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    How to spend $450 million wisely

    Blowing through a half-billion dollars is probably a lot harder than it seems



    Perhaps you have heard about the Affordable Care Act (aka Obamacare). One of its goals is to eliminate the problem of having people without medical insurance (a goal I consider laudable). Under the law, states could decide to create their own health-care exchanges on websites or let the federal government handle the process.

    My state of Maryland was one of the first states in the country, according to the Washington Post, to announce that it would create its own health insurance marketplace. After spending almost $126 million, however, the site crashed within minutes of opening. According to news reports, no one was sure why the site did not work, how to fix it, or how much any fixes would cost.

    So, we are now giving up and will use the system that Connecticut built at an additional cost “between $40 and $50 million.”1

    Misery loves company, so it was heartening to see that last week the state of Oregon gave up on its health-care exchange, opting to send its citizens to the federal website.


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    Peter J. McDonnell, MD
    He is director of The Wilmer Eye Institute, The Johns Hopkins University School of Medicine, Baltimore, and chief medical editor of ...

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