :

        Jerry:

        What plan are you talking about? The one with NO concrete details for three years? The one that no one in Montpelier has uttered a word about how it will be financed? The plan from the same cast of Montpelier characters who have brought us the expensive and failed VHC whilst telling us how great is was since 2012? The same plan from proponents of “single payer” who bring broad brush strokes of information from other countries that bear zero resemblance to Vermont?

        That sure sounds like a great plan Jerry. I guess the more you talk about it, and the more you post on chat boards about it, the more you convince yourself how great it is.

        When you are able to provide actual details of how your plan will work, you should not be casting stones at any organization that is asking tough questions of the folks in charge in Montpelier.

        • “The same plan from proponents of “single payer” who bring broad brush strokes of information from other countries that bear zero resemblance to Vermont?” Really?
          How would you provide universal, affordable, and accessible health care, Craig?

          • Craig Powers :

            Where are the details Jerry? No more broad brush, dreamy, talking points…

  9. ron jacobs :

    Although I am a fan of single payer and wish that Vermont would get off its butt and institute single payer sooner rather than later, the headline of this piece is unnecessarily alarmist. Many of the “problems” mentioned here are related to the recipients of health care not following through on their responsibility to update their information and changes to their status. Friends of mine who had to go through this process did as they were instructed, updated their info, and were told that their coverage could continue while their new info was reviewed. If the review proved they needed changes, then they would not be cut off, but their info would reflect any changes.

    • Jane Anderson :

      You’ve got it all wrong, the State of Vermont’s responsibility was to provide a simple functioning website that allows Vermonter’s to apply for Health Insurance and update their application as their circumstances change throughout the year.

      This website does not allow anyone to update their information, so how can you blame the folks who are required by law to use this piece of junk?

      • Craig Powers :

        Hear, hear Jane. You are correct.

  10. Problems at the health care exchange are just the tip of the iceberg for Gov. Shumlin and his administration.

    The Governor’s most significant health care reform problem going forward is his loss of credibly. A problem all of his own doing, it is his Achilles Heel.

    Going into the next legislative session the state will be focused on how to implement the single payer system. This $5 billion plus endeavor wrapped in countless risky unknowns is perhaps the most significant undertaking in the state’s history touching just about every citizen. Passage of legislation of this magnitude will require leadership from a Governor who has unquestioned credibly with the legislature and the people.

    The Governor’s loss of credibly dates back to the beginning of health care reform and the Hsaio study, which said single payer first year saving would be over $500 million and then go up in subsequent years. The Hsaio study was filled with assumptions that would be difficult or impossible to achieve. The Governor ignored problems in the study and crowed about the big savings, thus creating his first credibly problem when the supposed savings evaporated.

    The delayed and disastrous rollout of the fantastically expensive healthcare exchange that the Governor pooh-poohed as “Nothing Burgers” has proven to be another credibly issue. Nearly a year after its required opening, the exchange is still failing to perform to minimum standards adding more credibly problems.

    Last minute administration appearances in the waning days of the 2013 legislative session asking for $18 million dollars annually to run the exchange. This late action posed another question of the administration’s credibly on running health care.

    Misleading or false testimony to the legislature by Commissioner Larson on exchange security created yet another credibly issue.

    Under pressure resulting from massive health exchange costs, Robin Lunge, Director of Health Care Reform, presented commentary insulting the intelligence of the people of Vermont by telling us that the health care exchange saves Vermont money. Ms. Lunge tells us that the state’s payment of extra subsidies to low income Vermonters, not provided for under the federal exchange, actually saves us money. Does Ms. Lunge have any idea of what commentary of this sort does to the credibly of the Shumlin administration.

    With these and other credibly issues, there appears to be a growing sense of uneasiness developing in the legislature on single payer. How can they believe anything going forward based on what they have seen in the past?

    When uneasiness is present in any important situation, the best cure is to have trusted and credible leadership, something that may not be available in Vermont because of past behavior and actions of our leader. This is a problem for the Governor.

    .

  11. Kim Fried Newark, Vermont :

    Shumlin the hunter, ready, shoot, aim….again, and again, and again…….

    • Darryl Smith :

      Aim? Shumlin couldn’t hit couldn’t hit the truth pointblank with a shotgun. Yet Vermont’s starry-eyed voters will sign his band of merry pranksters up for years, at least until they sign him up as a US Senator.

  12. Dave Bellini :

    in yesterday’s Times Argus, Robin Lunge is quoted discussing the new $400,000. contract with Jonathan Gruber from MIT: “But it will help us explain to people… who will be winners and who would be losers.” This reminds me of the word used by the Douglas Administration when programs were being cut. Do we really have to have “losers” ? And, no doubt the “losers” will be state employees and anyone else with a halfway decent health plan currently. QUESTIONS TO LEGISLATORS AND ADMINISTRATION:
    .
    Do we have to hurt some people in order to help others? Can’t we just help those folks that need it? Must there be “losers” in a single payer? Mike Fisher, Robin Lunge, Larry Miller, Mark Larson…. Must we have “losers” ?? Will you guys decide who the losers are? Is “win/win” not possible anymore?

    Tell us who you choose to be the winners and losers please.

    • Dave:

      Let’s take your Jonathan Gruber cite a couple of steps further.

      Under the provisions of Act 48, wasn’t the Governor supposed to have provided a single payer financing plan to the legislature in early 2013?

      As of this moment no such plan even exists, never mind having been submitted to the legislature almost two years ago as required by law.

      Instead of having a well thought through financing plan, just about four months before the opening of the 2015 legislative session when single payer is to be the marquee issue, the Shumlin administration just signed a $400,000 contract with MIT health care expert, Jonathan Gruber, to help develop such a plan. OUCH!

      Here we have single payer, the biggest, costliest, most complex and risky undertaking in Vermont history and four months before the legislature is to take up the issue……no plan exists.

      This is like a college freshman being told on the first day of class that he has a paper due on the last day of class counting for 95% of his grade. Between drinking beer and having a good time, the freshman tells his parents not to worry, he’s got things under control. Finally in a panic, he begins working on the paper on the night before the last day of class. So, what quality of paper would you think the freshman hands in at the last minute?

      The freshman would be held accountable with a grade commensurate with his effort and having to face mom and dad.

      How will the Governor be held accountable for his performance on single payer and health care reform in general? Based on the exchange experience, it looks like the he’s going into the single payer finals with a D- average and an incomplete financing plan.

      This is not good considering the billions of dollars and people’s health care at stake.

  13. Judith McLaughlin :

    “If the situation hasn’t improved when lawmakers return in January “everything is on the table” to find a legislative fix for the issues that plague the state’s online health insurance market, he said.”

    Really, you simply can’t make this stuff up. Find a legislative fix??!! That’s what got us here in the first place. So, how does one find a fix for the legislature??!!

  14. joanie maclay :

    Everyone has a boss! All those listed in the above emails have a boss. YOU & ME. if we really want change we MUST make our voices heard at the polls. Remember follks….this is an election year.
    Take your concerns to the polls with you. .

  15. Ron Pulcer :

    God Help Us! The Democrats, well intentioned on healthcare, do not provide enough oversight of VHC and healthcare exchange. The Republicans in DC, promise to “keep us safe” (as in the 2004 election’s “Four More Years), yet did not provide enough oversight of military contractor waste, fraud and abuse, all the while passing “continuous resolutions” for off-the-budget war spending, all the while claiming to be “fiscally conservative”, and blaming it on Social Security’s Ponzi scheme (actually we don’t want to pay back the war debt IOUs we borrowed from SS).

    The two parties have failed in these respective areas. Both parties waste our tax dollars on more than one occasion. Blaming one side or the other is like the never-ending Israel – Palestine feud, except with campaign ads, campaign war chests and comment forums, instead of missiles (thankfully).

    The candidate list provided by VTDigger shows that there are TEN (10) people running for Governor.

    http://vtdigger.org/majorprojects/election-2014-comprehensive-candidate-listings/

    Besides the frontrunner R and D candidates there are some primary challengers in both parties. There are the usual perennial candidates. There is one independent that is posing as a Republican for primary, but will probably run in general election as an Indy. But there are some are new candidates.

    Hopefully, VTDigger will profile some of these folks and ask them some questions about their ideas and solutions for healthcare reform. Their chances of winning typically might be low. But maybe they have some different ideas to debate regarding healthcare, other than the usual Democrat and Republican playground fight.

    What have we got to lose in hearing from these alternative candidates? I don’t expect to see a Shumlin healthcare finance plan before November, and I am holding my breath that Mr. Milne will come forth with anything concrete. If his party actually had anything concrete, they would have brought it up in Congress years ago.

    Looking forward to reading stories about other candidates for Governor.

  16. rosemarie jackowski :

    It is time for the voters to step up and solve these problems. Continue to do the same thing over and over and expect a different result???

    Voting has consequences and voters usually deserve what they get. It is time to get out of the D/R box. There are other options. Take a look.

    http://www.libertyunionparty.org/?page_id=325

  17. Brian Hadley :

    Seems we should have implemented a system to make healthcare available and affordable FIRST, and then worried about usable websites, later. All this negativity is due to incompetent IT contractors. Seems we should focus on the problem at hand. Hod DID we even survive before the internet??????

  18. Peter Everett :

    Does anyone really expect a government run program to work with any efficiency? I certainly don’t. I expect every government program to run just the opposite, and, with much greater cost than expected.

  19. Ralph Colin :

    First it happened in Washington, DC. Congress voted for the ACA without anyone in either the Senate or the House having read it (how could they in just a couple of days?) or without having understood what they were doing.

    So the General Assembly in Vermont, following Congress’ example, did the same thing with both the Exchange and, later on, with Single-Payer. These people effectively vote for blank page legislation and leave it up to their respective administrations to fill in those blanks.

    Then the bureaucrats get their chance, but since they know not their behinds from their elbows – and being politicians – they screw it up for everyone.

    That’s what we call Government these days, folks. And as others have suggested in these pages and on these issues (above), we keep voting for the same incompetents and the same liars and yet we expect different miracles to occur. I guess it is our fault after all.

    Will we ever learn?

  20. hester fuller :

    Amazon doent have these problems. EBay and PayPal don’t have these problems. There are competent programmers out there who know how to make gigantic systems responsive and reliable. WHY HAVEN’T WE HIRED ANY????

    • Keith Stern :

      Because they don’t have political connections like the incompetent companies do. How many private companies would hire a contractor to do a major project and not have a performance bond required? Only the government.

    • John Greenberg :

      “Amazon doent have these problems. ”

      Actually, it does. Fairly frequently, in fact. I know: I’m an Amazon seller and I use the site daily.

      • John:

        Your experience with Amazon isn’t consistent with the findings of repeated customer service polls conducted over the years.

        A recent customer service poll conducted by Zogby Analytics and reported in the USA Today shows Amazon, for the fifth year in a row, to have the best customer service out 150 of America’s best known companies.

        See: http://www.usatoday.com/story/money/business/2014/07/19/customer-service-hall-of-fame/12690983.

        Hester’s point is that a massive business such as Amazon with complex operations around the globe and $75 billion in annual revenue resulting in millions of transactions can consistently deliver great customer service while Vermont’s tiny health care exchange with tens of millions of dollars in financial support is hardly able to function.

        Hester has a legitimate point.

        Your comment, on the other hand, seems to indicate an inability to put Amazon and the Vermont exchange customer service records into proper prospective.

        • Darryl Smith :

          Please don’t confuse the issue with facts, stick to hyperbole.

        • John Greenberg :

          Peter,

          I am not an Amazon “customer,” assuming that means someone who purchases from Amazon. I am an Amazon SELLER, meaning a third-party merchant who pays them for use of their site. Hence their “service” to “customers” is irrelevant. Amazon’s “service” to sellers is laughable; put bluntly, they don’t give a ….

          In any case, my comment was directly responsive to Hester Fuller’s, which concerned COMPUTER problems, not customer service. And it’s not really a debatable proposition that Amazon’s computers DO fail quite regularly: I am regularly told that this or that function is unavailable and that they are working on the problem. Call me a liar if you want to.

          As to “proper perspective,” while I didn’t comment on this before, I will now. Amazon has been in business, dedicated exclusively to and entirely dependent upon the use of internet software for roughly 20 years. If you think there were no kinks along the way in developing the system: think again. If Amazon’s computers fail often enough, they’re out of business.

          The computer systems used to implement Obamacare haven’t been up for even one year yet. They function poorly, from everything I understand. I’m not defending that. But Obamacare is working: millions of Americans who lacked medical insurance now have it; pre-existing conditions no longer preclude millions more from getting or keeping coverage. And despite the kinks in the computers, healthcare is being provided and providers are getting paid.

          The suggestions that private companies do all this perfectly, or that the track records of a company with 20-years of fixing its own mistakes is commensurate in any way with a company with fewer MONTHS than that strikes me as truly lacking in “perspective.”

    • Kathy Callaghan :

      AMEN!

  21. David Dempsey :

    How to fund the single payer plan set to begin in 2017 is a huge unknown at this time. But I have heard very little about the other major thing needed to start the proposed single payer plan, the required federal waiver. Based on the failure of the Vermont Health Care Exchange, why would the federal government think that the state could administer a single payer plan. Meanwhile, the state exchange has kicked every insurance company out of Vermont, leaving only BC/BS, with token competition thrown in to denounce the obvious monopoly. I doubt that scenario would help lower the cost of health insurance in Vermont. Vermonters deserve better, and action is needed now, not in January.

  22. Steve McKenzie :

    If the situation hasn’t improved when lawmakers return in January “everything is on the table” to find a legislative fix for the issues that plague the state’s online health insurance market, he said.

    Mr. Fisher conveniently failed to note that the Federal subsidy to create the Exchange ends in 2014. Vt has spent $72m of the $171m earmark to date, with dismal results. Clearly our legislature has no idea of the final cost to get the Exchange working, as they continue to discover new problems that have to be corrected (in comparison, New Hampshire chose to use the federal exchange, and has spent $4m of their $8m grant, and the Federal exchange allows changes).

    I’ll assume someone in Montpelier will get around to mentioning this unknown added taxpayer liability in 2015, conveniently after the fall elections, which is the Governor’s approach in regard to providing details on single payer financing, etc., which he was required by law to present on 01/15/2013.

    Act 48 was signed on 5/26/2011.
    Three years later, no details.
    No further details for voters to consider until after the election.
    The entire first-of-its-kind system to be defined in the remaining 24 months before 2017.
    Vt Health Connect still not working, and no idea of when/if it will and what it will ultimately cost.

    If I were the Governor and/or Mr. Fisher facing re-election, I guess I’d choose not to discuss all the facts now as well.

    I truly hope the voters of Vermont consider the facts they aren’t receiving in November.

  23. Lance Hagen :

    This is definitely a ploy by Rep. Fisher to ‘distance’ himself from the VHC disaster. It is an election year and he wants to ‘wash himself’ of any blame. Problem is, his ‘fingerprints’ are all over this mismanaged program. He was the administration’s chief ‘water boy’ in the Vermont House, pushing this entire scheme through his Health Care Committee, squelching any input that did not fit his plan.

    This is a fine example of a politician at their worst!

  24. Ethan Rogers :

    Love the headline “Problems with VHC at Crisis Stage”. I heard a news report two days ago that the State intends to spend every bit of the $171 million the Feds allocated to VT to set up this disaster. Two years from now, everyone involved with this disaster will be in higher positions with more responsibility and increased salaries. The only thing that will remain constant is they’ll still be lying every time they speak.

  25. Ron Jacobs :

    I think the headlkine is quite misleading. Either that or the definition of crisis has been downgraded. Although I favor a single payer system, I think that VHC is a good health care system. Are there problems with the website? Yes. However, as your article notes, a good number of the problems arise because individuals signing up or transferring are not doing so in time orjust not at all because they are “unwilling or unable.” As for those who write that governments can’t run anything, I would argue that it is precisely because the ACA/VHC is an attempt to wed private industry into a government program that it fails, If the profit motive were removed from the website design and some good techies were hired by the government to design and ensure the site viability, the site would most likely be operating quite well. Why? becuase there would be accountability and there would be no reason to make a lousy website first so that a private company “needed” more money to fix it. Every person I know who applied for VHC got it in a timely mannner and can now afford their healthcare. That’s a good thing. It isn’t a crisis.

  26. One of the tests of leadership is the ability to recognize a problem before it becomes an emergency. ~Arnold H. Glasow Our state emergency budget cuts because of increase spending more than our state can afford and VHC not being properly vetted before being launched according to this quoted test is lack of proper leadership. This is why I’m running for Vt. House. Vermonter’s deserve better.

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