Silicon Valley Redneck

"Selected a plan"

So here it is, coming up on the deadline for switching my Kaiser coverage to something Obamacare-compliant in time for Bealtaine....

I go to the kp.org site, which used to work fine with Iceweasel.  Mostly, it still does.  But!  The new stuff added to promote signing up for the new plans doesn't even think about working.

So, fire up Chromium, sign in to kp.org, and go to "shop for plans".  It promptly forgets that I was signed in.  Apparently there's a complete separation between existing customers and new customers.  And I need to choose a brand-new username.  Hey, look!  My existing one is available!  But I can't use my existing password, because it contains special characters, and some imbecile has decreed that passwords may not contain special characters.

So, I stumble through the fool application process; this being off-exchange and unsubsidized, at least I don't need to fill in detailed financial records.  Nor even smoker/nonsmoker...?

And: previous coverage, Kaiser, yes.  Fill in the magic number.  Coverage before that?  Only two options: "yes, and here are all the details" or "no".  No option for "yes, but that was 14 years ago, through a long-since-defunct employer, and I have no records nor recollection of what it was".

Then, Electronic Signature!  The awesome security feature of... type your name twice.  Because clearly no impostor can spell my name the same way twice... right?  But... shouldn't the test be three times?  If I say it three times it is true, and all that?

Finally: Apply!  Get summary page.  Print summary page.  Hyperlink sez: "Click to payment detail page".  Clicking hyperlink does nothing.  Middle-clicking hyperlink gets the previous page, in a new tab.  There's no smegging way to get to the page for entering a credit-card number!

And so I click on the hyperlink for "paper application" and it sends me a PDF... with all the fields freaking' blank.  It threw out all the information I'd filled in, and just sent me a blank form.

At this point, I presume I'm in the official statistics for "Signed up for Obamacare coverage!" despite having been given no option for actually paying the first month's premium.

Oh, and the "cheap" plans?  Bronze and lesser silver?  While the descriptions of coverage are complex and highly confusing, it looks to me like the coverage is absolute crap.  And it's not like they're actually cheap, either.  I went for top-silver, which is still cheaper than my old plan but doesn't look like out-of-pocket costs get too far out of hand.  And, since it's direct from Kaiser, I ass-u-me that it actually covers treatment at Kaiser facilities.

Update: Oh, great!  Now I'm trying to fill in the PDF form.  Previous coverage: Kaiser, dummy!  Dates of coverage: uhhh... I try to fill in the range, near as I can remember... and I get errors.  The PDF won't accept the things I'm trying to fill in.  Looks like it wants exactly one date, not in fact a range.  I leave it blank.  They've got my name and medical record number; let them figure it out.  Or, I guess, I can write in an explanation with a pen after I print it out.

Oh, and the field for credit card expiration date?  Calls for format "mm/yyyy"?  Expects a full date, mm/dd/yyyy.

Was any of this even alpha-tested?

Really, now: when it comes to forms, I make a pretty good Napoleon's Corporal, having a real knack for failing to grok which-of-several-possible-meanings is called for.  And I've seen, many times over the years, that forms are generally filled with ambiguities and just-plain-wrong questions.  But... did anyone, ever, try to fill out this PDF (clearly not), let alone run through the on-line application process?

How do you say "peregruzka" in Mexican?

Really, now: if the State Department can't translate one freaking word into Russian, or even get it in the right alphabet, is it any surprise that HHS can't translate an entire website into Spanish?

A grand opportunity for Science!

Skimming McMegan's latest, I come across this:

A few years back, Oregon found enough money in its budget to add 10,000 people to Medicaid. Because more than 10,000 people wanted to go on Medicaid, it used a lottery to hand out slots ... and thus gave researchers an excellent setup for a randomized controlled trial of the effect that health insurance had on peoples’ lives.

My first thought: yes, but it wasn't double-blind!

My second thought: Obamacare, plus the healthcare.gov fiasco, may offer a golden opportunity for a double-blind study of the usefulness of health insurance / prepaid health plans.

Because, at this point: there's a large pool of potential patients who don't know whether or not they have coverage, and neither do their doctors.

So long as everyone is kept in the dark, this provides perfect conditions for an ambitious study!

Well... as long as the covered-or-not condition of the subjects can eventually be determined.  Does no good to collect data on individual outcomes unless, after the fact, you can assign each subject to the correct group.

Timing

Well, I got around to checking out some of the ACPA-compliant health plans Eternal Emperor is offering for next year.

The terminology probably makes perfect sense to those who shop for health plans on a regular basis, but for the rest of us, figuring out the basic "how much will I pay for what, under what conditions?" is highly confusing.  However...

The Bronze plans, as expected, look pretty darn dreadful.  At least, being offered directly by EE (and not on the exchange), they presumably provide actual access to doctors, at least at EE facilities... at prices which are considerably above what health-care services ought to cost.  Basically: pay high premiums and Don't Get Sick.

The middle Silver plan, if I'm parsing it right, actually looks decent, though with premiums and out-of-pocket costs it's still an outrageous amount for a reasonably-healthy guy to be paying.  And: I'm not too clear on out-of-network coverage, and the network is strictly regional, so, um.  If I travel more than a couple of counties away, and a tree falls on me, I might not be covered at all?

The middle Silver plan doesn't cost that much more than the cheapest Bronze, and it's significantly less than my current plan, but I'm still not clear on the differences in out-of-pocket costs and out-of-network coverage.

But, as it turns out, I have until the end of March to decide whether to switch from my grandfathered plan to a new one.

So, I'll try to get all projected doctorin' done by the end of January, at the current co-pays.  Assuming none of the tests turn up anything expensive, it'll be downgrade time, presumably to Middle Silver, thereby lowering my premium from Insane to merely Outrageous.

On usernames and passwords

Apparently the Obamacare website has odd, and poorly explained, constraints on both.

One company with which I've done business has very narrow constraints on allowable passwords (small character set, small range of acceptable lengths).

Why?

I mean, seriously: if you've taken the slightest precautions - sanitizing inputs against Bobby Tables, for example, and storing passwords as hashes - what constraints are really appropriate here?

Technically speaking, both fields need to contain only characters which will be consistently transmitted by a variety of Web browsers, and consistently handled by any server.  So, no control characters nor rubouts.  The username should presumably be made up entirely of graphic characters, anyway, and of somewhat limited length.

Apart from those considerations, why not just allow any dang UTF-8 string that passes basic sanity checking and is not unreasonably short (password) nor unreasonably long (username, just in case you get some wisacre wanting a name that's 972 letters in Sanskrit)?

If I want my username to be "G'rig𓀙/42Ѿd^𐇑 Mc🍩", and my password to be "President Chauncey Gardiner is a stuttering cluster@@@~X|~~ NO CARRIER", what business is that of anyone else?

Half baked?

If the Obamacaid web site (plus back-end IT infrastructure) is 70% feature-complete, works for 80% of users, and has 90% uptime...

That works out to just about 50% baked, no?

Not even wrong broken

So it seems the Obamacare website (the easy part, remember) still isn't up to the "works 80% of the time" standard.

Let's review reliability numbers, shall we?

99.999%, five nines: about the minimum you can get away with selling to a serious business that depends on your product or service (but where no lives are at stake).

99.9%, three nines: OK for many non-critical uses.  Don't try to sell it for serious uses unless you have an effective monopoly.

99%, two nines: possibly acceptable for cheap consumer goods.

90%, one nine: broken.

80%, zero nines: not even broken.

Then, at the high end, we have the wonderful world of aerospace and medical equipment, where... well, how many failures are acceptable over the 30-year working life of an airliner or a deep-space probe, or during open-heart surgery?  The teams that work on that stuff need to live reliability.

Of course, all these numbers really apply to hardware, even if there's also software involved.  For software, if it ever fails, it's broken; we just put up with a certain amount of brokenness in the software that we use day to day (e.g., any known word processor or web browser). The question becomes, is it so broken that it's positively unusable, or is it merely inconvenient and infuriating on rare occasions?

Update: The Administration is positively boasting of one-nine availability.

Centralized efficiency

With all the talk of how much better Single Payer would be than Obamacaid (because it'd all be run by the Feral Gummint, and therefore inherently much more efficient than a haphazard quasi-private health-care payment sytem)...

Y'know, we have an example of Single Payer in the U.S.

We have Single Payer Military Procurement.

Which, with its wondrous efficiency, has recently brought us LCS, F-35A/B/C, NLOS-C, ... er.  Not such great examples?

And various targeted contracts, whereby, e.g., the Army contracts with a preferred bidder (i.e., the one whose owner checks the most boxes on the "oppressed minority" form), which has no ability to deliver on the contract, and just passes it through to some non-minority-owned company, all facilitated by a group of rich white Beltway Bandits.

And the infamous $600 hammer ($10 for the hammer, and $590 for the paperwork to prove that the Government isn't getting ripped off).

(No, the Air Force's expensive Mr. Coffee doesn't exactly belong here.  That wasn't a Mr. Coffee.  'Twas a restaurant-grade coffeemaker, plus a requirement to operate on a moving aircraft without splling hot coffee all over everywhere.  Mostly bona fide operational requirements, and not at all comparable to a household appliance.)

Still utterly missing the point

From here:

I continue to believe, and [I am] absolutely convinced, that at the end of the day, people are going to look back at the work we’ve done to make sure that in this country you don’t go bankrupt when you get sick, that families have that security,” Obama said. “That is going be a legacy I am extraordinarily proud of.”

Uh, right.  Except:

1. The insane premiums resulting from mandatory participation in the crooked system (plus the coverage mandates and other misfeatures that raise prices still further) mean a lot of families, if they actually sign up and pay the premiums, will have trouble eating.
2. Obamacare fails in any way to address the real illness-to-bankruptcy path, which runs via loss of income.
3. By the way: if you get sick and lose your income?  Guess what else you lose if you can't keep up the premiums.

The happy-shiny is all image, so the ruling class can feel good about itself.  The reality is that, once again, the working class gets the short end of the stick.  And, if you get seriously sick and don't have a large cash reserve (and good luck building one while paying big bucks for your health-plan premiums), you'll end up bankrupt.

Failure to grok the scale of the problem...

... and its nature, for that matter.

From this article:

He cites the movie Apollo 13. When it looks like the ship is going down, and someone says that this could be “the worst disaster NASA has ever experienced,” Ed Harris’s character says, “With all due respect, sir, I believe this is going to be our finest hour.” This, he says, is the Obama administration’s bunker-mentality.

The quoted Obamacare "navigator" is missing an important difference, here.

The Apollo 13 emergency was purely a technical problem.  The equipment had malfunctioned, and a technical solution was needed.  It was only difficult and dramatic because the failure happened in an inaccessible location, and people's lives depended on coming up with a workable solution in a hurry, with materials available on site.

So, think of it being on the scale (and nature) of just one of those "glitches" with the website.

In the case of Obamacare, there are many visible technical problems, which are almost certainly masking further technical problems which lurk deeper in the website and its back-end.

Worse, though, is the vast and tangled web of social problems involved in implementing the greatest tax-farming scheme in human history.  As noted in the article: people who have actually "found out what's in it" just aren't biting.  And that's on the demand side; on the supply side, we have yet to see how many doctors will settle for Obamacaid payment schedules.

It's a fine example of the conceit of central planners, and the ITCPAMOTM fallacy: "If They (i.e., a team of actual rocket scientists) Can Put A Man On The Moon, then... well, surely We (i.e., a self-selected group of liberal-arts majors who keep telling each other how smart we are) Can [fill in the blank with a vastly larger, more complex, and more expensive task requiring dictatorial powers and whose failure risks the lives of tens of millions of people and not just three].

Putting a man on the Moon was an expensive exercise in known physics and advanced engineering, and the only lives risked were those of volunteers.  Exercises in central economic planning are different in kind, and risk the lives of the unwilling public.

Truly epic incompitude.

Patterico has also picked up the story about the Obamacare website's back end being only about half-baked (60% done, 60% not done yet... not that much difference).

Not even the payment system?  Not coded yet?

Why am I not surprised?

After all, the front end - the part the end-users see - is the easy part.  A reasonably competent web-development team - say, three good developers and a manager - could have done the job, and done it well, in a couple of months, given a coherent spec to start with.  Heck, I could have done it in a single-digit number of months, and I'm not even a web developer!

And yet: after three years, the front end code was far from ready for prime time.  It didn't work.

Lurking behind the easy front-end code is the far more complicated back end, which deals with all the various, incompatible, fiddly databases, looks up your premium, calculates your subsidy, runs your application past the Department of Homeland Security, takes your money, and sends everything off to the third-party payment company of your choice.  Basically the stuff ehealthinsurance.com has been doing for a while, plus the incredible extra complexity of dealing with the government bureaucracy and the subsidy system.

And, unsurprisingly given the state of the front end, this part turns out to be about half written.  Tested?  Working?  What do those mean?

The really big complexity, of course, is the actual operation of the third-party payment system, and its interaction with the vast chaotic system that is the American Public.

Those of use who've been paying attention have been expecting, all along, the third part of the system to fail... but I, for one, was expecting the death spiral to start around the middle of next year (moved up from my earlier prediction of 2016-ish, once I saw what the premiums were going to look like) and proceed gradually, with things falling apart over a period of a few years.  Now, with even the easy stuff not working, the premiums turning out to be even more out of line with what ordinary people can afford, the coverage on offer being largely substandard, and the cancellation notices going out?  Dead and rotted by New Year's.

And meanwhile we have even more laws and regulations getting in the way of real reform.  Progress!

Addendum: and what's with "getting the system working for 80% of the users" or whatever the latest promise is?  Where I come from, that's called "zero-nines reliability," or, more commonly, "Does.  Not.  Work."

Beyond spin, and well into twirl

According to this in the NYT:

But unlike Mr. Bush, who faced confrontational but occasionally cooperative Democrats, Mr. Obama is battling a Republican opposition that has refused to open the door to any legislative fixes to the health care law....

Hello?  Until a couple of weeks ago, 'twere Obama who refused to consider legislative fixes that might involve Republicans.  True, when the Republicans were trying to delay the individual mandate through legislation (y'know, legally), they were really bent on killing the whole thing... but now that Obama is proposing to delay it by executive fiat (i.e., illegally), suddenly Republican opposition to changing the law is the problem?

"Cost sharing"

So you've bought yourself an Obamacare Bronze health plan.  Congratulations!  Now consider: what if you get sick?

Let's assume for the moment that you've chosen a plan that actually covers visits to real doctors, in your area, who are accepting patients.  Your expenses are 60% covered!  What, really, does that mean?

Well... consider this.  If you had one of those nasty old plans with 100% coverage, you'd pay nothing out of pocket, and the third-party payer (I refuse to call them "insurance companies" in this context) would pay... er... right around 10% of the bill, typically.  The other 90% of the bill, nobody really expected to be paid anyway.

With your modern comprehensive "real insurance" plan's 60% coverage, you have 40% "coinsurance", i.e., you pay 40% of the bill.

Which is four times the total amount that would have been paid under the old plan, right?

And it seems that the ACPA's fine print somehow repealed long-standing laws against kickbacks... anyone wondering what's going to happen?  Anyone?

Nobody from either party seems to be questioning what things ought to cost, as, e.g., Tom McClintock did with regard to education budgets a few years back.  Well, his work was widely ignored, so perhaps there's no point.

Just for kicks, though, let's make some wild assumptions and try to get a handle on what a routine doctor visit ought to cost.

Let's see, now.  We've got one high-skill worker and one medium-skill worker, each with continuing-education requirements.  Call the annual cost of employment, say, $200K and $125K respectively.

We've got an examining room.  Basically a broom closet, in a building with a receptionist.  Call it 100 square feet at $10/sq ft/month, so $12K/year.

We've got some moderately-specialized equipment, with useful lifetimes from 3 years to 25 years.  Allow $50K/year depreciation for the lot.

This comes to $387K/year.  Call it $400K.

If we assume 2000 working hours/year for doctor, nurse, room, and equipment, this gives us $200/hour.

Since routine doctor visits are scheduled in quarter-hour chunks, one quarter-hour visit ought to cost about $50.

Eternal Emperor's list price for an office visit this year is $331, whereof 40% is $132.40.

So, by my BOTE calculation, they're only overbilling (for a routine visit) by a bit over a factor of six; assuming the price doesn't change next year (yeah, right), the Bronze Plan $60 copay for the first three visits should actually be the entire payment, including profit, while the 40% coinsurance after that is about 2.6 times what a doctor visit would cost if we just burned down the whole damn third-party payer system and paid cash for routine health care at free-market prices.

And that, kids, is why, in the Great Recession and with people losing their jobs and their employer-provided health plans left and right, it was necessary to pass this monstrosity of lobbyist-written legislation to force everyone back into The System.  Because otherwise we'd be seeing spontaneous, free-market reform, and the masses might realize that they didn't need The System, and hadn't all along.

Guess what else is going away?

Obamacare doesn't affect those over 65, right?  I mean, they've got Medicare and all, so there's no such thing as being "uninsured," or having "substandard" coverage, surely?

BZZZZT!

My parents have fancy, high-end Medicare supplement (or whatever they're called) plans.  My mother has one from HealthNet, which basically pays for everything Medicare doesn't, no questions asked.

It's no longer available, as of 01 Jan 2014.

What, Medicare-supplement plans need to include maternity care and pediatric dentistry now?

For the moment, she can be added to my father's retirement Medicare-supplement plan... which is employer-based.  Will the same thing happen to it in a year?

Prices.

Being intentionally nonspecific here, for Reasons.

Someone I know, who's been among the uninsured (not merely no comprehensive health plan, but no insurance of any sort, and... well, how things got this way is Complicated, but the process seems to have involved Obamacare dropping the "Portability" part of HIPAA immediately after passage, thereby adding to the pool of uninsured) for some time now, is taking one of those "one a day for the rest of your life" maintenance drugs.

It's pricey.  The name-brand product, if memory serves, had gone from around $100/month to $150/month over the last couple of years.  Fortunately, there's a generic now, at a still-outlandish $70/month.

And, now that there's a generic, does competition bring down the price of the name brand?  It does not.  The name brand now goes for well over $200/month.

Presumably this is because, as with so many other prescription drugs, no one actually pays list price.  Someone Else pays, and that Someone Else has negotiated a secret 90% discount.

But a huge jump in price, after competition enters?  Gotta be some other factor.  Like, perhaps, this is one of those categories of drugs that health plans are now required to cover 100%, with no substituting generics?  Another of those fine provisions added to Obamacare at the behest of Big Pharma?

Get the popcorn ready

Various stories point to a massive push by the U. S. Government to get the Obamacare web monstrosity all working and shiny in the next couple of weeks.

Hands up all those who have heard of Brooks's Law....

<reverb>
It's the BATTLE OF THE CENTURY!  Reserve your seats NOW!  Never to be repeated! It's GODZILLA versus SISYPHUS'S ROCK!  One time ONLY, from now to ETERNITY!!!
</reverb>

Another one notices the Potemkin economy

This time it's Joel Kotkin, over at Forbes, commenting on what passes for the Silicon Valley economy.

As I keep observing: the bottom has fallen out, and the middle is crumbling.

The real Silicon Valley, where the innovation happened, and (as Jordin Kare put it) fortunes grow from dreams, hasn't existed since the 1990s; the dot-com boom (v1.0), while seeming to mask its demise, was actually a symptom.

A few quick notes on scanning the article at hand:

Libertarians will celebrate the triumph of fast-paced greed and dismiss concerns over equity

Depends which breed of libertarian.  The current business climate is driven by a small number of people deciding how to invest vast amounts of other people's money, and that, in turn, is substantially driven by government policy, which the holders of the concentrated money are in a position to influence.  In any case, it's a positive-feedback loop of concentrated power, which this small-l libertarian considers a Bad Thing.

Another suggestion is that they can cut hair, walk dogs, and work on the houses of the digerati; given the extraordinary housing prices in the places where the anointed live, how they will afford to live anywhere near them is a bit of mystery.

Or get a job as a grocery clerk... Palo Alto still has full-service grocery stores, unlke the cities to the south, which are almost all self-checkout these days.  Still: it's not just the insane cost of housing.  The "progressives" in Sacramento and D.C. insist on adopting policies that drive up the price of everything.  (If you think the premium on your nice new Obamacare policy is outrageous, just wait until you get sick and find yourself paying 40% of list price for health care.  Remember, kids, list price for health care is ten times a reasonable price, so at 60% coverage you're paying four times what it should cost, plus the premiums.)

The people who settle in these places are not, as often asserted dummies stuck at the low rung of the meritocracy; the cities with the fastest-growing college-educated populations are primarily in the Sun Belt and Intermountain West, such as Houston, Austin, San Antonio and Nashville.

Although many of the new economists believe these areas are generating mainly “crummy” jobs, employment is expanding in higher-wage areas such as energy and manufacturing as well as services and even high-tech.

Which I might be doing in 2015, in a DIY sort of way.  Emigrate to America in 2014, get settled in, healthy, and relaxed, then launch a high-tech company in my barn, and try to persuade other disgruntled engineers to follow.

The price of this enlightened progressive profit-taking largely falls on working class Californians, and traditional industries, which get stuck with exorbitant energy prices.

This.

There's much more to say, but I woke up late this morning and need to get going now.

Damn phonebots

Just had a call from a phonebot (apparently a meatbot, not the silicon type) wanting to talk at me about the new "health care reform..."

Hold it right there.

It's not reform, goddammit!

The purpose of the ACPA is to prevent reform, and to lock everyone into the crooked third-party payment system while breaking it still further.

You want health-care payment reform?  Here are some ideas:

• Require that the amount actually paid by a third-party payer, plus the amount paid by the patient, add up to the amount billed by the provider (so long as the amount billed does not exceed a published limit for the service in question).
• Start enforcing the laws against price-fixing, conspiracy in restraint of trade, and so on.  If these laws have exemptions for "insurance" companies, fix them.
• Include government-run third party payers (e.g., Medicare) in both of the above.
• Allow formation of group health plans / insurance pools for groups other than companies with full-time employees.
• In general, remove the special tax and legal status of employer-provided health plans.

Those are just a few of the obvious ones.

Alas, the Stupid Party will never promote these, as it's almost as locked to Big Finance as the Evil Party.

"80% coverage"

Wait, lemme get this straight...

Under the new health-care payment regime, your health plan has to pay at least 80% of your bill in order to be considered "real insurance" - as opposed to a boring major-medical policy that pays 100% of everything over the deductible.  Is that about it?

So... if you're paying 20% of the bill... and the nominal price of health-care services, as shown on the bill, is generally about 10 times what a reasonable price would be (because the third-party payers, including the government, have been cutting themselves about a 90% discount when it comes to paying the bills)...

... then you're stuck paying twice what the services should have cost, plus the outrageous premium.

Have I got this right?

Update: here's this helpful bit from the Murky News:

The law also will often make some policies more expensive because it limits out-of-pocket expenses to $6,350 annually for an individual and $12,700 for a family.

Note that the category "out-of-pocket expenses" does not include premiums.  So, assuming my new compliant policy were to cost the same next year as my non-compliant policy does this year... my actual expenses, just for me, would be a minimum of $10,152 and a maximum of $16,502.

And: you know how "they can't cancel your coverage just because you get sick"?  Well, they can still cancel it if you don't keep up the payments, no?  And, if you're struggling to pay the premiums when you're healthy... and then you get sick, and miss a few weeks of work... guess what you won't be able to pay?

This calls for a layer of meta-insurance, which promises to pay your health-plan premiums if you get sick and miss work.  Another fine racket!

Basic structural problem, probably by design

No, I haven't tried the Obamacare exchange thingy; I got a budgetary estimate from the California web site a few months ago, when The Powers That Be were hyping the "not as expensive as feared" pricing.  If memory serves, I fed in some basic information (age, sex, maybe ZIP code) and got a number... that was close to $7000/year* for the cheapest allowed option.  Certainly I didn't create an account and feed in large amounts of personal data.

But here's the thing: it seems that now the exchanges have gone... well, "live" seems rather a strong word... anyway, now that they're supposed to be open for business, one does not simply get a quote, even a budgetary one.  It's necessary to create an account up front.  Does this include feeding in all the personal data required to apply for the subsidy?

I wonder how much of the traffic is just people like me, who know damn well that they don't qualify for any subsidies, just trying to get a handle on What It's Gonna Cost.  This should be static data, and should not require creation of a user ID.

I'm kinda waiting for Emperor to give me a hint as to next year's premium... and they've gone from "You're all set with your current coverage!  It's gonna be fine!"  (Emperor's lobbyists had a hand in writing the damn law, after all) to "The great thing about your grandfathered coverage is that you may be allowed to keep it" to "We'll offer you the option of keeping your current coverage or switching to one of our Obamacare-compliant plans," but as yet they've offered exactly zero information about what any of those options will cost.  There is the suggestion that the status quo option leaves me subject to both the Cadillac Health Plan Tax and the Uninsured Penalty.

Oh, and "probably by design"?  Hey, it's a way of getting just about everybody to hand over all their personal details to a brand-new government department that seems to be employing a lot of political operatives, and to lack even the most rudimentary information security.

 

* Based on the assumption that all the healthy youngsters who don't have full-time jobs will sign up at inflated prices to subsidize me.  Your reality may vary.