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Hey, Sometimes Government Works

Three months after health care reform became law, the political conversation hasn't changed all that much--except that, instead of arguing whether to pass reform, now we're talking about whether to repeal it. But, behind the scenes, the Obama Administration has been busy putting the law into effect. Today, officials at the Department of Health and Human Services (HHS) unveiled one product of those efforts: An internet portal for consumers trying to get health insurance on their own.

The portal lives at www.healthcare.gov. The idea is to give every working-age American without job-based insurance a place to see available insurance options, compare them on an apples-to-apples basis, and make an intelligent choice. Nothing quite like it exists right now, at least on a national basis. E-health.com, a private website, lets people compare and actually buy policies from private carriers. But it only provides information on private plans--and more limited information at that.

If you want to appreciate the difference--and, more important, get a sense of why this site is helpful--I recommend doing what I just did. Go on the two sites, plug in some sample information, and see what kind of information you get back. I tried a series of hypothetical customers living, as I do, in Michigan: Families and singles, some with pre-existing medical conditions and some without. E-health gave a nice summary of private options. But only the federal site (screen shot below) let me know whether I was eligible for Medicaid, S-CHIP, or COBRA. Only the federal site gave me direct access to the hospital ratings from Medicare's website. Only the federal site had a section on how I go about appealing coverage denials.

This isn't to diss e-health.com, which is a perfectly fine website if you're easily insurable and have the money to afford coverage on their own. (As Phil Galewitz of Kaiser Health News reports, e-health is among the companies bidding to run the federal website and, later, state-based versions that will operate as a portal into the new insurance exchanges.) Also, to be clear, healthcare.gov remains very much a work in progress. Some of the material isn't exactly user-friendly. Some of the key information--like pricing and quality data on plans, as opposed to hospitals--isn't available yet. (It's coming soon, I'm told.) As people examine the site more thoroughly, more flaws are bound to emerge.

But putting together and presenting this much material after just three months strikes me as impressive. And that's a positive sign about more than just health care reform. Sometimes government fails, as it did (spectacularly) with the oversight of offshore oil drilling. But sometimes government works really well.