Why do we think quarterly status reports (QSRs) are such a problem?
Look, people recognize that paperwork and bureaucracy are endemic to any large enterprise. To run a large health care coverage program of 6.8 million people, we are going to need to get information from the people getting coverage–they are going to need to fill out a form or two.
When you need to go to the much-maligned Department of Motor Vehicles, there’s a form… and sometimes there’s a line. But we can be pleased when the DMV makes the renewal of driver’s license automatic so we don’t have to show up in person every time. We can be annoyed when staffing cutbacks means the line to get service is longer than it needs to be.
We may think these bureacratic barriers are avoidable or annoying. But we don’t expect that they are placed there on purpose.
A long time ago, I was an intern for Vice President Al Gore, assigned to his “reinventing government” project. The whole philosophy was how to make government work better for citizens and consumers, to streamline processes so that people could get what they needed and were entitled to from the government in the most hassle-free way possible.
QSR’s are are the inverse of “reinventing government.” It’s government in the service of the budget, of the bureaucracy, rather than the people and the patient.
It may be better than a direct cut in eligibility. But that’s doesn’t mean it’s good, and it probably has a more insidious impact on how people view government (and their relationship to it) in the long run.