Mark McClusky says for elite athletes today, pushing boundaries and breaking records is all about "the aggregation of marginal gains."
The Obama administration has called in additional computer experts to help fix glitches in the health care website, HealthCare.gov.
The site has been up for more than two weeks now and has been riddled with issues. Today, President Obama addressed those problems in a speech at the White House.
NPR health policy correspondent Julie Rovner joins Here & Now’s Jeremy Hobson with details.
JEREMY HOBSON, HOST:
This is HERE AND NOW.
Healthcare.gov has been live for almost three weeks now, but the glitches are still an issue. President Obama spoke this morning from the White House and took the opportunity to highlight what is working well, saying there is more to the health care law than the website.
PRESIDENT BARACK OBAMA: So let me just recap here. The product is good. The health insurance that's being provided is good. It's high quality and it's affordable. People can save money, significant money, by getting insurance that's being provided through these marketplaces.
HOBSON: But the president also owned up to the many problems people have been experiencing.
OBAMA: There's no sugarcoating it. The website has been too slow. People have been getting stuck during the application process. And I think it's fair to say that nobody is more frustrated by that than I am, because - precisely because the product is good, I want the cash registers to work, I want the checkout lines to be smooth. So I want people to be able to get this great product.
HOBSON: NPR health policy correspondent Julie Rovner joins us now. And Julie, let's pick up on what he just said there. He says nobody is more frustrated by this than I am.
JULIE ROVNER, BYLINE: Well, I think that's probably the case. You know, this is obviously the administration's signature achievement. This is not the rollout that the administration wanted. Now, we did get warnings all spring and summer. This went up sort of faster than I think the administration had hoped.
The states really had until December to decide whether they were going to do their own exchanges, and they were still trying to get states to opt in really into the beginning of this year. So this was kind of put together more quickly than they had anticipated. And they did warn us that there would be glitches and bumps. But obviously this is worse than anybody had anticipated.
HOBSON: Well, how bad are the glitches at this point on healthcare.gov, and what about this additional help that the administration is bringing in to fix these problems?
ROVNER: Well, as I think I mentioned last week, things are definitely better than they were at the start. It's easier to get on. It's easier to create an account. The administration has made things a little bit smoother. But things are still not good. It is still difficult to get on to, you know, it was supposed to be very seamless. You could get on, create an account, find out how much things would cost, sign up for a plan.
If things went well, you could do the whole thing, you know, certainly in under an hour, which for selecting health insurance, it would be a very, you know, big deal, much easier than it used to be. But obviously it's - that's not how it's working. And so they have, you know, the administration announced yesterday, on a weekend, that they were calling in what they're calling a tech surge, you know, the best and the brightest to come in and help fix things. Unfortunately that's about all we know.
They have not given us any details on who these people are, where they're coming from or what they're going to do. So we really don't know that much about, you know, how serious the problems still are or what it's going to take to fix them.
HOBSON: When you say on a weekend like that, what do you mean? What does that tell you?
ROVNER: That tells us that they're working, you know, 24/7. But we pretty much knew that, that they've been working 24/7 since this rolled out, to try to get these things fixed, to try to get ahead of the, you know, all of the bad press. You know, one of the big ironies was that during the government shutdown when things weren't going well, all eyes were focused on the government shutdown and the potential for, you know, a default of the government's debt.
The Republicans who were so dead set against this law were kind of, you know, stepping on their own headlines. Things weren't going well, but that wasn't what everybody was paying attention to. Well, now that that's behind us, this is what everybody's paying attention to.
HOBSON: Do we have any idea at this point how long it might take to fix these problems? Did the president give any indication of that today?
ROVNER: No, he really didn't. And, you know, we were sort of set up for him to talk about what the problems were, how serious they were and how long it would take to fix them. And he really did not address that. It's one of the big frustrations for health reporters and tech reporters, both of whom are working on this story. We hear a lot of sort of outside experts giving their, you know, well, if this doesn't work, it might be this.
But the administration itself has really not been very forthcoming, telling us exactly what's wrong and exactly what they think it's going to take to make things better. And that's been, I think, a source of a lot of frustration for, obviously, people who are trying to buy insurance online, people who are trying to help people buy insurance online, and those of us who are trying to tell the public, you know, when they'll be able to buy insurance online.
HOBSON: And one of the most important things here is that a huge pool of people - not just people with health problems or older people, but also young healthy people - sign up. That's the way that this whole law is going to work if it's going to work. Do these glitches on the site make it less likely for healthy young people to sign up for coverage?
ROVNER: Well, that's certainly the biggest concern that the supporters of the law have. You know, it's still very early. We're three weeks into a six-month open enrolment period. But there is a worry, you know, that the people who are going to be most motivated to buy insurance are the people who need it most. So those are people with health problems, people who haven't been able to get insurance before.
They're going to keep coming back and coming back and coming back until they can get on and get insurance. The people who may not need it so much, those young healthy people whose, you know, moms may say, hey, you should really go out and buy health insurance, they may get on and, you know, if they have to wait a long time or if they get kicked off or if they, you know, call an 800 number and say, you know, you have to wait, come back tomorrow, they may not do it.
And that's a real worry, that if this - these problems don't get smoothed out, those people who are not so motivated may not sign up. And then if you don't have enough of those people in the pool, if you only have sick people in the pool, then premiums will start to go up, and then the whole thing starts to collapse. So there is a worry that if this doesn't get fixed and doesn't get fixed pretty soon that it could collapse of its own weight.
HOBSON: And just to be clear for people who are listening to this who have health insurance through work, they don't have to do anything, right, unless their company decides to drop their insurance?
ROVNER: That's right. This is not for the vast majority of people. And I think with all the attention that's being paid to it, people keep forgetting that. This - 85 percent of the country really doesn't have to do anything. If you have insurance through your job, if you have Medicare, if you have Medicaid, if you have VA health insurance, this is not for you. This is for the 15 percent of the population who either has no health insurance or who purchases insurance individual - on the individual market. Those are the people who are eligible to purchase on these exchanges.
And if you have income of less than 400 percent of poverty - it's about $45,000 for an individual, about $90,000 for a family of four - you'll be eligible for tax credits to help you afford it. Those are the people who need to be going to the site - or at least going to the site when the site is up - and looking at their insurance options. You can wait until December 15 to sign up to have insurance that begins on January 1. If you want to avoid this penalty that everybody keeps hearing so much, you can wait until February 15. So you don't have to do this right away.
HOBSON: Julie Rovner is NPR health policy correspondent, talking with us about the health care law after President Obama addressed it today. Julie, thanks as always.
ROVNER: Thank you.
HOBSON: And you can go to hereandnow.org if you've got questions about the health care law. We're taking a look at them. We're putting them through experts and seeing what the answers are. Hopefully we can bring some answers to your questions because it is a very complicated law. And we're all trying to get our heads around it. So go to hereandnow.org to leave your questions. This is HERE AND NOW. Transcript provided by NPR, Copyright NPR.