http://www.itpro.co.uk/business-intelligence/big-data-column/19594/future-cities-widens-its-reach-big-data

Present Situation Be Damned, Full Speed Ahead

The Affordable Care Act’s Healthcare was reviewed, state-by-state, last week.  This week brings another table (below) of dubious data collected with sincere effort to try to estimate the ACA’s impact on Audiologists.

Requests for updates and corrections last week went unheeded.  Logical explanations, in order of probability, are 1) nobody reads this column except Harvey Abrams, 2) few readers understand the healthcare provisions of the act, and 3) the data were correct. Logical proofs follow:

  1. Dr Abrams requested permission to use last week’s Table 1 in an upcoming presentation.  No one else commented or requested permissions.  Ergo, no one reads this column except Harvey Abrams.
  2. The Onion’s headline:  “Man Who Understands 8% Of Obamacare Vigorously Defends It From Man Who Understands 5%.”  According to the article, both men understood 3% in post-discussion.  Ergo, few readers understand the healthcare act.
  3. If data go undisputed, they are not proved incorrect.  Ergo, they are correct.

Perhaps such logic underlies reports of the Present Situation, in which the US Government is closed, even the USS Enterprise can’t make it through the online health insurance portal, and fewer than 1/3 of medical groups are agreeing to participate in the healthcare system.  Economists are tough and don’t let trifles such as these stand in their way.  Hearing Economics is made of the same stuff and forged ahead this week, slicing through the Present Situation.

The Portal

healthnet confirmation of aca plan coverage
Figure 1. Proof of Portal Passing.

Despite claims to the contrary, it IS possible to self-enroll for health insurance via the online portal. I did it (see Figure), it only took a week, and it answered 3 questions:  How hard was it? Could I get a better insurance rate?  Did Arizona enrollees seriously qualify for a “one hearing aid per year” benefit? The answers were:  Not Bad, Yes, and Yes.

The portal is amazing but it’s easy to see why it remains a work in progress. Those poor software engineers and managers have done a fantastic job of navigating HIPAA, political, insurance, and state specific obstacles, not to mention a government shutdown, inadequate funding, too many chiefs, and direction that was too little and too late.

Put yourself in the following scenario and ask yourself why the code writers didn’t commit group seppuku weeks ago:

As late as the last week of September, officials were still … debating whether consumers should be required to register and create password-protected accounts before they could shop for health plans.

Holy Cow.  Medicare took a decade to get online and roll out HIPAA requirements.  The Portal People tried to create something as big as Medicare, state-by-state, in a matter of months.  When this is over, they all deserve medals, time off, and raises.

How Many Hearing Aids is That?

 

The insurance actuaries probably know, but they’re not sharing and I don’t know anyone else who can answer that question. Not every state, in fact NO state except Arizona, has the 1 hearing aid per year benefit built into the state plan.  That makes Arizona a good place to start playing around with data and making wild predictions.

The first question is “How many additional people will be covered in each state?”  Last week’s table gave percentages but Audiologists and Economists like to know “percentage of what?” Ditto for medical groups, which may explain why so few have signed up as providers so far.

Real numbers are hard to come by, given the Present Situation of a closed Census Bureau.  But why let lack of data stand in the way? The following Table uses secondary sources to try to estimate numbers of insured and numbers of insured with hearing loss. If everyone who qualifies in Arizona enrolls and avails themselves of benefits, well over 100,000 hearing aids could be dispensed annually in Arizona.  Thassa lotta hearing aids.  We’ll see how many end up getting dispensed, at what prices, and by whom.

Economically, hearing aid subsidies beget supply-side shocks which beget increased utilization rates which beget shifts in the Demand Curve, altogether shifting equilibrium.  It’s not a free market, but it’s a market that’s shifting rightward — more quantity at lower prices.

Let me know where I’ve miscalculated or missed the boat entirely.  Otherwise, logic will say that these data are correct, which I strongly doubt. Please join in — Harvey shouldn’t have to do this alone!  (Editorial note:  big tables are tricky in wordpress.  If the table doesn’t look right, try a different browser — Chrome, Mozilla, etc).

State

%

Insured[i]

Labor Force     (ages 16-64)[ii]Estimated # of Uninsured[iii]Estimated # Hearing Loss[iv]
AL18.8

2,158,000

405,704

81,141

AK21.8

365,800

79,744

15,949

AZ20.5

3,024,900

620,105

124,021

AR21.9

1,350,400

295,738

59,148

CA23.2

18,479,600

4,287,267

857,453

CO17.1

2,740,400

468,608

93,722

CN9.9

1,877,400

185,863

37,173

DE9.6

444,200

42,643

8,529

DC7.5

363,900

27,293

5,459

FL22.8

9,377,100

2,137,979

427,596

GA22.5

4,806,500

1,081,463

216,293

HI10.5

649,200

68,166

13,633

ID17.2

772,800

132,922

26,584

IL17.2

6,587,800

1,133,102

226,620

IN16.7

3,141,600

524,647

104,929

IA11.8

1,634,400

192,859

38,572

KS14.6

1,486,400

217,014

43,403

KY19.8

2,077,500

411,345

82,269

LA24

2,081,600

499,584

99,917

ME14.8

705,500

104,414

20,883

MD12.3

3,124,000

384,252

76,850

MA4.5

3,471,900

156,236

31,247

MI15.4

4,653,000

716,562

143,312

MN11.5

2,965,600

341,044

68,209

MS21.7

1,333,600

289,391

57,878

MO16.4

2,988,500

490,114

98,023

MT16.9

508,400

85,920

17,184

NE15.9

1,021,300

162,387

32,477

NV23.3

1,376,300

320,678

64,136

NH13.6

742,100

100,926

20,185

NJ15.2

4,597,700

698,850

139,770

NM20.1

935,500

188,036

37,607

NY13

9,581,000

1,245,530

249,106

NC19.4

4,723,500

916,359

183,272

ND13.8

392,800

54,206

10,841

OH14.7

5,733,600

842,839

168,568

OK21.4

1,803,900

386,035

77,207

OR17.6

1,957,800

344,573

68,915

PA11.9

6,493,100

772,679

154,536

PR6.7

1,209,700

81,050

16,210

RI15.2

561,200

85,302

17,060

SC20.5

2,164,500

443,723

88,745

SD14.4

445,200

64,109

12,822

TN17.6

3,108,400

547,078

109,416

TX28.8

12,596,100

3,627,677

725,535

UT15.7

1,354,000

212,578

42,516

VT9.2

355,900

32,743

6,549

VA14.7

4,203,400

617,900

123,580

WA16.9

3,476,400

587,512

117,502

WV19

806,000

153,140

30,628

WI11.8

3,046,400

359,475

71,895

WY21.3

305,900

65,157

13,031


[i] 2011 US Census data as reported in AARP Bulletin Oct 2013, p 32.

[iii]Calculated as ( % Uninsured * Labor Force)/100

photo courtesy of it pro

About Holly Hosford-Dunn

Holly Hosford-Dunn, PhD, graduated with a BA and MA in Communication Disorders from New Mexico State, completed a PhD in Hearing Sciences at Stanford, and did post-docs at Max Planck Institute (Germany) and Eaton-Peabody Auditory Physiology Lab (Boston). Post-education, she directed the Stanford University Audiology Clinic; developed multi-office private practices in Arizona; authored/edited numerous text books, chapters, journals, and articles; and taught Marketing, Practice Management, Hearing Science, Auditory Electrophysiology, and Amplification in a variety of academic settings.