A 10-year-old boy survived ejection from a near-vertical waterslide onto cement on the opening day of a publicly funded San Francisco-area waterpark, the construction of which illustrates many of the hazards of the United States’ government-run, taxpayer-funded health care system.
Video footage shot at The Wave, a new waterpark in Dublin, California, shows a boy plummeting several stories down the waterslide Emerald Plunge at an 80-degree angle. That part was intentional. The boy’s subsequent hydroplaning was not. Nor was his launch over the side of the chute. Miraculously, after bouncing on his right shoulder, the boy walked away with a few scrapes, Los Angeles Times reported on May 29.
The waterpark is a public works project. “Total project costs were $43 million,” a frequently-asked-questions (FAQ) document at Dublin.ca.gov, the park’s official website, states. “The largest majority of the funding came from development fees collected over the past decade, and $3 million came from the City’s General Fund.”
That the boy (and his parents) escaped tragedy at the government-run waterpark may be an especially welcome relief to people familiar with botched government projects. Such people understand that ambitious designs and public money do not a successful enterprise make. This is true of recreational projects, like a California waterpark, as well as higher-stakes efforts, like establishing a federal health insurance exchange intended to help millions of people buy taxpayer-funded insurance under the Affordable Care Act.
The failed launch of the federal exchange in 2013 is well documented and acknowledged without partisanship. One of the more thorough post-operative debriefs of the launch of Healthcare.gov, and all the dysfunction of the Barack Obama administration that produced it, is a 2015 book by self-described Obamacare supporter Stephen Brill, America’s Bitter Pill: Money, Politics, Backroom Deals, and the Fight to Fix Our Broken Healthcare System.
The cause and extent of The Wave’s failed waterslide rollout should emerge as city officials conduct their investigation of the accident. But the slide’s problems weren’t for lack of testing, according to park officials. After the boy survived Emerald Plunge, park officials insisted they had followed the manufacturer’s guidelines for the slide, which reportedly had been tested “scores of times” and approved by the California Division of Occupational Health and Safety the day before the near-tragedy.
The seal of approval the Obama administration gave Healthcare.gov was an equally poor predictor of readiness. The scope of the government project, the size of its clientele, and the complexity of the information the exchange was required to harvest from users warranted a testing phase of up to a year, judging by standard private-sector procedures, Brill recounts. The Obama administration allotted weeks. That was hardly enough time to discover, diagnose, fix, retest, and properly approve the site, as users and the Obama administration soon learned.
Miscalculation, miscommunication, or both have put half of The Wave’s waterslides out of commission so far. Similar categories of error beset Healthcare.gov in 2013. The government website’s builders succeeded in constructing their parts of the site to spec but failed to enable those parts to communicate with each other, according to Brill. The result was not a near-vertical water death trap but a virtual Tower of Babel.
One of the biggest problems with Healthcare.gov was its inability to accommodate a reasonable number of simultaneous users. The federal exchange quickly became fodder for Saturday Night Live writers. In the weeks following the launch, shoppers were stalled, stonewalled, kicked off the site, logged out, or pronounced ineligible to buy the taxpayer-subsidized health insurance plan of their choice, as Brill recounts. Ironically, the federal exchange’s launch problems occurred when Healthcare.gov was being underutilized. Relatively speaking, only a handful of people were trying to buy health insurance through the exchange in its earliest days, and even fewer succeeded, due in part to overcrowding.
The Wave has experienced similar shutdowns. The park’s main attractions include six waterslides, two pools, a water playground, an amphitheater, and picnic areas. Officials closed two of the six slides on opening day, pending further investigation of what caused the boy to go Evel Knievel. The park closed a third slide the next day, May 28, to allow officials to experiment with the slide’s water pressure, The Mercury News reported.
How well Dublin’s waterpark handles high volumes of traffic, and whether closing half its slides causes long delays at other slides, remains to be seen. The park had attracted 700 visitors by 2 p.m. on opening day, Mercury reported. That is an average of 117 visitors per slide before the accident and 233 per slide after half the slides were shut down. In addition, the park expects to employ 200 seasonal workers, according to the FAQ. That is one worker for every 3.5 riders, using opening day figures. Presumably, the park will wait to hire more workers until park admission picks up.
All of this prompts the multi-million-dollar question: Was construction of The Wave the best use of public funds? Unfortunately, the people of Dublin cannot know. Even should The Wave recover $43 million in ticket sales at $15 per customer, Dubliners will never know what value the same $43 million might have produced for them had the private developers paying millions of dollars in fees to the city over the past decade been allowed to invest their money elsewhere.
Meanwhile, the value proposition of continuing government-directed health care and insurance system continues to freefall, and too many Americans have gotten wet.
—Michael T. Hamilton ([email protected], @MikeFreeMarket) is a Heartland Institute research fellow and managing editor of Health Care News, author of the weekly Consumer Power Report, and host of the Health Care News Podcast.
IN THIS ISSUE:
* Senate Faces Shrinking Timeline for Obamacare Repeal
* Direct Primary Care Pioneer Folds
* Emergency Room Patients Routinely Overcharged, Study Finds
* Study: Healthcare Price Transparency Tools Seldom Used
SENATE FACES SHRINKING TIMELINE FOR OBAMACARE REPEAL
Senate Republicans are just starting to put together their plan to replace Obamacare, but [they] face a daunting calendar if they are to stick to their plan of trying to hold a vote by the fall.
Senate committee and leadership staff will start putting together a draft bill over the week-long recess. The draft is essentially a starting point for continuing talks, Sen. Ron Johnson, R-Wis., told reporters last week.
The task of drafting early legislative text follows weeks of talks among conservative and centrist Republicans.
“We have had these discussions, and it is time to draft a bill, and we will move forward when we get back,” Johnson said.
No specifics on the draft have been revealed. But the idea is not so much to get one bill together, and senators instead want to keep working through ideas, a source familiar with the matter told the Washington Examiner.
Senate Budget Committee Chairman Mike Enzi told Politico that enough consensus has been made to start writing a bill. However, he added that major fault lines remain, including how to handle phasing out Obamacare’s Medicaid expansion and how to control premiums but address coverage for people with pre-existing conditions. …
But when that vote could be is the big question, and major rifts are festering on Medicaid spending and how to lower premiums. Another sticking point is what to do about Obamacare’s individual mandate and what to do about the law’s insurer mandates.
The bill is expected to be far different from the House bill, which is called the American Health Care Act and narrowly passed this month. That bill was marred by a new estimate from the Congressional Budget Office that found 23 million would go without insurance over the next decade.
The estimate also examined a last-minute amendment that lets states waive some of Obamacare’s insurance requirements. CBO found that sick people who live in states that got a waiver could face much higher premiums over time.
Sen. John Cornyn of Texas told the Washington Examiner last week that his best guess is that the Senate could hold a vote by the August recess, which means lawmakers have only seven weeks to write text and vote.
SOURCE: Robert King, Washington Examiner
DIRECT PRIMARY CARE PIONEER FOLDS
Qliance, considered a pioneer of that medical model, told patients in an email that limited services will still be available for the next 30 days.
The closure will affect 13,000 members between primary-care and emergency-care services. Qliance’s physicians will independently continue to provide primary care for now in a program serving Seattle firefighters.
The company attracted early attention because it had been backed by big-name investors including Jeff Bezos, Zillow Chairman Rich Barton, Seattle Sounders owner Drew Carey, entrepreneur Michael Dell and Seattle venture capitalist Nick Hanauer.
Dr. Erika Bliss, Qliance’s CEO and co-owner, said in an interview that it “ran up against overwhelming financial difficulties and was unable to continue.” She said the company could not get enough bridge funding to get it to when new contracts would be able to come in.
Because the health-care system is “hostile to change,” she said, “it has been literally an uphill battle the whole way.”
Last year Bliss and Qliance President Cheryl Kilodavis bought the company from its investors in a management buyout. Bliss estimated the money invested in the company before the pair bought full ownership was around $30 million.
The company’s model offered unlimited primary-care service for a monthly fee, as well as virtual urgent-care services. Erika Bliss founded the company in 2007 with her cousin Garrison Bliss, who left the company a year and a half ago to open Bliss MD.
SOURCE: Kara Carlson, Seattle Times
EMERGENCY ROOM PATIENTS ROUTINELY OVERCHARGED, STUDY FINDS
An analysis of billing records for more than 12,000 emergency medicine doctors across the United States shows that charges varied widely, but that on average, adult patients are charged 340 percent more than what Medicare pays for services ranging from suturing a wound to interpreting a head CT scan.
A report of the study’s findings, published in JAMA Internal Medicine on May 30, also notes that the largest hospitals markups are more likely made to minorities and uninsured patients.
“There are massive disparities in service costs across emergency rooms and that price gouging is the worst for the most vulnerable populations,” says Martin Makary, M.D., M.P.H., professor of surgery at the Johns Hopkins University School of Medicine and the study’s senior investigator. “This study adds to the growing pile of evidence that to address the huge disparities in health care, health care pricing needs to be fairer and more transparent,” adds Makary, whose widely published research focuses on health care costs and disparities.
SOURCE: Science Daily
STUDY: HEALTHCARE PRICE TRANSPARENCY TOOLS SELDOM USED
Price transparency tools have been gaining in popularity among providers, the idea being that they can reduce medical spending by allowing consumers access to pricing data — which in turn lets them shop around for less expensive services. A new study published in Sage Journals, however, found that few consumers actually use these tools.
Tracking use of the Truven Treatment Cost Calculator among more than 70,000 families from 2011-12, researchers found that only 11 percent of families used the price transparency tool at least once. A scant 1 percent used it at least three times over that two-year period.
Younger patients, those with higher deductibles and those living in a higher-income community were the most likely to use the tool. Families with moderate annual out-of-pocket medical spending — between $1,000 and $2,779 — were also more likely to use it.
The data [show] that, when used, price transparency tools generally work as intended; patients who use them are more likely to receive lower-priced care for certain services. Overall spending remains high, however, because so few people use them, necessitating new strategies on the part of providers to increase their usage. …
Families living in an area with greater variation in healthcare prices were more likely to use the price transparency tool, as were those with high deductibles and those with total Medicare spending greater than $1,000. Younger families with at least one dependent were also more likely to use it.
SOURCE: Jeff Lagasse, Healthcare Finance