Slashdot Mirror
Cost of Healthcare.gov: $634 Million — So Far
First time accepted submitter Saethan writes "Healthcare.gov, the site to be used by people in 36 states to get insurance as part of the Affordable Care Act, has apparently cost the U.S. Government $634 million. Not only is this more than Facebook spent during its first 6 years in operation, it is also over $500 million above what the original estimate was: $93.7 million. Why, in a country with some of the best web development companies in the world, has this website, which is poor quality at best, cost so much?" That $634 million figure comes from this U.S. government budget-tracking system. Given that this system is national rather than for a single city, maybe everyone should just be grateful the contract didn't go to TechnoDyne.
Money != contractor knows what it's doing
"Lowest bidder"
Technoli
Why was 90+ million dollars budgeted for the development of one freaking website?
Pretty good is actually pretty bad.
It happens everywhere people can get away with it, just another 600 dollar toilet seat.
“He’s not deformed, he’s just drunk!”
The site had how many people try to sign up in the first day? If you want to compare it to facebook (a popular metric here no doubt) the number of people who attempted to access and sign up on healthcare.gov in the first day dwarfs the first several years of enrollment at facebook. If they had attempted to build a website to handle the load they faced (which will of course taper off quickly once the first wave of enrollees are signed up and done shopping) we would be bitching that they overbuilt the site because they would have tons of servers sitting mostly idle after the initial surge is done.
We need to wait until it has been up for a while before we go around calling it a failure.
Damn_registrars has no butt-hole. Damn_registrars has no use for a butt-hole.
I see opportunity here. Once this beast is _somewhat_ operational it will need to be fed and cared for. That responsibility, like most US government functions, will fall to US citizens. If a security clearance is required even better. Lemons from lemonade I say.
In other words, the issue right now is not the cost of the thing but whether any amount of money can make it healthy in the required time.
If this thing doesn't get right, "they" might have to wave the fine/penalty/tax to be payed by people who didn't sign up, which is why there is a political fight right now "shutting down the government"?
This figure is not just for building a website.
It is for all spending with CGI Federal over the time that they have been doing business with the Federal government, including payments from fiscal years before Obamacare was even passed.
The figure is now being regurgitated by various right wing websites without anything that even passes for thinking.
And also now slashdot, which is disappointing.
It's called 'The Cloud', you can buy additional instances that first month and get rid of them when you no longer need them.
That figure covers 114 separate contracts (see http://usaspending.gov/explore?tab=By+Prime+Awardee&fiscal_year=all&idvpiid=HHSM500200700015I&typeofview=transactions ) Not to suggest that it still wasn't overly expensive, but consider the fact that the system is a national transaction application that has to dip into numerous other federal data sources - and has a mission criticality above and beyond facebook. Still, many of us could have done it better and cheaper, but then again very few of us would actually enjoy working for the federal government and conducting our business the way any federal contractor is required to.
-- Religion is not an exact science
The solicitation number linked to actually refers to the HITECH act, part of the American Recovery and Reinvestment Act, to quote health it.gov:
The Health Information Technology for Economic and Clinical Health (HITECH) Act seeks to improve American health care delivery and patient care through an unprecedented investment in Health IT (HIT).
And it certainly sound like they've achieved an unprecedented investment at least.
Facebook as a privately held corporation for its first six years can cherrypick the cost of its infrastructure as it sees fit. cheap and powerful infrastructure is always a very warm prospect for a market that may be keen to see returns from a soon-to-be public company.
Facebook doesnt take into account the fact that its final cost is spread across the backs of millions of FLOSS developers its never known, whereas the US government is literally developing a system, an open market, that has never existed outside of a single state in its union. The government also doesnt attract facebook-level talent and as such is forced to contend with best practices as it outsources development to well-established industry players. the government began much larger and more fiscally sound than Facebook in its first year, so the purse strings are of course looser.
you're comparing a private company with independent autonomy in the software lifecycle to a government agency beset with lobbyists and average, but not astounding talent. in some cases edicts instituted by governing bodies of the program which may mandate outsourcing to specific vendors regardless of cost; this is how politics works in both private and public sectors. im also certain the signup rate for facebook in its first six years is dwarfed by the healthcare site in its first six hours, which may help explain some of the cost of the program overall. keep in mind the estimate of ~90 million may have been an intentional underestimate as the reform had to be sold to a congress that would rather see the president dead than re-elected.
Good people go to bed earlier.
When a site loads 50+ .js files after you click an 'Apply' button, something is wrong with the design.
It seems to me that the larger the bill and the larger the company sending that bill, the lower the competency.
Our three-person company handles web sites serving hundreds of thousands of users per day for a few thousand dollars. We could easily handle a few million users by adding a few more database servers at a cost of around ten thousand.
Handling what is potentially HIPAA-covered data? Much harder to do than just working with credit card information.
Almost 7 times over budget. And it didn't handle the load placed on it. 8 days later and it's still having problems. And you want to defend it? Oh it's ok that it's a huge steaming pile of crap because why exactly? Do you work at CGI Federal? I could see if it came in on budget. But even then, they obviously did not do any research into how many people would be interested in the site.
"Cowardice in a race, as in an individual, is the unpardonable sin." --Teddy Roosevelt
Everything done by the government costs 3-4x more because government contracts are a way to grease the hands of people who favors are owed to
did you forget to take your meds?
The US government is not known to be thrifty when it comes to spending. Big guns, deep pockets, no fucks given.
Join the Slashcott! Feb 10 thru Feb 17!
I would like to know if there are any connections between contractors and those awarding the contracts - ie Family ties, business connections, etc... in this day and age there is absolutely no way a website should cost this much. I team of around 20 proficient Web professionals should be able to make almost anything in around 1-2 years max, with a max cost no more than 10 million. Half a billion? Follow the money, this is at best gross negligence on the part of those awarding the contracts, at worst misappropriation.
Active duty military who get paid very little to defend the country, and VA staff.
...these are the same assclowns everyone wants to trust their healthcare insurance to when they claim they'll cover more conditions, add in pre-existing conditions, add tens of millions of people to the list of insured, won't hire any new doctors, quality of service will go up, and prices will go down? Yeah, right. And Social Security will still be solvent by the time I reach retirement age.
It's time we quit buying the bridges these idiots keep selling us.
In the end they will lay their freedom at our feet and say to us, Make us your slaves, but feed us. - Fyodor Dostoyevsky
Except that there are services nowadays SPECIFICALLY built for this type of scaling, like AWS. You can spin up extra servers for temporary high traffic - especially high traffic that was absolutely foreseen. Funny how Amazon's website can handle the traffic on black Friday just fine.
Sorry, but I've been doing web development for 15 years and have worked on large projects. I can't see the cost for this project being more than $20-30M for up-front development (that includes planning, documentation, meetings, coding and testing - all without outsourcing) and at most $20-30M per year for software licensing, hosting, bandwidth and maintenance. And I'm talking top-dollar.
For $634M, they could have gone down the wrong path (the one you mention) and committed to long term-contracts for those unnecessary idle servers and still have $300M leftover.
People who say "money does not buy happiness" are just people without money trying to make themselves feel better.
I have insurance through my employer and they have no intentions of cancelling. That said, I was curious about plans and premiums and chose to check it out. It has now been a week, and I have only been able to get to the Contact Infomation screen before i get the Unknown Error message. It took me 3 days to create an account alone without error. I have tried IE, Chrome, and finally caved into trying Firefox as well...and the site problems are not browser-related. They are coding-related. As of today, I am still unable to see actual plans or premiums...and my time is too precious to spend on the phone when there is a website that is supposed to work. I can also say, load is not the problem either. The first day or two had massive wait times on the site, now, I get in fairly quickly...only to see Unknown Error.
One: Schedule Fail. Compounded by late award of the contracts to develop/influence:
Contracts Awarded Dec 2011
Two: massive requirements base to develop specification for development and implementation: The PPACA was 1800+ pages, and the associated regulations are 10,000+ pages, and are STILL changing. Can't develop without a spec and design, with big parts of requirements still changing.
Three: inadequate testing. The above-referenced link states that security testing BEGAN in August 2013, less than two months before rollout. There's no mention of load testing
Four: Integration issues. The Obamacare Exchange system combines data from numerous agencies and systems, and integrating between them is always a difficult task
Five: Identity-management. This is in parallel to Integration, somehow all identities need to be federated into a single overarching system.
Twenty-three months, even with a top-flight team, would simply not be enough to do this: this is a 5-7 year job. . .
That's true, and a very good point. I don't work with HIPAA-covered data, but could they use something like amazon's government cloud?
Exchange launch turns into inexcusable mess: Our view
Park said the administration expected 50,000 to 60,000 simultaneous users. It got 250,000. Compare that with the similarly rocky debut seven years ago of exchanges to obtain Medicare drug coverage. The Bush administration projected 20,000 simultaneous users and built capacity for 150,000.
That's the difference between competence and incompetence.
The too-much-demand excuse also is less than the full story. In addition to grossly underestimating demand, the administration and its contractors seem to have made mistakes in building the websites. The system for verifying consumer identity has had persistent problems, as have pull-down menus.
Nor were problems confined to the 36 state health exchanges run by the federal government. Sites run by 14 states and Washington, D.C., bogged down because they have to refer to federal databases to verify consumers' identity.
much of left-wing thought is a kind of playing with fire by people who don't even know that fire is hot - George Orwell
But the government itself did not make the website. The website development was contracted out to a PRIVATE company...
The comparison to Facebook is complete BS.
Even though (as somebody already pointed out) the $634m number doesn't represent just Healthcare.gov, the comparison to Facebook is completely fallacious. Facebook has money coming in other than just their investments; the investment money that is referenced in the Crunchbase page is in addition to any other income that they had. In other words, Facebook spent way more than $634m in that period of time.
Lazy journalism at its best.
The real problem is that NOBODY, in ANY branch of the U.S. government, gives a shit about anything other than enriching themselves.
I cordially invite ANY evidence to the contrary.
If you are talking about politicians I'll agree with you. However if you are talking about government employees I have to tel you to taking a flying F@&K, as you have no idea what you are talking about. I am working without pay at this time. I don't know when I will be paid thanks to the shutdown, but that hasn't stopped me from doing my job.
It is all too easy to join the mob, shout invectives at the speaker and drown out reasoned debate. This post has it exactly right. We don't know yet whether the 36 state system simply underestimated the traffic, has some sloppy coding - which will be corrected quickly, or has fatally flawed architecture that cannot be easily corrected. Did they use Top Down Design, Bottom Up Design, or perhaps, as seems more likely, the designers are advocates for the Agile Software Manifesto. By January, we will know a great deal more about what they did, what went right and what went wrong. The are important lessons here for anyone who writes software, and it is too early to make valid conclusions until the details are made public.
This statement alone is scarier, than whatever was leaked by Mr. Snowden. Surprisingly, the President's cheerleaders — normally so suspect of government's invasions into our privacy — ignore this implication.
Gravity of the mission, whatever it is, has little to do with the cost of implementation. First step on the Moon was a gravely important mission, but it was easy for Neil Armstrong to do it...
Yet another argument for letting the government do as little as at all possible — rather than explode its size as the Administration is doing.
In Soviet Washington the swamp drains you.
Here's a nice overview of just what's going on with the ACA website. The chart from Xerox illustrates why the system is a just a teensy bit more complicated than Facebook. http://www.washingtonpost.com/blogs/the-switch/wp/2013/10/09/heres-everything-you-need-to-know-about-obamacares-error-plagued-web-sites/
I guess this was voted down because EVERYONE knows that the US Government has NO vendor management.
How is 634 = 500+93.7? Whilst I do agree to some extent to journalistic exaggeration, there is a good 40.3m chunk missing.
Obama ran on the platform that something needed to be done about the millions of people that had no healthcare.
I guess the only surprising thing is that only a million people tried to sign up. With all of the grass-roots programs encouraging people to sign up, with all of the hype, they should have been expecting traffic of DDOS proportions.
That's a part of it. The largest part in the evaluation is education of work force. Not a lot of rank and file programmers in the US get more than a bachelors degree. Why would they? Unless you're doing work with advanced algorithms or some sort of management there aren't a lot of drivers to have the additional education.
Because of the weight contracts have on education you see a lot of folks with unrelated degrees and foreign diploma mills. That leads to poor final output.
On a campaign level the administration knows how to put together software quickly. But that's not the way the law allows the gov't to operate. Large contractors have been gaming the bidding process for three decades.
This is pure bureaucratic inefficiency work at it's finest. Some examples if this is like a typical Federal contract would include things like:
Changing specs on what your asking for multiple times throughout. You start building to one spec and part way through things change to another spec requiring expensive redesigns. Case studies have been written and college courses taught about the sheer number of design changes on why certain federal programs that have run billions of dollars over.
Too many chiefs calling the shots which requires too many chiefs answering for the shots being called. For political purposes you can have people from any number of agencies and or divisions within an agency all trying to design the thing. Almost none of them have a clue what their doing, but they'll pretend to be a designer just because they can. The resulting quagmire can cause committee upon committee just to get things approved at any given level and in case you missed someone that feels overlooked they can bring the whole thing to a grinding halt just to remind everyone not to overlook their office.
If your the Federal Government your allowed, in fact your - required - to use racism and sexism when bidding things out. Anyone that is involved with government contracts is well aware of this and as a result contractors that meet the discrimination guidelines get selected over those that don't even when they cost significantly more. When your guaranteed to get a job even when your charging more money, do you think someone is going charge the market rate or their chosen rate?
Politics, don't forget about politics as the new administration gets in and typically wants to kills anything that was a signature of the old. If you think life is difficult with inter office politics, imagine having powerful senators and governors doing everything they can to run interference on your project.
This is only a small smidgen of reasons why these things run costs that are sky high as they are and part of the reasons why you see Republicans want to cut government spending. They look at something like this and say, the private sector would do this in a fourth the time for a fourth the cost (not taking sides, just explaining their logic).
As opposed to the health insurance industry, which is a billion dollar a year boondoggle whose only functions are to determine who gets billed for what, and to deny benefits in order to increase "shareholder value".
Even fairly incompetent governments around the world have been shown to be able to manage a single-payer system without it becoming such a drain on the GDP.
Every military person I've known have done it for the free college money they give out. The military basically buys service with tax dollars. These kids don't generally go die for free and if they do it's because they were brainwashed into nationalistic American exceptionalism.
Working at the VA is a huge credit on anyone's resume, especially in the Neurology/Medical sciences field. It's hard to get in there but a huge bonus if you can claim that experience.
People are inherently selfish but I will admit there are a small percentage that do things because they mean well and desire nothing in return. A dying breed for sure.
Der Tod ist der einzige Weg hier raus!
The plans are too expensive for poor people. This government healthcare stuff has made healthcare much, much more expensive. I mean back in the day I had a $10 deductible with full coverage for everything and I paid $348/mo. Now I'm paying $20/mo for my employer-supplied CDHP that gives me an HSA I can add $3500 per year to pre-tax, meaning I save about 30% on everything from bandages and antihistamines to Target clinic visits and emergency surgery. On top of that, the HSA covers anything beyond a $3,500 per-anum maximum: if I get cancer or break a bone or whatnot, I pay $3,500 and they pay everything (my deductible is $1500, but it goes toward this $3,500 maximum). They do pay 100% of any wellness service I contract--a doctor's visit for a check-up, physical, vaccinations, other preventative care is covered absolutely and I pay $0.
For the privilege of managing your own risk and being immune to sudden ridiculously high health care expenses beyond $5,500 per annum, while paying for absolutely everything yourself, you need to pay... $194/mo on the open market. Seriously. HDHP for an individual is about $200/mo. The cost of a plan with Wellness benefits (the insurance company pays for you to get regular check-ups and vaccinations to avoid the eventuality of paying out when you fall severely ill) and a $3,500 per-annum out-of-pocket maximum is around $300/mo. They charge you $200/mo to have a savings account and $300/mo to get two $75 doctor's office visits and a $15 flu vaccination for free.
The risk should be substantially lower if they supply clinical services. Some modern HMOs are as low as $70/mo and they have actual coverage. How in the fuck are no-coverage HDHPs $200/mo?!
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I think most of that went to Al Gore.
I come here for the love
What right wing sites, liberal???
There are no right wing sites. All of the sites, and the entire media, are left wing and biased. It is a constant attack on our principles, our freedoms, and America by the entire universe, and reality, which has an unfair liberal bias! Why do you hate freedom, liberal? Why do you hate prosperity? Can't you see that there are only a few conservatives (read, glorious defenders of freedom) left, and that the brave ones who speak out are shot? GLORY, GLORY HALLELUJAH! We shall prevail in the end!
Just wait until they actually start managing your health care.
You probably could have given a fourteen-year-old a laptop and a copy of ruby on rails and gotten better results.
I'm trying to teach myself to set people on fire with my mind... Is it hot in here?
But don't worry: the ACA is going to reduce the deficit.
Actually, we already know that there's some incredibly sloppy coding (such as dozens of .js files being loaded when hitting Apply) and we do know they were warned about significantly underestimating the traffic more than three months before it rolled out.
It's not forbidden and it's implied by the Constitution's reference to patents and copyright that Congress is expected to support the advances of the arts and sciences. This to me implies that it's expected that individual states will fund technological advancements in their own state.
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Just checked and I see Java, Apache (Tomcat?), Bootstrap, jQuery.
Would have been a lot cheaper if site were built with Microsoft Office Professional tools like InfoPath, Access, IIS and Word to edit the actual HTML templates.
Even Dreamweaver should have cut costs by at least half.
Or that the process of government contracting imposes extra expenses and deters talent.
Most of the companies that apply for government contracts are companies that are in the primary business of landing government contracts, as the process is heavy and arcane enough that it deters most other people. People who work for such companies have to have a higher tolerance for bureaucracy than do many people in tech (though I think this is a cultural difference rather than skills per se).
I'm fairly uneasy with how many people are happy to jump in with the idea that giving preference to women and minorities is why quality is low and costs are high. (Which you did not say, but which has been repeatedly mentioned here.) I think we have a system complex enough that navigating and gaming the system becomes the primary skill that allows one to get contracts. Preferences may be used to game the system, but that doesn't mean it's about incompetent or corrupt women and minorities:
https://www.youtube.com/watch?v=Jr1kwC0je1Y
Get paid very little to ... go out and put on a political show that has no impact on our lives and safety aside from destroying our economy and creating a lot of panic so that our public servants can seize power and get us to call them "leaders".
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The important lesson here is that a project which ran over budget by more than 6x failed to meet a very foreseeable design requirement. Keep this in mind the next time you see someone on here assert that the ACA is going to reduce the deficit.
When I was working as a contractor, the contract was so poor, we didn't always know what we were supposed to be doing. Heck, we weren't allowed to read the contract. They came to us after the contract started and needed a list of servers and all third-party software that was installed. Since no one could read the contract, we didn't know why this information was needed and management couldn't (or wouldn't) tell us. So some admins included things like Apache and Cold Fusion where others provided a list of all software that wasn't included with the OS (like expect). And hardware replacement was interesting. For example, the contracting company was responsible for providing new servers if the server couldn't perform its function any more but the agency was responsible for providing a new server if they wanted something that wasn't able to function on an existing server. So lots of push from the contracting company to improve performance and keep systems going when they should have been replaced years before.
The contracting company brought in a troubleshooter because were were in the red contractually. He reviewed the contract and recalled when it was first put out for bid. He'd reviewed it and recommended the company don't bid on the contract because it was so poorly written. He did get us back in the green but there was a lot of hard feelings with the agency in part because we weren't able to read the contract so didn't know that we had a process we were supposed to follow when we changed the functionality of servers (so contractually we were supposed to upgrade Apache on a server that had been converted to a DNS or Mail server a couple of years previously).
[John]
Shit better not happen!
"Commerce", "Necessary and Proper", and "Spending" clauses.
The problem with your idea is that this site was NOT built by the government. It was built by private contractors in a competitive bidding process.
And you want to turn the police over to private contractors?
Lots of other things are done by private contractors for the government. For example most of the defense department procures everything it gets via competitive bidding from private contractors.
I'm looking forward to the day when the federal government runs all of healthcare with their awesome efficiency and competence.
Except for ending slavery, the Nazis, communism, & securing American independence, war has never solved anything.
It's not all their Federal work. It's all work for the Centers for Medicare and Medicaid Services, which is the group implementing and managing healthcare.gov.
Because the private sector has a proven track record of delivering (for the majority of Americans) shittier healthcare and a higher cost.
Oh, and what "decision" are you talking about? The death panels?
$6 trillion. And we got less out of that than Obamacare.
This is one of those things where you just shake your head.. how fucking stupid are these people.. I would have taken 2/3rds that and done a way better job :p
Ars has a great article up going into more depth of why this happens so often here: http://arstechnica.com/information-technology/2013/10/why-us-government-it-fails-so-hard-so-often/
I see this comparison a lot, so let's dive into it.
http://www.marketwatch.com/investing/stock/fb/financials
Facebook had a COGS cost of 1.36 billion, and a R&D cost of 1.4 billion. Since they basically only operate a web site, that's all the cost of operating a web site. So to 2.76 billion dollars in a single year spent on Facebook.com.
Healthcare.gov spent 614 million over three years. At $200 million a year, that's roughly in line with Facebook's spending level back in 2009.
And Facebook has never gone down, right? It's never had a load issue, right? Yeah, didn't think so.
"And when things still go wrong, they simply throw 'more money at the same people who caused the problem to fix the problem.'" - Hey, that describes the ACA itself!
My sister, in Washington State, is fairly poor. (She's an aerialist and aerial instructor, and working retail part time to fill in the gaps. I'm hoping she'll be doing a bit better as she builds her personal trainer clientele, but artists generally don't make a ton of money.)
On Tuesday afternoon, she called me up because she didn't have a lot of experience picking insurance plans - this will be the first time she's had insurance since she turned 18, and she's in her early thirties. We went over the options, and chose a local HMO we both know*. She'll have a $200 deductible, $1200 out of pocket max, modest co-pays, and easy access to providers.
After her subsidy, she will be paying $5.62 a month for this coverage.
I. Am. Ecstatic. (Especially since I've essentially been her back up health insurance in an emergency.)
* Not my favorite place in the world, but decent enough and it's the coverage we had growing up.
After I graduated but before I started my new job, there was a period of time when I needed short-term health insurance. A friend sent me a link to an online health care clearinghouse where I was able to search for what I wanted (catastrophic coverage) and buy it ($5k deductible, everything covered, $26/month), with very few hassles. The system worked quite well, and I doubt they spent a billion dollars* on the site.
*Correct to one significant figure
You're of course assuming that the purpose is the same as it's stated purpose, to work, rather than funnel money that used to go to the Good 'ol Boys to the Good New Boys.
The Bottom lines is we pay $5 - 5.5K per capita for health care or $ 1.57 - 1.727 trillion, just add the DOD budget to the Medicare/Medicaid and the difference is a measley $200B of chump change; anything that doesn't gut the DOD is just liberal feel-good smoke and mirrors. Middle-class People are reporting their quotes on the exchanges are in the $500.00 a month with a $20,000.00 anual deductable range, that's just insane.
Apocalypse Cancelled, Sorry, No Ticket Refunds
Yea cause all apps basically scale infinitely without any architectural oversight. Cloud solves everything. Do you pitch your snake oil as a consultant or just a clueless in house IT lifer?
Before it was scrapped, the Canadian government had shelled out over a billion dollars to pay for the federal gun registry. It was initially budgeted to cost a few hundred million. Why the bloat? Because they didn't factor in the cost of every single department and major player having a different computer system, and wanting integration with their systems, and they didn't want their individual departments to pay for it, or have to change their own internal systems. So it all got added into the registry's budget instead.
Magic doesn't work in my presence. My power of disbelief is too strong.
And that in itself is a problem. that time span is > one presidential term. The government has a very hard time with long duration large projects that have high visibility. On the one hand, there's this tendency for massive scope/requirement changes as the funding source (Congress) changes. To combat that, wise managers try to institutionally stabilize the scope and requirements with a lot of procedural things (formal reviews, waterfall processes, etc.). That solves the "customer changing the requirements" problem, but also makes it difficult to be adaptive as problems crop up.
Back in the day, when Social Security was rolled out, I'm sure they had similar problems (there are probably people still alive who spit fire at the word Roosevelt). But, because it was a paper system, it rolled out slower, and could adapt on the fly. Today, there is this naive expectation that the wonderful software app (or website..all the same) will manifest in all it's final bug-free glory on opening day. I note that none of the counter examples that have been cited in the posts so far had that trouble free rollout.
THis is the classic big-system, scalability problem. "Me and some friends can whip this out in our living room over the weekend, what's the big deal" The big deal is that you and your friends are dealing with 50 fractious state customers with totally disparate rules, some of whom are actively working to subvert the system; you're not working with 300 million potential customers; you're not required to comply with tens of thousands of pages of regulations and requirements ancillary to the several hundred pages of actual requirements. Do you and your friends have a DCAA approved accounting system or equivalent? (Don't want the taxpayer ripped off by fraudulent accounting, after all?) Do you have appropriately certified facilities with access according to the various regulations? Are those folding beach chairs in your living room ergonomically acceptable? (more an issue for your worker's comp carrier.. you DO have workers comp, don't you? Only if there's a problem will OSHA get involved) Sure, you're not running a steel mill or a coal mine, but there are significant lost time injuries (usually RSI) at software companies too.
Doing *big* things requires *big* companies, just to handle the sheer volume of the stuff that arises.
That's far better than what I can get quoted, and I've been offered no subsidy. I'm trying to get a college student to get herself some insurance with an HSA; she takes care of herself and never goes to the doctors ever, so I figured an HDHP like I have (I have a CDHP through my employer) with an HSA option and Wellness coverage would be good. Holy crap the options are expensive and it's a bring-your-own-money plan >:|
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During the Regan expansion, I chose to sign a contract with the Navy. My path did not involve any contribution on their part towards my college education; AOCS is not a scholarship program, and like a fool, I decline to participate in the GI Bill.
I truly did it because I thought it would be exciting (it was, mostly), but we were not (formally) at war with anyone until Desert Shield/Storm came along. As an added bonus, I learned to fly and got to play with really fascinating machinery- "something in return". I would concur that my motivation was indeed selfish from a strict interpretation, but not exclusively so. And most of my peers came from the same frame of mind. Despite a minority that saw it as a path to the airlines, most of us "mean(t) well and desire(d) nothing in return" save the pay and adventure. I would conclude the percentage might not be that small, even today. OTOH, I would strongly encourage my son to choose any branch other than Army or Marine Corps as the chance of getting fired upon is much greater than in the others.
Have you ever noticed that anybody driving slower than you is an idiot, and anyone going faster than you is a maniac?
You missed a key point.... competition. There was no competition once the contract was awarded and thus no incentive to do anything right.
How many of those were 304 not modified? And how large were they? I don't know but no one else seems to except one guy who does web design, and apparently knows little to none about servers.
All of that happens client side, making his DOS comment ridiculous. He did not say that caching was disabled, and did not give a byte count. I'm discounting the whole report until I have time to look myself.
Still doing better than the NIH's 6 billion dollar catastrophe.
Occasionally living proof of the Ballmer peak.
We could have a health timeline, a colonoscopy video upload button, sharing permissions that are really awesome. Yaaay!
Medicaid/Medicare and Tricare/VA, the only government administered healthcare programs in the US, have been more or less doing okay all this time. Sure, there are some flaws in the VA when it comes to mental health coverage, but we're getting better at diagnosing and tracking PTSD.
Occasionally living proof of the Ballmer peak.
Because the private sector has a proven track record of delivering (for the majority of Americans) shittier healthcare and a higher cost.
Oh, and what "decision" are you talking about? The death panels?
The private sector still lets you choose. You can change and shop around, which my company does every few years. When we get to single payer, are you going to fire the government, your sole source of health coverage when you're unsatisfied with your coverage or service? The hundreds of thousands of service denials from Medicare and the VA should wise you up, but I can understand if that never happens.
"Now, I doubt any of you would prefer a rolled up newspaper as a weapon against a dictator or a criminal intruder."
No, now you have $600M spent and you STILL don't have a website that works. This amounts to treason you know.
Hardly. Incompetence, maybe. Treason has a specific meaning, not just "someone doing something I disapprove of".
Keep in mind that $600M is about 25% of the cost of a single B-2 bomber, and the nation is going to get a hell of a lot more benefit out of this web site then they will from the 21 B-2's that we built to mostly gather dust.
I don't care if it's 90,000 hectares. That lake was not my doing.
This figure is not just for building a website.
It is for all spending with CGI Federal over the time that they have been doing business with the Federal government, including payments from fiscal years before Obamacare was even passed.
The figure is now being regurgitated by various right wing websites without anything that even passes for thinking.
And also now slashdot, which is disappointing.
If you chase the links to the original treasury website, half of the $634 million was paid after the passage of the 'Affordable' Care Act, so I'm especially interested in the specifics of those contracts- which are still more than triple the $93 million dollar original ACA website contract.
So perhaps it's a $300 mil website instead of $600 mil. That's not really much of an improvement, to be honest.
"No, it's all lies! The website only cost a bit over a quarter-billion dollars!"
We do have to find out more specifics, to be sure. We've certainly sent that company a massive amount of money since 2010.
Alcohol, Tobacco and Firearms should be the name of a store, not a government agency.
Over budget means the estimate was wrong, it does not point to any design or technical failure by itself.
First day load is going to be most of the user base, and at least one reporter from every news org, and the bad guys trying to hack it, and the curious public. If they built for first day load it would be overspending. Had they budgeted for 10x the servers, it sounds like you would have been okay with that a year from now when they are idle?
And it has to load data from IRS, HHS, and other places that were not designed for this load.
Succeed day one and you find yourself atop the wasteful spending list next year. The only real problem I see is outdated info for determining eligibility, which is in systems external, and hardly something we can blame here.
Yesterday there was a story about a school district spending millions on some shitty tabletsfor students, only to recall them and basically admit compleet failure of the project.
On a comment on that story I linked to a story about West Virginia spending way too much on enterprise routers that the didn't ever need
And there are thousands of examples of this kind of incompetence every day that just don't show up on our radar.
Our system of governmental management is broken. It has been broken for decades. The people who are making the decisions, writing the specs, supervising the progress, and awarding the contracts don't actually have any expertise in doing those things nor does anyone on the project have the vision or pride to see a project be done well. It doesn't help that all of the management of these projects can blame the very contractors that they hired when everything falls apart. There is no accountability, no negative repercussions of being part of a hugely over budget and mismanaged government project, because even if you do get fired you can go work for the same few contractors who are experts in getting the goverment contracts that everyone knows are going to be over budget and mismanaged.
We setup a system of goverment contracting that absolves the goverment management of any responsibility and encourages the externalizing of responsibility through layers of contractors and subcontractors. Anyone who would have a clue or give a shit about their job and the quality of their projects and work doesn't work in the goverment bureaucracy.
My friend said it best about these kind of people: Get into the public sector to do good, stay to do well.
And this sadly, is the worst of all outcomes.
At least with the government running things, they can enforce cost controls, have people in it for the long term...
But long ago, people found out that was just not innovative enough and wasn't as productive as many private sector outfits.
So what did the US... and many other countries do.
They try and get the best of all worlds, and end up with the worst of everything.
They try and control and run it via government, while pushing production to the private sector.
Sadly, most of the things that make the private sector work are absent in government due to the government controlling it.
free-competition - not there... replaced by a single purchases with a complex bid process
failure - well government can't fail, so it's not like if they make bad choices/purchasing decisions that they are out of business.
simple transaction - nothing is simple with the government. It is not just about getting the job done at a good price. It is about various other mandates (propping up this or that group, meeting untold regulation if they are needed or not,....)
Because everything the government does it does badly. That's the nature of government. If you want "good" government, you whittle it down to just those activities which history has shown aren't credibly done outside government -- military, justice system (police and courts), funding basic scientific research (not technology research!), and so on.
I agree. One such area is health care.
http://www.huffingtonpost.com/2013/03/26/charts-health-care-costs-americans_n_2957266.html
http://www.washingtonpost.com/blogs/wonkblog/wp/2013/03/26/21-graphs-that-show-americas-health-care-prices-are-ludicrous/
Every military person I know did it because they thought it was the right thing to do. I guess we know different people. And how do you explain the people who reenlist? They go to more expensive colleges?
I'm guessing you met your sample during or shortly after college, giving you a sample bias.
You forgot one element:
Cost-plus contracts. Otherwise known as "Pay-to-fail, then fix. . . "
My brother had already graduated college when he decided to enlist in the Navy. Maybe they paid part of his bills, I know they paid for his MBA. But that wasn't the reason he signed up in the first place.
I worked for the VA for a few years in IT. It wasn't for the money, I can tell you that, and while it was a great experience in how to write code, most of the other skills I used there were worthless outside (I'm not a coder anymore, so that's technically worthless too). But the other people I worked with there were very dedicated to their job.
Mostly...fresh unicorn blood. And a crapload of middle men.
Trust me, you can have .gov paying $150,000 for a contractor to a big firm. Which then hires a smaller sub-contracting firm. Who then may even have to pay a third company who holds the H1B visa. And in the end the level 3 Java developer is earning a meager $50K.
This total figure includes building out an entire health care IT system, not just the cost of making *one* website.
Comparisons to facebook.com are irrelevant.
Thank you Dave Raggett
One of the ideas in the healthcare meme-o-verse is that private industry can do it better.
Is that really true? What country actually has a privately run health care system that works? Surely not the US, with its high costs and history of large groups not covered, and many who can't get insurance at all. And the mechanism where employers pay for health insurance is miserable. Being employed and having coverage should not be conflated, especially when so many are vulnerable to losing jobs when we go through an economic cycle.
What health care systems work well? Socialized ones.
Even in the US, with its horrifically high costs the best part of the health care system is Medicare.
Sometimes government does it better.
Having done a few contracts for the feds over the years, I have a pretty good idea why something like this happened.
Probably the biggest one was standards chosen before the project was even conceived and shoehorned into some product it wasn't intended for.
With the NSF, it was using Ada and ISO/OSI instead of C or C++ and TCP/IP. We solved that problem with creative prevarication. Since there was no imaginable way that the functionality was even implementable in ISO/OSI, we got away with it.
With DOI, it was using IIS and Windows rather than Linux and Apache. We told them that would increase development costs by a factor of ten and delivery would take twice as long. A waiver was quickly produced that let us do things our way.
It tells you how awful the federal contracting system is if you have to lie or bully them to let you deliver a working product.
Why didn't I get a piece of that action?
You're just proving his point. Private industry does a fantastic job fleecing patients.
I swear to God...I swear to God! That is NOT how you treat your human!
The college money benefit is pretty borderline really. For some it works out because they actually have to time to take classes when stationed near a school. But others end up doing revolving deployments in such a way that actually attending school is impossible. And if you wait until you finish your enlistment to go to school you only have 10 years in which to do it and during that period you can only collect the benefit for something like 36 months. So in order to actually get all of the benefit you need to go to school full time for three years straight.
With all of that I haven't found it to be worth my time to persue a degree. Luckily though I picked a career that doesn't require it especially given the six years of experience I gained during my service.
By the way, to participate in the MGIB you have to pay in a set amount of cash during your first year of service. That money is presumably matched or something by the government and held to pay out the benefit later. I only knew one guy that didn't pay into the MGIB and I can't think of any that have yet to actually use it from my group of friends. I would wager that there is a lot fewer tax dollars paying for educations in the military than you might think. And given the way that the military straight up uses people I think it is a more than fair trade.
Put that way, I can't object. This is efficiency ... of a sort.
There's a crappy dynamic spreadsheet that shows you the healthcare plan marketplace that says "powered by Solara" I think. So, I'm sure they're getting a fat cut of that. And, when you set up a new account, you're quizzed on credit report questions gleaned from Experian who also sponsors a support line. You figure millions of people will be verified every year and I'm sure Experian isn't charging pennies per hit.
I swear to God...I swear to God! That is NOT how you treat your human!
Reposted
Private insurance still lets you choose. You can change and shop around, which my company does every few years. When we get to single payer, are you going to fire the government, your sole source of health coverage when you're unsatisfied with your coverage or service? The hundreds of thousands of service denials from Medicare and the VA should wise you up, but I can understand if that never happens.
Or maybe ask the increasing number of brits who are pulling their own teeth if their single-payer system is working for them.
http://www.cnn.com/2007/WORLD/europe/10/15/england.dentists/index.html
Single payer doesn't eliminate the problem, and it manages to add another deficit-increasing entitlement to the mix.
"Now, I doubt any of you would prefer a rolled up newspaper as a weapon against a dictator or a criminal intruder."
To get it to actually work will require 10x that in money and time. But long before then everyone will wind up in court, the whole thing will be scrapped and they'll start over with an Indian company in India.
Not GP, but on a lark I went there and checked. The signup page generated 80 total requests, 3484.09KiB. 55 are JS files, at 1998.25KiB. The bulk of the size goes to jQuery stuff (multiple modules like dataTables, jquery-ui, etc.), and there are 41 files under 20KiB (25 under 5KiB), suggesting they could have been minified pretty easily. Refreshing shows that almost all files come back 304, except for a 1x1 tracking .gif, a SAML2 session timeout extension POST, and the page itself.
Notably, everything loads from the healthcare.gov domain, so all those millions of first-time visitors had no chance of having any of the extremely common jQuery libraries already cached. This means that each one of those new visitors triggered 80 requests. If only a million people tried to sign up on the first day, that works out to 80 million requests for ~3.245TiB of data. If they were evenly distributed across an entire day, that's a sustained 926 requests/s using ~39.4MiB/s of bandwidth. Not super-high, but of course what happens when a third of the country tries instead?
To their credit, almost everything else on the rest of the site appeared to take fewer than 20 requests (some pages, only 2) and averaged ~100KiB.
I'm looking forward to the day when we all subsidize relatively expensive ER visits, and when we create something called "bankruptcy law" where after someone has sold their house and still doesn't have enough to pay their medical bills, the heavy socialist hand of government steps in and interferes with the free market, saying the liability no longer exists. That'll be the real socialist revolution, finally ushering in the era that Marx promi--
Oh wait, sorry. That's the status quo that I was describing, the thing we hippies (Republicans) are trying to keep, that The Man (reactionary Democrats, with their "people should have to pay their own bills" hardass attitude) reformed, because the status quo was not only consuming too much of the GDP (thanks to the inefficiencies), but "too pinko", as those unyielding Adam Smith worshippers put it.
What the right wing Man needs to understand, is that when an uninsured hippie goes to the ER for subsidized health care, that's not really communism, man. It's just Jesusism. Jesus said people shouldn't have to pay their bills, man, especially once they're bankrupt and living in the street and no longer part of the ownership society that The Man keeps telling you, is so keen. Jesus said it's in society's interest to simultaneously bankrupt and subsidize everything, because a nation of homeless sick people, like, that'd be a far out party! A Party In The Streets, man!
Sure, the ER visits cost more and the overall quality/duration of the care isn't as good, but Democrats who point out performance value issues like that, are just being penny-pinching economists. Hey penny pinchers, do I have to remind you what Jesus said about rich men entering the kingdom of heaven?
Democrats, don't you see? Don't you get that your Republican Brothers just want you to join them in tuning in, turning on, and dropping out? It'll be grooovy, man! Republicans want to protect your freedom to run up bills at someone else's expense. Republicans are the modern followers of our heros, LBJ, FDR, the last bastion in protecting our FREEDOM to have those squares with their jobs, bail us out. Freedom, man. Why do all you Democrats hate our freedom to be dependent on the taxpayer-funded social welfare handout called "bankruptcy?"
Not having to pay our medical bills is a right, dammit. I can prove it: there's nothing in the constitution that says we don't have the right to make other people pay our health care bills! And that means our handouts are a 10th amendment protected right. Take that, man.
(Who's who in liberalism vs conservatism: it's all so confusing!)
"Believe me!" -- Donald Trump
And you want to turn the police over to private contractors?
Sure, why not? Look at how well it works in shopping malls.
Where are you? It will be pretty interesting as a map emerges of what prices are available where.
(I believe her plan would be about $260 without the subsidy. She is, as I mentioned, fairly poor. But then, that's pretty darned decent coverage.)
Nearly every libertarian book, essay, and blog post is just a google search away.
Shakin' my head, man, shakin' my head.
I've known many Canadians and Britons (both when I lived in the UK and after). Although this is at best clearly merely anecdotal evidence, the only of them that ever preferred the US system to the national system they grew up in (or were still covered by) were two people whose incomes were well into the six digits.
Most of the fear-mongering about the UK's NHS and the Candian equivalent in the US is by people who have never had any experience of either system.
> The hundreds of thousands of service denials from Medicare and the VA should wise you up
Presumably, being denied service by Medicare and the VA is MUCH worse than being denied service because of a corporation instead of a government? Or is it supposed to sting less if I'm not being "denied" service so much as being offered something I could not possibly afford?
Private medical insurance doesn't solve the problem, and it manages to add another income-crippling profit sinkhole to the mix, all the while profoundly increasing costs at every level of the system.
I was also concerned on the tax credit vs. subsidy question. I don't know how it works in other states, but in Washington, she was given the option to have her subsidy applied up front to her monthly payment. I don't know how other states are handling this, and Washington built their own exchange and has an administration that is fairly committed to making this work, so they might not be typical. But the $5.62 a month is her upfront cost, not a refund she gets later. (She could have done it that way, but this clearly worked better for her.)
In this particular case, with this HMO, I'm not so worried on the limits, but then this is an area I'm pretty well versed in,* which is why she was calling me. There are things I'm not super thrilled about with this HMO - their limited formulary meant that I had my allergies poorly treated until I finished school and went into tech** - but they're pretty upfront about what is covered, and they're good at not screwing people financially. Which, yes, is often not the case. (I may seriously not miss working at Microsoft, but I do miss the insurance...)
* In my case, it's been all about the spine injury, mostly.
** This might not sound like that big a deal, but before my asthma was well controlled, it would tend to totally freak out if I got any kind of bronchial infection, and not only did this mean I was sick a lot, but I was ending up in the emergency room about once a year for years in there. This hasn't happened for almost two decades, now. And, like, I'm a runner and martial artist now. Better living through modern chemistry. (Yes, new drugs are part of this, but for most of the time this was a serious problem, the drugs were there, just not available to me until they were off patent.)
The system wasn't overloaded from people trying to sign up. That's government propaganda for you.
http://www.latimes.com/business/money/la-fi-mo-california-health-exchange-glitches-20131001,0,7108713.story
"State officials said the Covered California website got 645,000 hits during the first day of enrollment, far fewer than the 5 million it reported Tuesday."
And that's just hits. The government refuses to say how many people have actually registered accounts and how many have actually bought insurance.
The web-site not only can't handle a moderate amount of traffic, people aren't interested in signing up or buying the product even if they can get through.
http://www.washingtonpost.com/blogs/wonkblog/wp/2013/10/03/a-trickle-not-a-wave-what-insurers-are-seeing-in-obamacare-enrollment/
"After two days without any word on sign-ups, Blue Cross Blue Shield of Louisiana received some reassuring news Wednesday night: Seven people had signed up for its plan on the marketplace that day."
Work Safe Porn
If the health insurance industry only wasted a billion dollars a year, we wouldn't care about Obamacare. I'm assuming you meant "trillion dollar a year boondoggle", and even that is low.
Government sites are not allowed to use AWS.
You forgot there's a 50,000% markup on any contract involving government work.
I did look for a neutral estimate beforehand, one not tied to single-payer advocates or defenders of the medical insurance industry... ...then I made the effort moot by typing "billion" instead of "trillion", just as you said. Oh for an "edit" button. Thanks!
Ah, I see I misunderstood your comment. (Sorry, home with a cold.)
So the question really is about how well the site estimates one's future tax credit. (Which is why there was all the encouragement to expand medicaid, for the people who don't make enough money for the tax credit to apply.) *shrug* I am not hugely concerned - it would seem to most likely be a problem in her case if her income changed greatly over the course of the year. Which isn't that unlikely, but then it's likely to go up. (I'll have to remind her to look at restructuring how she pays if it does go up significantly. But I'm not stressing - as long as she realizes it's a potential issue, she'll deal with it. She's poor because of her choice of profession, but she's also smart.)
You act as if it's all or none as to which scenario to plan for and serve.
There are numerous ways that they could have spread the load around so that the initial extremely high load they had to expect could have been served quickly, but several months from now when the load drops to the fraction they aren't saddled with a bunch of extra servers idling with nothing to do.
Here is one of the .js files I happened upon...
1) You can spend your own money on yourself. When you do that, why then you really watch out what you’re doing, and you try to get the most for your money. 2) You can spend your own money on somebody else. For example, I buy a birthday present for someone. Well, then I’m not so careful about the content of the present, but I’m very careful about the cost. 3) I can spend somebody else’s money on myself. And if I spend somebody else’s money on myself, then I’m sure going to have a good lunch! 4) I can spend somebody else’s money on somebody else. And if I spend somebody else’s money on somebody else, I’m not concerned about how much it is, and I’m not concerned about what I get. All government spending falls into the fourth type.
Can't we just get the Tricare people instead of the VA people?
The VA has more problems because the patients have more problems, to be fair. The medical record of an 18 year old perfectly healthy recruit will be much more slender than that of a 90 year old WWII veteran who has had heart surgery and a pacemaker, has diabetes and an amputated foot, and cataracts removed.
Occasionally living proof of the Ballmer peak.
Regardless of your thoughts on the ACA's other provisions, the idea of having state and federal bureaucrats handling the money for so much of the economy is pretty troubling.
These are the people who brought you the DMV and their federal contractor equivalents, who are arguably even less competent and hard working.
Clearly, the bidding process was flawed. Or the specifications put in. Or the vetting of the bidders. Whatever it is, the government, once again, has done a poor job.
Sure, private enterprises have problems with contractors too on occasion — but, if they do it too much, they go out of business, because a smarter competitor wins...
Though this is off-topic, yes, this is, what I'd do. The police-services company would still be hired by the government (usually — the town's) — for a multi-year contract. If they don't perform — crime too high or citizenry too upset over some methods, they get fired and replaced by a competitor. This is not much different from the current practice of employing individual officers — just cheaper and would allow better-run police departments to expand beyond a single town bringing their better methods with them.
In Soviet Washington the swamp drains you.
Where were the stress tests? Not sure about the rest of you who are web devs, but when we're putting out a new product, we hit it with around 2-3x of what we expect our capped demand to be ahead of time to see what happens. I work in the financial industry so we -do- get in trouble if our new web apps fail, and we're still contracted under a certain amount of money so if we go over what we give as an estimate, we eat the loss(which directly changes what our profit-sharing take will be, which is motivation to not screw up).
And if I ever put out something like this, I probably wouldn't be working here much longer. Though a file like that would never make it into production anyways because somebody else would see it and go 'WTF'.
As opposed to what - business? The more I work in IT, the more I become intimately familiar with how badly most projects go. The difference is that not each failed IT project at a business gets national attention, which is what happens for every government project.
There is only one real difference between a corporate IT project and a business IT project: who controls the red tape. In business, that varies with size. In government, it is ultimately controlled by the voter, and how much insistence there is on covering your ass when a failure invariably becomes public.
Incidentally, this also points to another difference between government and IT: in business, you can actually fail. The vast majority of business failures are accepted as part of the process. Government is not allowed to fail, and failure in any area is a huge issue, requiring huge amounts of red tape to provide political cover.
Either accept that government, like business, can fail, or quit demanding an impossible and non-existent perfection from it.
Those who can, do. Those who can't, sue.
Dentistry in the UK isn't covered by the NHS per se. Saying that there is financial support via the NHS for dental treatment for low income and unemployed people and some groups get free dental treatment (children, retired people, pregnant women etc.) Cosmetic and expensive work like implants aren't covered by NHS payments but extractions, simple fillings etc. are. The major problem a few years back (your scare story is dated 2007) was that few dentists would take on new NHS patients for logistical and funding reasons. That was fixed and now they actively solicit NHS-funded patients -- indeed I was nearly chased down the street a few weeks back by a dental receptionist determined to sign me up as an NHS patient when I declined private treatment after an examination.
The same non-NHS deal applies with opticians and prescriptions for glasses and contact lenses although some places, like my home nation Scotland, offers free eye testing and a voucher for the first £80-odd towards glasses on a two-yearly cycle.
Private healthcare can be purchased in the UK (google "Harley Street" for details) as can private health insurance (BUPA, for example) but it is supplementary to the NHS and in most cases private patients who suffer serious problems requiring expensive treatment in an ICU or the like tend to get transferred to the NHS when the insurance runs out.
Please provide a source for that claim because Amazon seems to contradict that:
http://aws.amazon.com/federal/
People who say "money does not buy happiness" are just people without money trying to make themselves feel better.
While many full time employees will find employer provided insurance their best option, it can have substantial drawbacks. My employer policy is reasonably priced for the employee, but a family plan is $700 /month with a $5000 deductible and $8000 out of pocket max. The provider network is also small and omits several area physician groups and hospitals. This is not uncommon for smaller companies.
The exchange plans are just as costly without the subsidy, but at least it gives options to those who are self-employed or who find the employer insurance less than optimal for their circumstances.
Note to those shopping for insurance, in many cases you can go directly to the insurer and price or buy insurance. The prices are probably the same, but at least the insurers website should work. Also, there are private health plan comparison websites that still exist and are selling 2014 ACA compliant plans.
One more reason why having the federal government run everything is such a bad idea. If Facebook had wasted this much money and had such a poorly functioning website, people would move on to some other social website and they would be out of business. Amount of my money wasted: zero dollars. Sometimes the market really does work.
In the case of Healthcare.gov, it will never get shut down or go out of business...ever. hundreds of millions of dollars of our money will continue to be thrown down this rat hole, year after year after year.
But the people that are most likely to use this website (low income) don't pay federal income taxes anyways, and they get subsidized stuff from it, so what do they care? Keep voting for more federal government involvement! Free shit for all!
it is also over $500 million above what the original estimate was: $93.7 million.
A government project has gone several times over it's original budget? Shocking!
How many of those were 304 not modified? ...
All of that happens client side, making his DOS comment ridiculous.
First, 304 headers are generated by servers when a client requests a page that has not been modified since the last access date reported by the client. Clients don't generate those headers themselves, so, no, its not all client side.
Now if you understand how DDOS attacks work (All they do is open a LOT of connections), then you'll understand that having 50 or 75 separate links in your page, even if they ALL get cached, will still cause 50 or 75 separate connections just so your server can tell the client "304: Not Modified"
That, along with the fact that most systems are setup to limit http/https connections to 2 per client at a time and that many people have some not insignificant latency, is the reason behind embedding js directly in the html source and using sprites with CSS.
I only found 4 external JS files linked in their source, not 50, but the point is that 50 js files, even at 0 bytes each, with 25 million visitors is DDOS quality.
I worked as a consultant in a big consulting firm. The formula is simple: awesome sales team, lots of faceless and C-grade developers. The government got had by a good sales job. Bad developers take 10x as long, and induce 5x as many bugs. Adding more developers makes the problem worse. All the government needed to do was higher top talent. Maybe approach google or microsoft to build the website. Rolling out something like healthcare.gov requires top-tier talent. Sure the initial estimate will be bigger, but how can you compete with top-notch sales attack teams? The problem is endemic to the whole industry.
Like all pain, suffering is a signal that something isn't right
I'm pretty damn sure for another $50M you could license a tech transfer from Amazon and have your own fucking AWS, in your own datacenter.
A successful API design takes a mixture of software design and pedagogy.
Who treats a rash with medical care? And besides, these HDHPs don't cover that; if you show up at the clinic for poison ivy and a Prednizone prescription, you pay for that out of pocket. If you show up for appendicitis and it costs $1300 for xrays and surgery, you pay for that out of pocket.
Support my political activism on Patreon.
This whole sordid affair was sold on the premise that costs would go down. And millions of foolish people believed it. And it will never, ever be turned off. It will suck resources at a fantastic rate.
Murphy was an optimist
This site is so crappy that Drudge actually linked to its Javascript:
https://www.healthcare.gov/marketplace/global/en_US/registration.js
That's some high-quality crap right there.
#naabhaprzrag, #sverubfr-000, #agi-fcbafberq, negvpyr[pynff*=' negvpyr-ary-'] { qvfcynl: abar !vzcbegnag; }
I have insurance through my employer. It's considered a cadillac plan and will no longer be offered next year, rather than paying the surcharge. When I was a private contractor I paid cash for medical as I needed it. I may have to go back to that.
Oliver's law of assumed responsibility: If you're seen fixing it, you will be blamed for breaking it.
> Why, in a country with some of the best web development companies in the world, has this website, which is poor quality at best, cost so much?
My guess would be, because the government did not use them.
Alternate answer: Perhaps it was written in ADA?
Oliver's law of assumed responsibility: If you're seen fixing it, you will be blamed for breaking it.
More than that, the whole thing seems just to be invented from nothing in order to criticise the developers. The link they refer to as their proof simply doesn't show that the $600m was all spent on healthcare.gov - it may have been the cost of setting up all the IT infrastructure behind the ACA.
Our private insurance system is also responsible for driving up health costs themselves, which deflates your argument considerably. There is a reason health costs in the US per capita are so far outside the norm for developed countries.
Namely, "private efficiency" isn't about cost/benefit efficiency, but rather profitability.
First, those other contracts have continued - they didn't drop out of the total when the ACA was passed.
Even the ACA contract isn't for 'building a website', kids. It's for creating and running the 36 federal-based exchanges. The design of the web site you use to access the exchanges is a very, very small part of that.
I'm not saying the website wins any prizes, of course. But as far as what money is being spent on, everyone here is doing the equivalent of confusing the cost of, say, creating American Express' web site with the cost of running American Express. This is ridiculous.
Possibly it is not directly that women and minorities are not competent for the job, merely that such requirements tend to attract companies that are more focused on ticking boxes than providing quality service (as suggested by your second paragraph).
When comparing the cost of healthcare.gov to IT costs for private enterprises, Facebook is one data point but don't forget all the money spent on startups that failed. We The People have already received infinitely more return on our money than those people did. In other words, dumb comparison.
Why are you comparing your costs (after your employer pays most of it) on your current insurance to the full price of a plan on the exchange? You don't need to buy anything on the exchange, you're already covered.
Wut?
I said government should do things which private organizations have historically failed to do effectively.
Basic scientific research rarely has a short-term monetary impact. Nor are the results generally protectable as intellectual property. How could they be? The results are little bits of new knowledge about the nature of the world around us. You have to put many of these bits together to make any money, and the bits you find are as likely as not to have no relevance whatsoever to the business in which you engage.
The government has to fund it because outside of what's achievable by hobbyists no one else will... and if we don't advance science then the next decade's engineers won't have a foundation on which to build your new iPhone Uber Deluxe.
The constitution has nothing to do with the matter.
Moderating "-1, Disagree" is simple censorship. Have the guts to post your opinion.
The ACA was designed to fail. The goal all along was single-payer. Everything is going according to plan. Nobody is that fucking stupid.
Remember, you heard it here first.
I don't even want to say apples to oranges, because in such a case both are at least still fruit. Facebook is a site where if some little thing goes missing, is out of order, some text is wrong, etc - no worries. People sign away their privacy, and they had no real need to protect it - not now, and especially not during the first 5 years. Facebook tied in with ad places, but that was only for ads...nothing major. The obamacare site on the other hand has PHI/PII issues to deal with, HIPAA, and various other security concerns. It has to share, in a secure manner, this PHI/PII information with third parties - which means designing interfaces with those 3rd parties. It has to be able to connect with various data points to get info about you. It has to be able to make accurate recommendations about very important life decisions. Was it done poorly? Yes. Is comparing it to the operating costs of facebook fair? No, not at all. Is $634M way, way more than it should have cost for something at the quality level as what we got? ......yes, definitely.
If she never goes to the doctor, maybe she should get Catastrophic coverage (if she's under 30), especially if she doesn't qualify for any subsidies (which don't apply to Catastrophic plans; out-of-pocket subsidies only apply to Silver plans).
You can't get any subsidies because you're already covered by an employer plan.
Even private corporations that outsource key components of their business frequently have problems. Thus the current private sector trend for insourcing. If you want to see how bad things can get in the private sector, take a look at the Dreamliner. It really is an eye-opener when one of the largest, best run private sector companies goes through a disaster like that. There are always added costs when you outsource something that you have the ability to handle internally.
So what the heck makes you think that outsourcing should be the default for governments? There the impedance mismatch is far worse than in the private sector, making the likelihood of efficiency much lower.
Sometimes you do need to outsource, such as in cases where you are procuring weapons systems. But the reality is that these situations are guaranteed to stick you with great inefficiencies.
No, the idea that government should outsource everything doesn't make any sense.
Though I wouldn't see those people as being more likely to be women and minorities, either.
I do suspect that is might be axiomatic that the more barriers there are to being considered for a job, the less likely the primary consideration will be the quality of work.
And I find it rather depressing that the preference for women, minorities and veterans are called out so much more frequently than all the other barriers.
Up until now, I've had a "catastrophic" health plan that covered "really bad" things (basically I pay 100% of the first $10K of anything, and 0% of everything over that) and left me to pay cash for routine care, which is the way it ought to be.
I paid $55/month for my premium, and found a local doctor who charged me $60 cash for office visits. There's a local radiology company that charges very reasonably for imaging, and I pay $75 for a complete blood workup including PSA and A1c.
Now, I have to have a minimum "Bronze" plan, which I found out after a week of trying would cost me nearly $400/month, nearly $5K/year.
Before I was paying $600/year to cover "really bad things" plus $300/year for my two routine care visits. In the past 15 years I've been doing it this way (I'm 39 now), I have never once come close to spending $5K in a year on medical care, and now I'm paying that just for a high-deductible insurance premium.
Fuck you, Obama, and the millions of screaming, idiotic young morons who swept you into office on the wings of a rainbow colored unicorn.
the number of people who attempted to access and sign up on healthcare.gov in the first day dwarfs the first several years of enrollment at facebook.
Facebook had hundreds of millions of registered users in the first 6 years. As in, more than the entire population of the US. So unless people are registering for US healthcare from other countries, I'm going to have to call bullshit.
That's like saying a computer is HIPAA compliant. AWS does nothing to ensure HIPAA compliance. It's all a matter of how it's configured. There's nothing inherently "HIPAA Compliant" about AWS. It doesn't meet ANY of the criteria set out in the final rule until an instance is configured to do so.
Yeah, no one has ever joined the military because it was the only option left. I hope the sarcasm was obvious enough for you.
Using a system engineering Waterfall approach is fine for designing hardware, and the embedded software that runs in it. I approve of Waterfall when it comes to pacemakers. But when it comes to software, stuff that can be easily upgraded and replaced (because it's "soft"), a test-driven iterative software engineering approach is the only responsible way to create a high quality product. Agile is a known good way to achieve that.
The big problem is that projects generally fail slowly and expensively when the organization ordering the work only knows how to deal with managing a Waterfall project, and they order work from an Agile company.
The Waterfall organization says "we want X and Y delivered on Due Date Z". The Agile organization says "We'll put X on the top of the stack, but might not get to Y by date Z." The Waterfall organization says "Not acceptable, you committed to delivering X and Y on Z, so do it or we cancel the contract." The Agile organization quietly mumbles "whatever, dumbass" and violates their own processes to crank out a bunch of shoddy shit to meet the date. The Waterfall organization says "you met the contract by delivering on date Z, now it's time for the next phase where you promised features A and B on date C. Oh, and by the way, features X and Y suck, so fix them too." The Agile organization quickly cashes the check, again says "whatever, dumbass", and starts cranking out patches and even more shoddy shit. Now they're stuck with a bunch of poorly-performing, non-unit-tested code, and there's no longer a way of fixing it short of a rewrite. Of course there's no time for this rewrite, because there are more features to add and bugs to fix. And checks to cash.
If the Waterfall organization is extremely inept (and any organization that is trying to manage or own software with a Waterfall method is, by definition, inept), and the Agile organization is unabashedly greedy, it's easy to see that they can get years into their contract before some astute bean counter decides to pull the plug and eat the sunk costs. Both sides are looking hard at the shit that resulted from this mess, and both sides blame each other. It's easy to blame the Waterfall organization, because they're generally stupid and incompetent, run by MBAs and not engineers. But the Agile organization needs to show some responsibility too, and call a halt to caving in to unrealistic demands instead of cashing the checks.
John
Anyone remember the diablo III launch? Somewhere on the order of 1-2 million people trying to log in all at once and blizzard still managed to make everything work right within hours of bringing the system live
If by "within hours" you meant that "a few people were able to play the day it came out," you'd be more accurate.
Absolutely. Here's another way to look at it. At $200/mil a year in spend, an (to make numbers easy) an average spend of $100k per employee (which for a salary+benefits+sg&a number is probably low), that's 2,000 people working on the web site. Facebook has 3,000 employees. And thats if it was all employee costs, no equipment.
Remember they have to interface with 50 different state systems, plus other government agencies. It adds up quick, 5 people per state to figure out the state requirements and interfaces is 250 people right off the top, for instance.
I'm afraid there are a lot of ./ users who have build a web site that sees 10k users a day, which is not that hard on commodity hardware, but have no clue what it takes to handle 10 million while staying inside the lines of a bevy of government requirements.
Government contracts...particularly Federal government contracts...are a mess. Just getting considered to bid on a govt contract is, for most companies, impossible to qualify for. The game is rigged and the rules are set by a few very large companies. Northrop Grumman, IBM, Ascenture, and Deloitte are a few of the better known ones.
The selection process is based on basically two factors - the vendor being able to meet all the requirements in the contract and putting in the lowest bid. One of those requirements, typically, is prior experience delivering services to the Federal government. This effectively shuts out new participants. The lowest bid is easily gamed by putting in a sub par system and then making money on change orders to fix what should have been done right in the first place.
Compounding this is a general ineptitude on the Government side in terms of project oversight.
There have been many instances of huge government IT projects that have failed. Just google "IT project failures US government" and you will see numerous examples. Part of the reason is what I outline above but there are others. Government projects tend to be very large in scope and large projects represent more risk. Politics plays a big role. Current IT systems are usually a hodge-podge of outdated, inefficient, understaffed, poorly documented pieces of software often numbering in the hundreds. It's just a massive undertaking.
So the cost overruns and poor performance of the Healthcare.gov system is no surprise to me. I'm hopeful that it improves but history suggests otherwise.
The summary is misleading to the point where I think it's deliberate:
Lets look at "Not only is this more than Facebook spent during its first 6 years in operation"
This is worded like it's comparing the cumulative cost of Facebook's first 6 years to the ~3 years that Healthcare.gov has been in development. But they're actually talking about the annual cost of Facebook compared to the cumulative cost of Healthcare.gov. As for Facebooks annual cost Facebook spent 449M in 2010, 1.1B in 2011, and 3.19B in 2012. FB also has the advantage of a far slower rollout, dealing with far less sensitive data, and needing far less integration with other systems so it's unclear if it's a valid comparison for things other than load.
There's another whopper in "it is also over $500 million above what the original estimate was: $93.7 million". So lets look at what the article actually said:
Take that out, and you’re left with roughly $363 million spent on technology-related costs to the healthcare exchanges – the bulk of which ($88 million) went to CGI Federal, the company awarded a $93.7 million contract to build Healthcare.gov and other technology portions of the FFEs.
So Healthcare.gov was never supposed to cost $93.7 million, only the contract to CGI to write the code was $93.7 million, the rest of the numbers had nothing to do with that.
There's certainly issues with Healthcare.gov but this story looks like a partisan plant to me.
I stole this Sig
Absolutely — in fact, you read carefully, I acknowledge just that in my post. However, those, who have such troubles too often get eclipsed by competitors. Government, however, has no competition — more or less by definition.
So, instead of switching the service-provider with the same ease Verizon can be changed for AT&T, we are forced to foot the bill for the repairs and upgrades to something, that has not worked right since inception.
Nothing, really — I never said such a thing... My point is, the government should only be allowed to do the things, which can not be done by non-government entities (like courts and military). Just as you should not be running Seti@Home inside your kernel, you should not be managing private citizens' healthcare inside federal government, for example. And, note, I said "can not" — a so-called "market failure" to do, what somebody thinks is worth doing (like, most recently, the "municipal WiFi"), is not a justification for making the government do it instead. No, sir.
Luckily for all present, this was not my idea...
In Soviet Washington the swamp drains you.
Congratulations, you're clueless both about the amount of red tape and strict rigor that is required when handling HIPAA data, and about the meaning of "the cloud" in this context. Why did you even bother to comment?
In the context of handling peaks of demand in computer power, "the cloud" refers to 3rd party services such as Amazon EC2. You'll often be running on virtual machines, with no easy way to ensure in a 100% foolproof fashion where data winds up. Even if you keep everything in memory, it may be swapped to disk on the host operating system, with no convenient way to wipe it. Granted, it won't be easy for an attacker to exploit these kind of phenomena, but HIPAA doesn't care about such arguments; a potential breach is a potential breach. To legally use a cloud service for HIPAA - protected data, the cloud service in question would need to go through a lengthy certification process so that they can offer a "HIPAA-compliant cloud service". Now they could have gone to Amazon and asked them to do just that, but it would have come at a price... (see my post is suddenly not offtopic anymore)
Oops sorry, I'll have to retract that post. Looks like someone took care of it already.
Seems pretty simple to me - you collect a well-defined amount of information, compare it against a small number of possible healthcare coverage options available, then present the user with a list of possible/available choices w/ prices (factoring in the legislated subsidies, if applicable) and once a selection is made, you hand the customer info off to the selected insurance company...
None of those are hard nuts to crack, most first-year programming students could do it.
As for the 'amazingly high number of visitors' some officials are liming, pish-posh, a quarter-million hits/day is nothing staggering, and is probably smaller than when the Gov't rolled-out a similar website for all retires to enroll in Medicare part d, andi'm sure it is a fraction of the traffic the Obama For America 2008 & 2012 campaigns administered for a tiny fraction of the reported $600+ Million cost (so far).
Is there any real reason a dozen techs in silicon valley couldn't have implemented this in less than 6 months for under $1 M?
Ken
What health insurance industry? We haven't had a health INSURANCE industry for decades. We've had a health CARE industry which we insist pay us for every little sniffle and then get mad when they won't cover the The Pill.
Once upon a time we had a health insurance industry... It didn't pay for visits to the family doctor but when you had a major hospital stay it kept the cost from wiping out your life's savings. That was actual insurance. But then the government got involved with what tax deductible "insurance" plans had to cover and regulated genuine insurance out of existence.
Moderating "-1, Disagree" is simple censorship. Have the guts to post your opinion.
It sure looks like this website was made back in 2004. I'm guessing that the time travel was expensive.
I also wonder why the used images for text, which has been SO critized for... the last decade?
At a first glance, I think someone slipped about 5 zeroes too many on that price tag.
Why in the world didn't they just go to one of the dozens of "roll your own" web site companies that specialize in this kind of thing?
They could have at least kept it in the US.....good grief......
Ferret
Sic gorgiamus allos subjectatos nunc
I keep hearing this. The paper work adds little or nothing. If you've ever worked with any large organization they always have large paper work requirements. It's necessary to keep employees from embezzling and/or giving juicy contracts to family.
The 30% comes from the fact that gov't contracts usually require higher paid union workers because a lot of the time the contracts are social programs designed to spread wealth in disguise. Think they old public works projects but without the stigma.
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not everyone knows this, because it's bullshit. Bureaucracy isn't adding to the cost. Most of the time the cost is in line with private interests. It's just that when the gov't loses money it's just lost, but when the big corps lose money the gov't bails them out.
The most common reason you see gov't "waste" money is when they're pumping money into the economy to keep it going because too much of the wealth has concentrated at the top. You're not seeing waste, you're seeing socialism in the only way Americans can stand it after decades of anti-socialist propaganda from our corporate masters...
Hi! I make Firefox Plug-ins. Check 'em out @ https://addons.mozilla.org/en-US/firefox/addon/youtube-mp3-podcaster/
Really? No such thing as Connection: Keep-Alive? Every request opens a brand new connection?
Fuck me, I didn't know that.
Now, a poorly designed server that actually does not allow keep-alive, that would be something to complain about. But the web design expert did not address that. If someone has an actual test of this, then we have something to talk about.
Try again.
Government isn't in the business of efficiency. It's in the business of job creation. And to do that, they have to create and reward multiple levels of useless hierarchy, with waste at every level. This is so that everyone get's appeased a little bit, instead of the most efficient getting the benefit.
Not to mention that Facebook had some pretty severe growing pains for aperiod of more than a year, with frequent downtime - and remember how godawful Facebook Chat used to be? Ugh.
toresbe
A fair point. But they are also the barriers most likely to be the differentiator to young white males who tend to predominate in the US and UK it industries.
Wait until you see what they will get to actually make it work! I will bet the correction will be almost as costly, if not more so.
We just lost a contract to a "government insider" type of company where we came in at half the cost. We have done exactly the same project at 10 Fortune 100 companies in the last year, plus two large government organizations. The biggest complaint from the government? We didn't have enough hours people's time on the project. 2600 for them 600 for us. When I asked why this mattered if our references and past performance show we could do the work as described. I was told that they only get this funding once in awhile and needed to "take advantage of it." Ummm...ok...now I know why things are so screwed up.
Why is Gov IT expensive and low quality? Several reasons.
1) Politics. Not something you have to deal with in the private sector. It isn't supposed to be part of the bureaucracy, but it is. High level management seems to be trending more towards their political masters. It is called political interference. Want some jobs in your District? There are procurement rules, but every manager knows how to get around all of the rules, the higher the manager the better they are at doing it. Also every time they (Management) gets caught breaking their own rules, the reaction isn't to punish the person who broke the rules (who is likely politically connected anyway), but rather to make more rules so "this can never happen again", which really means you are just punishing everyone who actually has to follow the procurement rules. Just procurement can take much of a year for even a small project.
2) Regulations. Government IT is (supposed to be at any rate) held to a higher standard. Security, Privacy, Redundancy, etc... Projects have to be over designed to meet all the extra requirements placed on them. This makes projects cost much more, take much longer to design, and implement.
3) Policy. What does this database/application do today? Because you know what, it is going to change tomorrow. Everything will have to be redesigned for the 15th time. Which also makes the systems wonky for lack of a better term, as every redesign causes its own problems that don't get caught. Much to my regret policy drives IT, not the other way around. When management wants something done a certain way, no isn't a welcome word.
4) Contractors. Government has rid itself of most IT staff, basically to look like it cost less and that government staff is smaller. Nothing is done in house anymore. Everything is hired out to contractors. Contractors charge a LOT of money. Some are good, most that do government work, do a lot of government work. They suckle at the teat of unending money and guaranteed contracts. Parasites. While some delay is always going to be fault of government with change orders and the like, many I am sure draw out contracts to extract the most they can.
5) Power. What IT that does exist in government largely is a maintenance role. Running networks, systems, etc... I don't know if they are paranoid about also being outsourced, or if it is just a normal government management power type play to try and protect their own fiefdom but they are actively obstructionist. You want something done. It has to be this way, according to this, by them, when they say so. From a technical perspective in many cases this makes sense, however I doubt much of it has to do with anything technical and more about making sure their kingdom is secure.
So why did a project cost 10x what it should? Well it isn't so far fetched when you think about it.
You want *facebook* or *google* to handle my HIPAA compliant data?!
His ignorance covered the whole earth like a blanket, and there was hardly a hole in it anywhere. - Mark Twain
That's $634m to LAUNCH the healthcare.gov site. How many more hundreds of millions are they going to spend over the next year to -fix- it?
Well, extrapolating, probably another 200 mill. It will take a couple of years for the systems to be truly stable. Just like any other complex software.
His ignorance covered the whole earth like a blanket, and there was hardly a hole in it anywhere. - Mark Twain
Catastrophic Coverage is $194/mo.
"Catastrophic Coverage" is what's called a "High Deductable Health Plan"; for your employer, it's a "Consumer Driven Health Plan". You have a high ($1,500 or so) deductible and a reasonable out-of-pocket maximum ($3,500, $4,000, $5,400, etc.). No prescription coverage. Often these plans do include wellness coverage, but non-wellness plans are out there too; wellness coverage is becoming popular because it reduces insurance company risk.
Sans-wellness, you can get one for ~$200. With wellness, $300 and up.
What the fuck sense does that make?
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Most of the catastrophic coverage plans I see in the exchange (for 27 year-old) are in the $90-200 range. If someone "never goes to the doctor, ever", then the deductible doesn't really matter that much.
HDHP is not the same as Catastrophic.
"Marketplace catastrophic plans cover 3 annual primary care visits and preventive services at no cost."
Catastrophic plans at the $200 range make no sense, is my point. It's a rather large expense for little benefit. I have a CDHP because I save money in my HSA and use that for everything; it costs me little, and the savings go toward covering my health care costs. $90 is more like it.
The long and short of catastrophic is that you want to manage your own low-impact high-probability risk (i.e. clinical care) with a safety net on your high-impact low-probability risk (i.e. major surgery, cancer, etc.). An HSA lets you save up money, which you siphon a small amount from to cover your high-probability low-impact risk; but you should retain some savings in there each year, and if you incur a high-impact risk event (i.e. cancer) you have the $3500 or $5600 or $10,000 in the bank to cover your per-annum out-of-pocket. The insurance company gives you some other balances ($1500 deductible, so in one shot you can't totally drain it) and hopes that they come under or just over (i.e. $1800, they pay $300; $7000 in one year, they wind up paying out some $1400; etc.).
You take most of the risk. Catastrophic events aren't supposed to happen often--you should be ancient before you wind up on diabeetus maintenance or radio-chemo, and then you've been paying in for 40 years so they got $50k or so off you already anyway. By then you should have a family plan with higher cost but better coverage--it costs you more with less return, but also better controls your risk so your expenses are more predictable--to handle a spouse and children, so they've got more positive benefit out of you anyway and that covers other people. Not everyone experiences a huge catastrophic event--injury from vehicular collisions and sports, major disease like diabeetus or cancer, etc. don't happen to everyone, and some of these are small (cancer is expensive; car and sports injuries are in the few thousand dollar range at worst, sometimes several hundred; diabeetus is maintenance and cheap)--so it balances out.
Thus I am bewildered by the high cost. It doesn't make sense to me.
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