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Lessons From the Healthcare.gov Fiasco
Nerval's Lobster writes "In theory, the federal government's Health Insurance Marketplace was supposed to make things easy for anyone in the market for health insurance. But fourteen days after the Website made its debut, the online initiative—an integral part of the Obama administration's Affordable Care Act—has metastasized into a disaster. Despite costing $400 million (so far) and employing an army of experienced IT contractors (such as Booz Allen Hamilton and CGI Group), the Website is prone to glitches and frequent crashes, frustrating many of those seeking to sign up for a health-insurance policy. Unless you're the head of a major federal agency or a huge company launching an online initiative targeted at millions of users, it's unlikely you'll be the one responsible for a project (and problems) on the scale of the Health Insurance Marketplace. Nonetheless, the debacle offers some handy lessons in project management for Websites and portals of any size: know your IT specifications (federal contractors reportedly didn't receive theirs until a few months ago), choose management capable of recognizing the problems that arise (management of Healthcare.gov was entrusted to the Medicare and Medicaid agency, which didn't have the technical chops), roll out small if possible, and test, test, test. The Health Insurance Marketplace fiasco speaks to an unfortunate truth about Web development: even when an entity (whether public or private, corporation or federal government) has keen minds and millions of dollars at its disposal, forgetting or mishandling the basics of successful Web construction can lead to embarrassing problems."
That sounds familiar.. I've said the same thing here and elsewhere. But it's not like my analysis is unique. There are lots of people who have done large implementations in the past. This one turned out with the expected results. They'll get it working right in a few months.
Serious? Seriousness is well above my pay grade.
the govt shutdown helped create some of the problems.
There's a cream for that.
But we can't tell yet if your insurance will cover it.
"What in the name of Fats Waller is that?"
"A four-foot prune."
Remember that this is only for people that live in states that tried to stall off the inevitable. I live in Kentucky and despite being a pretty red state we have a Democratic governor and he saw the writing on the wall. Rather than try and delay and delay it we have our own. Numerous other states did the same thing. I haven't heard anything about ours being down.
I'm just curious if anyone knows of an alternative way to sign up without using the website. How many homeless have access to computers & the knowledge to use them anyway?
Some people die at 25 and aren't buried until 75. -Benjamin Franklin
"Unless you're the head of a major federal agency or a huge company launching an online initiative targeted at millions of users, it's unlikely you'll be the one responsible for a project (and problems) on the scale of the Health Insurance Marketplace."
Going by budget, even if you are the head of Facebook and Twitter, you are still not going to be responsible for a project on the scale of the Health Insurance Marketplace.
This farce is wholly, completely, and unarguably inexcusable.
"Prone to glitches"?? That's being rather generous... it doesn't f'ing work! I still can't get it to create an account, let alone actually use it for anything.
1) choose management capable of recognizing the problems that arise
2) test, test, test.
Sorry, but this is pure bunk. The website should have been designed to scale. Both of the experiences learned are reactionary responses (recognizing the problems and testing). If the website would have been designed to scale by simply creating more server instances then this would have never been an issue.
I learned that most people fail to understand the importance of a good software architect.
I wrote a tasteful missive about the dangers of politicians of all creeds, stripes, colors. When it came time to click "submit" I just couldn't bring myself to do it. Modern politics is brought to us by the Seventh Circle of Hell. I laugh so that I do not cry.
The first steps of progress in making things better would be if one party gained some competence, and the other turned off their Petty Hate Machine(tm). You, humble reader, can decide which party is which. Choose the one that makes you happiest and upmod accordingly ;)
I don't see how anybody could build a semi-complicated system from scratch in a few months. A system this big would take at least a year to get right, and that's if everything was spec'd appropriately, and the coders were good, and the project was managed well. Since the project actually got under way only several months ago, I knew it would be - at the very least - quirky. If it ran at all.
Agree to delay the individual mandate, in exchange for a repeal of the debt-ceiling laws.
Give republicans what they want: they don't have to sign up for health care if they don't want to, and there will be no penalty. But in exchange, get them to admit what they know, that Reagan proved deficits don't matter. Just let the government create money (as banks do) to fund services.
A healthier population will create more. The argument should be about the desirability of universal health coverage, not about how to finance it. The Modigliani-Miller theorem of Finance says that if you have a good idea, it doesn't matter how you finance it. Let's stop arguing about finance and concentrate on the important things: the desirability of universal health care and its positive effect on continued innovation.
Always leave room to add an explanation if it doesn't work out.
not trying to troll, but i thought insurance is already affordable in the United States of America? my cousin in USA has health has Blue Cross and Blue Shield for $75.00 USD a month. what's the problem? surely people make more than $100 a week in USA?
maybe healthcare.gov can take lessons from Blue Cross and Blue Shield website? i got a quote in one minute but i had to type my cousin's postal code.
Those who fail to learn the lessons of history are doomed to repeat them in summer school.
they should have just sold policies through eBay and/or Amazon.
"National Security is the chief cause of national insecurity." - Celine's First Law
Part of the problem is the usual problems with large-scale IT projects: it's not until you're well into it that you really get a grasp of what's involved. Nothing government-specific there, that plagues all large IT projects in private industry. Part of the problem, though, lies exactly in the fact that contractors were used. Contractors are mercenaries. They're here to deliver this project, and once they get their paycheck they're on to other work. They won't be around to deal with the fall-out and maintenance headaches from their work, and they don't have any vested interest in the quality of their work as long as it's good enough to pass review and get their payment check cut. In fact, poor quality is actually an opportunity to get paid twice since fixing the problems is a new project. Full-time permanent employees may not be as efficient as contractors, but on the other hand they've got a vested interest in making sure the system doesn't create any more problems than necessary because they know they're the ones who're going to have to clean up the messes. Long-term employees also have a better grasp of what's already involved in the current system, which translates directly into a better grasp of what the new system will need to do. They're less likely to miss major complications because they already have to deal with them.
Part of the problem with contractors is also the fact that large organizations like governments limit themselves to Tier 1 contractors. And there aren't a lot of those. So it rapidly becomes a situation where the Tier 1 contractors aren't really concerned about quality and results, because they know their customers will by policy refuse to consider any alternatives outside a small set and those others aren't any better about quality. If the government switches from contractor A to B, that means B can't take on another customer who takes their business to A (because A and B are the only Tier 1 firms and the customer can't consider anyone who isn't a Tier 1 firm) and it's a net wash for A.
I can hear someone screaming about how to choose to/for whom and where to release first: how about by acceptance/ratification/support of the program?
I used the site and managed to get through. It was buggy. Really all it asks you for is a username/password your name and address your age and if you smoke. Why they spread this over several pages is beyond me- amazon could have done it on one form. However I have also tried to get insurance the normal way which requires much more information (health history etc). I think the exchange is much much easier.
...actually had to do nothing to stop this - they made the mistake in thinking that the government could actually do something right.
Just let the government create money (as banks do) to fund services.
So we don't need any taxes, then? Heck, we don't even need any government bonds for funding! Why half-measures, why not send $1M to everyone? I wonder how that would end: "since we adopted the leaf as the currency, we're all rich!". I can see no flaw in this plan.
Socialism: a lie told by totalitarians and believed by fools.
Now I'm not saying incompetence isn't plausible, or even likely. But I also wonder if this wouldn't be somewhat intentional on the part of a few people as a political maneuver, whether via who the contracts went too, artificial delays, etc etc, in order to make the project become politically embarrassing. Sabotaging a co-workers project is not unheard of in the corporate world to get ahead or inhibit their credibility, so why would the government be any different...
You never realize how much manually made unmanaged "linked" lists suck, till you have src.link.link.link.link...
As a software engineer, I'm very curious about where this $400 million went. In all the articles about this project, I've never seen a breakdown of where the money was spent, at least at the granularity of people/hardware/software. Typically software projects spent most of their budgets on people, but a $400 M project that is basically a year old implies on the order of thousands of employees. That can't be right? Did they get dinged by ridiculous licensing fees from the usual suspects? Where did the money go?
I don't know how the government could have required it under contracting law, but the contract should have required that all involved, from corporate CEO's on down would have to use the system to get their own health care insurance for the next five years or so. It would have come out a lot better if they'd had to eat their own dog food.
This
made me laugh.
I've been in the unfortunate situation of working for a government agency when Booze Allen Hamilton came in to help make changes and improve things. They did much of the former and none of the latter.
Typically, dealing with whoever was going to actually use the process they were changing was something the Boozers did just to check off an item on a list. They did not listen to users because they assumed government employees were all idiots and could tell them nothing they really needed to know about the processes they were about to change.
Personally, if I were going to change business processes that had been in place for decades I'd want to talk to the people who work the current processes and find out how they work before I started trying to think up better ways of doing things. BAH never did that. They brought in workers for planning sessions, listened for a couple of days, then distilled the results of those discussions into a document of findings that was obviously written before the research ever started and contained exactly zero input from the field workers who truly understood job requirements.
Boozers, in my organization, were almost universally so convinced that their shit didn't stink that they were worse than useless. In the course of years of contacts with them, I met exactly ONE who listened, learned, and improved things.
Based on those past experiences, I can only surmise that the folks responsible for this current fiasco simply said "Oh, we don't need to talk to anyone from the government about how they run web sites that stand up to incredible traffic swings. We know what we're doing."
And some idiot government executives trusted them.
I don't know who to be more disgusted with.
It seems like many times when a large government entity spends billions of dollars on a large IT project to consolidate or make more efficient the handling of lots of data, it frequently ends up in massive amounts of wasted money and failed projects, with lots of pork doled out to consultancies and middlemen, and in the worse cases ends up with the project abandoned entirely with all the money down the toilet. Many examples have been posted to /. in the last 10 years.
Are there some good cases of where the money was well spent, and a solid, cohesive working product came out of it?
Some of the root cause may be the politicizing of the contract process in the first place (beltway bandits and congress critters mandating a piece of the work go to their district) and the letting of cost-plus contracts. Other times may be the requirement to take the absolute lowest bidder, which ends up with someone who lowballed the job and cannot possibly execute it properly within the promised budget.
How does one properly motivate and direct a team under these conditions? The actual production of the software needs to be isolated from the politics above, and act as if they are working for a small company developing a new commercial website. With lack of competition - it's not like people can go to all those other government healthcare websites - a replacement incentive needs to be put in place if one wishes to tread down that path. In a monopoly situation, these are common problems. Highly centralized services do not take into account basic human nature.
Earlier in the last decade, there was a famous powerpoint slide that made the rounds within Aerospace circles. It was titled "SLI - The Work of a Nation" and showed which pieces of the Space Launch Initiative* were to be built in which congressional districts. It was the butt of many jokes as de-centralizing the production of such a complicated item always results in ballooning costs as it makes it extremely costly and difficult to integrate the various components. That may not be the case here but it's definitely seen in other federal projects.
* the then-current name for the over-bloated, impossibly expensive shuttle replacement heavy launch system now known as SLS - Senate Launch System as goes the joke.
I don't know about you, but does the site really need links and JS from ad sites (like doubleclick, chartbeat), YouTube, and Facebook, as well as whatever googletagmanager and optimizely provide - as noticed by what I had to temporarily allow in NoScript - to simply make the site work to, you know, helps people get access to healthcare insurance?
It must have been something you assimilated. . . .
The reason for the mandate (and for the original single-payer system) is that currently the cost of health care for the uninsured is hidden in the "uncollectable debt" category in the hospital's accounts receivable. It's all the bills for ER visits and emergency care for people who can't pay. I was taught a basic rule back in high school business classes: you can't manage costs until you've got them laid out where you can see them. The idea was to get all health care being paid for and accounted for so we can see where the money's going and do something about the areas where it's costing more than it should. It was also to help with shifting the costs from expensive emergency care to much cheaper preventative care, the idea being that when people know they're covered by insurance they're more likely to go to the doctor before things get critical instead of putting it off and hoping they get better so they don't get nailed with a doctor's bill and ending up at the ER in critical condition. If you have no insurance the bill's going to be a killer either way so it makes sense to go for the chance to avoid it, whereas if you do have insurance the bill won't kill you either way so why wait and suffer more than you have to?
I find it interesting that the team behind the technical aspects of Obama's presidential campaign were so capable (more here...it's a great read) and yet he still chose the tried and false alternate model of outsourced government contractors to handle this.
A methodology more similar to what was used on his campaign would have been far more successful and cost significantly less.
"Don't blame me, I voted for Kodos!"
After all, Obama has already delayed the Employer Mandate part of the ACA by executive fiat.
"I do not agree with what you say, but I will defend to the death your right to say it"
It's obvious. I'm Serious.
Using GOP stereotype followed by reference to a some sort of private business no matter how irrelevant it is to point being discussed. Does any product sold by amazon and ebay has to comply with HIPAA, ACA and any other relevant state and federal laws regulating insurance and patient privacy?
>> when an entity (whether public or private, corporation or federal government) has keen minds and millions of dollars at its disposal
Not sure there's any evidence of "keen minds" here, but I'd suspect that the root of the problem is that there were millions of dollars allocated to the project. With that kind of money, the incentive is probably to put as many billable bodies on the thing, regardless of qualifications or result.
> Agree to delay the individual mandate, in exchange for a repeal of the debt-ceiling laws.
The Republicans were the ones to add the personal mandate. Offering to remove or delay this will be of no value to them. It's their bad idea to begin with.
Not a good bargaining chip.
A Pirate and a Puritan look the same on a balance sheet.
This happens every time a major new internet service is launched. And it _always_ will. See, here's the problem: at launch everyone is interested and wants in. After a few weeks/months the interest dies off and the site hits a BAU point. So if you're designing one of these sites you're stuck either:
a. Spending billions on infrastructure for 3 months tops of high volume and then getting ripped to shreds in the press for 'wasting' all that money. or...
b. Taking your lumps up front and waiting a few months for people to forget about it.
The guys running healthcare.gov opted for 'b.', and I would too. The kinds of people that just want to say bad things about the ACA would have a field day with 'a.', with 'b.' they'll have to acknowledge (or at least ignore) the fact that in a few months it'll be working more or less as intended.
Hi! I make Firefox Plug-ins. Check 'em out @ https://addons.mozilla.org/en-US/firefox/addon/youtube-mp3-podcaster/
"Keen minds and millions of dollars".
Maybe millions of dollars (ours), but keen minds? Not so much.
A bullet may have your name on it, but artillery is addressed to " Whom It May concern"
It's funny all the finger pointing, how the government screws up IT, etc.
I've seen dozens of major web site projects and many other major IT projects totally screwed up. It's not government, it the human people involved and they are everywhere!
Central Planning does NOT work.
Successful giant endeavors evolve organically out of small, working endeavors.
So ~30 hostage-takers get to override the other 500 House and Senate members? We have a first-past-the-post system, which guarantees a 2-party system. If we had a proportional system, we could have these kind of splinter groups in a coalition government, much the way Israel runs. But when one faction holds its breath until it turns blue, the whole government can fall. We HAD a national referendum on Obamacare, i.e. the last presidential election, where the Republicans were the ones who wanted to make the election about it - AND THEY LOST.
Agree to delay the individual mandate, in exchange for a repeal of the debt-ceiling laws.
Give republicans what they want: they don't have to sign up for health care if they don't want to, and there will be no penalty.
Yes and I'm sure it will all end there. [/sarcasm] No, giving in to extortion only leads to more extortion. What Republicans want it to get something they could not get through the normal legislative process, so they're throwing this tantrum and holding their breath until they get what they want. As any parent knows, condoning this type of behavior only reinforces such behavior.
No one *has* to sign up for healthcare and the penalty in 2014 is $95 (ninety-five).
The rest of your post is okay by me... :-)
It must have been something you assimilated. . . .
Do you realize the Repubs. Had zero input to the bill?
A bullet may have your name on it, but artillery is addressed to " Whom It May concern"
Nerval's Lobster has a firm grasp of the obvious.
A successful project requires ...
1. A detailed and unchanging specification.
2. Experienced and qualified managers.
3. Incremental releases.
4. Test.
He forgot ...
5. Realistic schedule.
Seems to me someone like CGI Group "multinational information technology (IT) consulting, systems integration, outsourcing, and solutions company" and Booz Allen Hamilton "Client service. Innovative ideas. Exceptional people. Core Values. Solid performance" could have handled designing a simple website which takes user input and stores it in a back-end database. Ask for our tax dollars back and move forward with another vendor. Perhaps a 16 yr. old high school kid who knows Javascript.
Join the Slashcott! Feb 10 thru Feb 17!
"...but I seriously had no idea it would be this bad."
How would you design a Healthcare Extortion Racket?
"New York State's healthcare plans range from Fidelis Care's 'Bronze' plan at $810.84 per month to $2554.71 per month for something I didn't bother to look up because if I had $2500+ a month to spend on doctors, I'd buy a doctor and have him/her live with me and dole out pills like I was Michael Jackson. The deductibles - the amount you pay out of pocket every year before you the insurer has to give you anything at all - are outrageously high. Fidelis Care Bronze has a $3000/year deductible per person. I'm in pretty good health; it's a rare year I spend that much on doctors. After the $3000/year deductible, they pay 50% of your bills. So if you rack up $5000/year in medical bills, you pay $4000 and they pay $1000. Pretty damned crappy."
Repeat, from my JE.
"Flyin' in just a sweet place,
Never been known to fail..."
Any talk about technical reasons why the ACA website does not work is irrelevant. The problem is the Republicans trying to eliminate the ACA. The aim is to get as much ACA 'infrastructure' in place as soon as possible, and get as much public support, as soon as possible, so that repealing the ACA is as difficult as possible. Whether the website actually works is unimportant. There will be plenty of time and money to get the web site working later if the Republicans can be stopped.
Hell, Ted Cruz was talking about this back in July, “Moreover, we have, I believe, the best opportunity we will have, and possibly the last good opportunity we will have to defund Obamacare with the continuing resolution.” and, “If the subsidies kick in, the prospect of full repeal of Obamacare diminish dramatically,” This is what the government shutdown is all about.
That implies that everyone who doesn't have health insurance is choosing not to.
That's the stupidest thing I've ever seen on this site. Not a single republican voted for the individual mandate, and had zero input on writing this bill.
The federal government doesn't have the culture to actually create and run something like this and just stamping your feet while insisting it much change won't change it. The civil service system itself militates against what you want because it makes it hard for the government to actually hire the right people, fire the wrong people and reward people based on performance. There is nothing intrinsic to government work that says this cannot happen, but our system as it actually exists all but ensures that you'll not have the ability to build this sort of team. Add on top of that even if you did, you'd need looser rules of procurement to let these employees take risks, try new things, etc. You know like when someone on staff says "hey let's buy 500 small servers instead of 50 REALLY expensive blades" and the experiment gets caught up in procurement kabuki until the whole purchase order is, well, OBE...
It's pushing 20 years since I first saw an academic study showing that IT project failure probability increases dramatically - the latest was 2005:
The Challenges of Large-Scale IT Projects
You're darn right I won't be put in charge of such - not without a gun to my head. I'd want to de-scale anything down to a size where you could reasonably spec and test it. As the article says, "test, test, test". A formative experience in my programming was FORTH, a language that strongly rewards small incremental experiments, compiling as you go, building from small functions up to large ones. I'm not saying use FORTH, but the philosophy of getting the basics working and building up has really worked for me for a whole career.
By contrast, all the large-scale projects I've worked on have all taken a philosophy like building a skyscraper or 747 - no one person can comprehend it, design everything before the first screwdriver is picked up, so the design process goes on for months and years, etc. And then you have "crunch time" from then on as the fond beliefs of the design team smack into reality, and the specs are proven to not match needs. Incremental building and testing tends to reveal these problems.
The fear that drives these philosophies is that you'll have the thing mostly built...and discover it doesn't meet every need and can't without some huge rebuild, because you didn't think of everything up front. Rather like an old system that's been patched to death and has to be tossed because it just can't keep up with changes. I think the fear exaggerated, particularly if the design-build team is at least roughly aware of the whole project dimensions.
The advantage of more-incremental projects that are never large because you take one part at a time is you develop in priority order. The 80/20 rule suggests that 80% of the clients will want about 20% of the options available - so get 20% of the offering working, and working well, first.
Canada has this story of medical records: http://news.slashdot.org/story/09/10/10/0124227/open-source-could-have-saved-ontario-hundreds-of-millions /. covered it, "open source" would have saved 95% of project costs, but I think it was also about the open-source development was in small increments, no large projects.
As
Is to let federal project managers directly hire their own contractor teams and have them report to the government. Federal managers need more latitude in how they spend money with their evaluation criteria being primarily on how effective the team's delivery actually was. If responsibility and authority were both in their hands, and federal managers could be fired based on how poorly their teams executed an initiative you'd suddenly find a lot more federal contract teams working together smoothly.
someone who doesn't know how to spell "taught" is in no position to give lessons of any kind.
They should have told Intuit, "Design the healthcare exchange website for us or we'll pay someone else to build an 'official' TurboTax competitor. Also we'll pay you $400M."
Contractors win by being low bidders, and they take their cut off the top, and use what's left to hire their programmers. This self-selects programmers from the bottom. The result is obvious - if you pay peanuts, you get monkeys - one fiasco after another. The system itself is terminally dysfunctional.
Sadly nothing new here in terms on government "understanding" of the need to: 1. Freeze the specs. 2. Have your Lawyers look at the contract for the tiniest of loopholes and then hold the contractors to it. 3. Be aware that contractors (especially the big ones - no acronyms supplied here) will indeed be like Lawyers and say "ooh you didn't specify that - it's a change request" 4. Test early, test often - and then test, test & test again. 5. Pay good attention to usability. Check this out: http://www.theguardian.com/society/2013/sep/18/nhs-records-system-10bn Sixteen billion US expended so far (and still counting) - negligible returns.
Clearly this is all because of {current President} and all the rest of the {President's affiliated party}. If only this were done by {opposing party to that of the President} instead none of this would have happpened!
Every story I read leads me to believe that the fault is with the government and not the contractor. The White House delayed rule making to avoid the election, the congress screwed with funding and delayed the start and agency did not finalize the rules until well after the scheduled project start and in fact continually changed them along the way. Because of this development started late and was faced with continual changes. Its not the contractor's fault that its not done on time. It is the contractor's fault that they lacked the professional integrity to walk away at the point they knew it was impossible.
I have a big problem with Republican's pointing fingers because they spent all of their time trying to delay this and keep it from happening and then when they have some success they say "See we told you it wouldn't work!" Kind of two faced to me.
...that socializing a major part of the US economy isn't easy?
Oh wait, that's probably not what you meant to say.
-Styopa
According to washington post “Obamacare is fully implemented January 1st, even though the regulations haven’t been written yet. And Brian, we’ve got 33,000 pages of regulations that they’ve already written. If we stacked it up here, it would be seven feet tall.” No wonder it costs a lot to implement. I've seen software with much smaller specs being late and over budget. This should be the warning for our lovely legislators. Every page could be the cause of bugs and delays. Better yet maybe legislators should go and code this crap themselves? When you write 33K pages of crap then you can read them all and implement everything. In assembly please.
Name a single privately run corporation that has had this kind of massive clusterfuck of a fail. NAME. JUST. ONE. You know you can't. Sure, you can probably find some much much smaller examples, but the only organization that can consistently screw up to the tune of billions of dollars is the goverment, of course only after stealing MY money from me at gunpoint. This is the fault of the unions and leftists that now control our goverment right from the mafia run streets of chicago to the now mafia run whitehouse.
turned off their Petty Hate Machine
If only we had a congress full of people who often disagree but at least respect each other. That lack of respect is just turning our lawmaking process into an arrogant power struggle - "I'm right and you're just stupid."
I was thinking a while ago about how it would work in a country with no taxes, where they paid all the expenses with freshly-printed money. It would be almost like a wealth-tax, with the inflation making people's money worth increasingly less. Ultimately you'd have the problem of too many people buying up precious metals, and other non-producing assets just to stave off the inflation, meaning the cost of government would ultimately be paid by the people who had no choice but to use cash.
Is 1563649 a prime number?
Considering that the design of the ACA is based almost entirely on a bill that Mitt Romney and his Republican friends pushed through at the state level, that has to be the most disingenuous thing I've ever read, period. The ACA barely even resembles what the Democrats originally wanted, and is remarkably close to what Republicans said that they wanted. The way that the Republicans voted on the actual House/Senate floor is largely immaterial.
Check out my sci-fi/humor trilogy at PatriotsBooks.
I think it would be great if the Green Party ran a candidate for President, with a Libertarian party member as the Vice-President.
If coalition governments work well in other countries, let's try one here for a change. It couldn't be nearly as bad as what we currently have.
If you think I voted for Trump because of this post, you're wrong. I voted for Dr. Jill Stein of the Green Party. Again.
So ~30 hostage-takers
54 Democrats voted along party lines to "pass" a modified continuing resolution that they knew in advance would not pass the House. So no, not ~30, more like 54.
We HAD a national referendum on Obamacare, i.e. the last presidential election,
I voted in the last presidential election. I don't recall seeing any ballot entry for "support ACA". What "national referendum"? Trying to claim that every vote for Obama was a vote in favor of the ACA is as meaningless as trying to claim that every person who goes to McDonalds does so because they like the fine urban atmosphere and prompt friendly service.
Those Republicans who added the amendment to the CR did so because THEIR referendum told them to. Either you claim that an elected official has a "referendum" on a specific item and has to follow that and accept that the Republicans are doing what they promised they'd do, or stop pretending.
If you really want to talk "national referenda", let's talk Gitmo (still open). Iraq. Afghanistan. Open and transparent government (one way mirror -- NSA sees us, we don't see them). Hope AND Change (not "Hope FOR a change".) There certainly must have been an overwhelming mandate in the national referendum, and yet these are delayed or forgotten.
As for the ACA itself, and delaying the individual mandate. Keep very centered in your mind that Obama has delayed the mandate for corporate compliance by a year on his sayso alone. People who donate money got a delay. People who vote don't deserve a delay. Why is this corporate voice in the process now irrelevant, when it is so unethical in everything else?
Most hospitals are non-profits.
does that mean they are immune to the laws of economics and accounting?
Oh, but you have to remember a couple decades ago, some political group thought up a similar thing in reaction to someone else thinking up something. It's completely applicable today.
If you think I voted for Trump because of this post, you're wrong. I voted for Dr. Jill Stein of the Green Party. Again.
No, wealth is unaffected by inflation. Wealth is not a stack of dollar bills. You must me invested in the means of production to have wealth, and the value of that is determined by what's produced, not the currency in use.
Hyper-inflation destroys savings, not wealth. Usually, hyper-inflation also destroys economies and governments. And, of course, it would be hyper inflation: with no practical limit on how much the government could spend, it would try to spend infinity dollars on pork barrel projects and outright checks mailed to supporters.
I doubt people would but precious metals, though, there are several stable national currencies, easier to just us Canadian dollars or Swiss francs or whatever, if it came to that.
Socialism: a lie told by totalitarians and believed by fools.
So we don't need any taxes, then? Heck, we don't even need any government bonds for funding!
So, this "debt ceiling crisis" we're coming up on soon? You do realize that raising the debt ceiling is the authorization for the government to print more T-bills, which is what they sell to people to get money to spend. That is, in effect, printing money, since they print T-bills (or create electronic ones) and then immediately exchange them for cash.
It's not an unknown phenomena. Some companies have "cash cow" products. They aren't really made of cash, and they aren't really cows, but the idea is they can produce something that is readily exchanged for cash.
When Obama was re-elected there was a whole string of articles in the press (and associated Slashdot discussions) of how good the technical team who built his campaign infrastructure was. I keep thinking that it is a shame that he did/could not hire the same people to make the health care marketplace work well. It's nearly as if the same contractors who produced ORCA for Mitt Romney got hired to bring about this fiasco. So educate me - is the health care marketplace system much more complicated than the election system? And if not was there a compelling reason to go with large contractors vs. the smart guys from the election team with a demonstrated track record?
I used to work at CGI. Those guys are great salesmen. Know next to nothing about programming. That's the business model. No wonder healthcare.gov doesn't work. Pretty sad.
I dont know who wrote it. But I guess we lucked out. Some of the prices were cheaper than COBRA.
What if you were an investigative journalist and found out 3 months ago Kathleen Sebelius decided to pull the plug on development of the actual Healthcare.gov. Instead she directed web development employees to start winging an intricate maze that makes it look like the site is working. But never produces any results?
It was a disaster from the beginning!!!!
>Lessons learned
>....that socializing a major part of the US economy isn't easy?
ABC News just reported "Walmart Shelves Emptied in Food Stamp Shopping Spree", which occurred when a power outage resulted in electronic Food Stamp cards being given UNLIMITED purchasing power: .......excerpt start....
Louisiana officials are trying to decide what to do about a massive shopping spree by families on food stamps when a power outage lifted the caps on their spending cards.
Police were called to Walmart locations in Mansfield, La., and Springhill, La., on Saturday as shoppers cleaned out store shelves. ...
Springhill Police Chief Will Lynd said some customers were pushing more food than any household could store in a refrigerator and freezer.
"I saw people drag out eight to ten grocery carts," he said.
Lynd said that around 9 p.m. CT on Saturday, a Walmart employee made an announcement on the intercom saying that the computer system had been restored and card limits had returned. At that time, customers left shopping carts full of food in store aisles.
"At that point in time, they knew the jig was up and they couldn't purchase what they wanted to," Lynd said. ... ...
He said one customer made about $700 in food purchases.
The Department of Agriculture, which administers the food stamp program, said the issue was not related to the government shutdown
The shopping frenzy was triggered when the Electronic Benefits Transfer system went down because a back-up generator failed at 11 a.m. EST Saturday during a regularly-scheduled test, according to Xerox, a vendor for the EBT system and based in Norwalk, Conn.
The outage allowed recipients to spend unlimited amounts of money because the spending limit was removed for their EBT cards.
The EBT system was affected in 17 states, where individuals and households access programs like Supplemental Nutritional Assistance Program, Temporary Assistance for Needy Families, and other programs.
Source information: .....excerpt end....
URL: http://abcnews.go.com/Business/walmart-shelves-emptied-food-stamp-shopping-spree/story?id=20563982
Author: Susanna Kim via "Good Morning America"
Date: October 14, 2013
Title: "Walmart Shelves Emptied in Food Stamp Shopping Spree"
This is why a lot of us don't want to expand the welfare system -- look at the people who take advantage of the system.
In addition, our borders have allowed in a third of the population of Mexico without restriction, so just imagine how the welfare system is going to collapse this country in a few years.
Maine's Medicaid Mistakes... how to roll out a new system the wrong way.
http://www.cio.com/article/print/20133
New Economic Perspectives
*ALL INSURANCE IS A RACKET* Their money comes from not covering you, DUH!!
What America really wanted was socialized medicine but they don't know that. Instead we got fed to the lions. There is a documentary showing Obama's deal with the Devil (Insurance Cabals) to get ACTA. It's pretty sad.
CAPTCHA: cleanly
Nice to see that the 'Healthcare' website is full of images of non-white invaders, how 'diverse' it all is... and how sickening.
So, anybody care to explain to me why white people aren't allowed to have their own countries any more?
What's that you say? You're so stupid that you can't even go back to first principles and ask yourself WHY all this immigration is happening to white countries, and ONLY white countries?
If 'diversity' is so wonderful, why aren't you demanding that India accepts millions of Africans and Chinese every year, and vice versa?
If I can't choose NOT to live around non-whites, WHO is forcing me to live with them, and what right does that person, or persons, have to do that? ANYBODY who claims to have the right to FORCE you to live with people you don't want to, is claiming you as their PROPERTY or SLAVE, and is thus admitting they are a slaveowner.
The Fed buys a significant quantity of government debt with "printed money", because that was the easiest way to just add money out of nowhere when it was in a hurry to do so. But that's a half measure - if you really believe in government money printing, why bother with such half measures? Just pay all government bills from accounts where, when the checks are cashed, the money is created on the spot (raise the depositor's balance without lowering any government balance). No taxes, no debt, what could possibly go wrong?
Socialism: a lie told by totalitarians and believed by fools.
Personally the ACA is the same thing as the UN coming in and telling the people of France they have to either buy 'insurance' for a product they don't want or pay a fine,
Actually it's like France telling the people of France they have to pay into statutory sickness funds. But odd you bring up France: If we used their system we could use the savings to retire the personal income tax. Freedom from income tax sounds like a worthy freedom, n'est-ce pas?
http://blogs.reuters.com/david-cay-johnston/2012/09/11/a-tale-of-two-healthcare-plans/
There's a problem with that: the laws that say hospitals can't turn people away when they show up in the ER with a problem. And frankly there's very good reasons for those laws. We had a system where hospitals wouldn't treat you if you couldn't pay, and it resulted in major public-health problems that were costing the country (not the government, the country) huge amounts of money to deal with. So we changed the system.
NB: we had the same situation and the same problems when we had private fire departments. We changed that system for the same kind of reason: out-of-control fires caused by fire departments not responding because none of the houses they were getting paid to protect was on fire yet, and by the time they did respond half the block was burning and there was no way to control the blaze.
How good insurance *could* be if politicians of both parties (at the state level) would let go of it. The regulation of state insurance markets is one of the dirty little secrets of American politics; State-level politicians get power (and campaign contributions) by having regulatory authority over insurance, which is why small-government conservatives keep calling for health insurance to be sold across state lines but "mainstream" Republicans and Democrats continue to block this decade after decade. Each state has government departments regulating insurance and has its own insurance laws, which means govt employees, and managers managing those employees, and legislative committees with oversight responsibilities (and power, which then invites lobbying) and executive regulatory bodies and high-salary low-responsibility appointed officials (available to "connected" campaign supporters) etc. The state politicians jealously guard all this opportunity for corruption, and their campaign warchests are the better for it. If you could get your insurance from a nation-wide market and via vendors like amazon and ebay, who actually know what they are doing and "get" customer service, the entire insurance discussion would be different.
also the big ones use sub contractors that can take a lot of overhead and can put lot's of PHB in there that get in the way of getting info to and from to the workers
AND THEY LOST.
But only by a few percent of the popular vote. This is a great cultural divide that can't be bridged by bullying on either side.
Heart attack? Oh, you're retired? Take baby aspirin, it's cheaper than coming here. Hope that works out.
Hey fuckstick, it turns out that some things are better off being run as not-for-profits instead of for-profit. I know that it may be hard to get that message while you're standing in line at Wal-Mart buying a made-in-China American flag and a gallon of Pepsi.
Kill yourself.
Straw man. Why not start with a Basic Income of $25k?
The reason standards of living increase is technology, individuals creating new innovations. Then biz can take over and incrementally innovate to package the disruptive innovations. Win-win.
The focus should be on innovation, not how to finance it. The money will take care of itself. Money is a tool, not an end; innovation and the advance of knowledge are the goals. Individuals create innovations; therefore empower individuals, with created money. As long as we continue producing things others want, whether the money is created or comes from taxes or is borrowed is immaterial.
Nothing. Index everything to inflation, which is mostly psychological, and make the indexing seamless with technology. Then individuals can go on with their lives without having to worry about finance so much, and create more innovation.
Life is an unalienable right. It trumps economics. Money should never be used as an excuse not to treat someone. People's lives are more important than figures in a ledger book!
VP is an empty post. Virtually no power. Tie breaker in the Senate, other then that seat warmer.
So it would have to be Lib president, Green VP. Sane party in power, insane VP to prevent assassination attempts, same as all the VPs going back to Quayle.
John McAfee 'It was like that time I hired that Bangkok prostitute; to do my taxes, while I fucked my accountant'
1. People in congress who use legitimate legislative procedures (which Democrats have used countless times to block Republicans) to represent their voters are not "hostage takers". Only idiots, like Obama and his drones, who hate the American form of government use this rhetoric
2. Obama supporters loved the way our election system worked when it gave Reid control of the Senate, Pelosi control of the House and Obama the White House and enabled them to use parliamentary tricks to ram Obamacare through under "budget reconcilliation" rules because it was such a mess that they could not even get it through a majority-Democrat congress under normal rules. But when the same election rules give the GOP control of the house we suddenly hear shrieks of horror about how the election system works. (It's just like the left whining about voting machines during the Bush years but being perfectly happy with them during the Clinton years)
3. We did NOT have a 2012 referendum on Obamacare... the BASE of the GOP wanted it but the "mainstream" of the party nominated Romney (of Romneycare fame) and that man was completely unsuited to engage in the fight. He voiced his tepid opposition, but everyone knew he did not mean it.
4. No.... "the whole government" cannot fall.... that can only happen in countries with the parliamentary systems you seem to be in love with. In the U.S. we have these severe fights over the most important things (like going to war, going deeper into debt, etc) and the government CAN indeed grind to a temporary and partial halt (it's designed to do that - our founders called this "checks and balances" and intended that no charismatic leader could take over and easily convert the nation into a tyrannical govt).
5. Nobody is holding his breath until he turns blue... though Reid and Obama are getting close to that by whining and complaining and screaming "NO!" to everything, with no negotiations and no compromise. What's actually happening is that the House is doing its constitutional job... being in charge of taxing and spending bills. (Senator Reid is trying to usurp this by calling every house bill "dead on arrival" and then trying to originate bills in the senate and use press corps pressure to make the house accept the senate bills)
If not a single Republican had any input on the ACA, why didn't we end up with the actual universal health care that the Democrats wanted?
Not just because it's the easiest way.
It also destroyed the market for treasure debt. There is no market rate for treasuries. Only the rate the government wants.
Now the government/Fed has a tough choice. Admit that government debt isn't going for less then inflation or continue to print money until something else gives.
I don't see the fed succeeding in curtailing it's bond buying. Treasure bonds will continue returning 'inflation'-.25% until the fed is buying 100% of every auction.
John McAfee 'It was like that time I hired that Bangkok prostitute; to do my taxes, while I fucked my accountant'
R massholes are Ds everywhere else. D massholes are Cs everywhere else.
John McAfee 'It was like that time I hired that Bangkok prostitute; to do my taxes, while I fucked my accountant'
That's a brilliant idea! If we had a Green Party president with a Libertarian VP, the rest of the country would give them a chance to try their policies the first year, then hang them both and reform the D and R parties.
authorization for the government to print more T-bills, which is what they sell to people to get money to spend
The dirty secret is that in recent auctions, the Federal Reserve bought 90+% of those - nobody else wants them.
What do they buy them with? They just inflate the monetary base, and then, poof, new money.
My God, it's Full of Source!
OUTSIDE_IP=$(dig +short my.ip @outsideip.net)
How many developers were against the ACA at the start? Maybe some sabatogee? The NSA knew that many in IT just don't "completely" follow instructions/orders so they canned them. The same can and will be said anywhere/everywhere about IT. SIN
Next big government IT project, I want managed by Ted Cruz.
Because there was not enough support from Democrats to pass a single-payer bill.
It would be symbolic of a new partnership of opposites. (Which country over in Europe had something similar this past year?) With the right planning, the Greens could use the attention it creates to get a few Congressional seats in left-leaning states, and the Libertarians do so in right-leaning states. Also, a certain number of cabinet positions would be guaranteed to be filled by libertarians (big or small L), just as a coalition would require.
They would have to point out their common causes, such as ending overseas wars and propping in dictators with our tax dollars, and ending the NSA spying immediately. The rest is details.
Besides, you have to recognize the reality of our media. If a Libertarian were on the top of the ticket, it would be demonized by all liberal media sources. Which is most of the national ones. With the Green party topping the ticket, the leftist media would be more likely to give them a fair hearing. In the campaign, and later if they won office, you would need the Greens on top for any hope of honest reporting.
If you think I voted for Trump because of this post, you're wrong. I voted for Dr. Jill Stein of the Green Party. Again.
So tell me what database software can run on multiple machines spread around the country, not lose any working data if any two locations go down at once (nor any resting data if 3/4 of the sites vaporize, so going to backups would not be needed for this), and handle 1000000 transactions per hour, and stay up 604800 seconds a week (continuously) despite plenty of backups. Once we have that, the rest will be easy, and can support older browsers and smaller PCs that poor people have ... HTML 3.2 FTW!
now we need to go OSS in diesel cars
What would prevent the government fromstopping at whatever income you consider reasonable? Once your remove practical limits on spending, why would the government not spend infinity? Would they suddenly stop being corrupt? Would the guy who sets the "Basic Income" at $30k not beat the $25k guy in the next election? Not that it really matters, because the $25k would buy one loaf of bread, more or less.
Socialism: a lie told by totalitarians and believed by fools.
In 1986 and 1987, 2 articles appeared in the literature by physicians from Cook County Hospital in Chicago detailing the extent of patient dumping to that facility (1, 2). The authors defined dumping as “the denial of or limitation in the provision of medical services to a patient for economic reasons and the referral of that patient elsewhere” (1). The majority of such transfers to Cook County Hospital involved patients who were minorities and unemployed. The reason given for the transfer by the sending institution was lack of insurance in 87% of the cases. Only 6% of the patients had given written informed consent for their transfer. Medical service patients who were transferred were twice as likely to die as those treated at the transferring hospital, and 24% of the patients were considered to have been transferred in an unstable condition. It was concluded that this practice was done primarily for financial reasons and that it delayed care and jeopardized the patient's health. This practice was not limited to Chicago but occurred in most large cities with public hospitals. In Dallas, such transfers increased from 70 per month in 1982 to more than 200 per month in 1983 (1).
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1305897/
The point is: we can have universal healthcare without you paying for it. The same way the shadow banking system has $100 trillion without you paying for it; because banks expand both sides of their balance sheet at once all the time, creating money out of thin air.
to pay a minimum of 80% of premiums towards benefits. Excess is to refunded to the buyers.
Personally, I would rather have a Single Payer system (Medicare for All) but we weren't about to get that with the political influence the Health Insurance companies have. (And it would be disruptive to all the people employed by the Health Insurance companies).
And if you think that the Republicans aren't getting money from the Health Insurance companies, I have a bridge that I can sell you.
Hopelessly pedantic since 1963.
The Republicans were actually shut out of the rooms (Pelosi and Reid had such large majorities that they felt they could not only ignore the GOP but actually abuse them) and the Democrats were so worried that the GOP might find out and tell conservative-leaning press what was happening that they had the Capitol Hill worker bees change the physical locks on the doors (just in case some Republican might have a key). The Democrats counted on the mainstream media (approx 90% of whom self-identify as libs) not making any issue of this....and of course the media did not.
When campaigning for President, Obama went all across America promising that ALL the negotiations would involve Doctors, Nurses, patients, home care providers, hospital and drug company people, Republicans and Democrats all gathered around a big table and broadcast live in C-SPAN for all to see (truly "open" government). What the people actually got was worse than any significant law in our history: it was negotiated in secret behind closed locked doors and nobody knows who was in the meeting, what cash and promises were exchanged etc and at the time the law was voted on nobody even READ the damn thing!
Now the thing is on autopilot because it turns-out huge portions of the bill essentially say "the president will appoint a bureaucrat to write a bunch of rules on this and those rules will be enforced as law".......... which means that most of what eventually becomes Obamacare will have never even been written or voted on by congress at all (the bill was about 2K pages (longer than a Bible, but the rules written by bureaucrats who's names we'll never know crossed the 20K pages many months ago). Oh, and THIS is where Sarah Palin warned of "Death Panels".... the bureaucrats are directed to setup a panel of people (not required to be doctors) to decide what treatments are "cost effective" and will therefore be covered or not covered - which will eventually lead to a panel of people deciding that some people must die, even though cures are available, because the cures are not "cost effective" to the government. When insurance was private, this stuff could be appealed, but under Obamacare it is not (where you gonna appeal? the UN?)
I am sure we can all rest assured that all Democrats will sit still and be silent when some future Republican president behaves this way.....
Why is it anything you don't like is "fiat"? Way to use loaded language instead of thinking about it.
Go ahead, try - see if you can figure out why the employers got an extension, but individuals cannot.
Bullshit. Everything has a price, and it's not "money" it's labor. According to your logic we should spend $10M treating an 85 year old man on his last legs who gets cancer, right? Laughable.
I agree in general with universal care, but trying to pretend money means nothing is facile. Money is a proxy for all the labor and training that goes into doctors and the equipment/drugs/support they use.
Life is an unalienable right. It trumps economics. Money should never be used as an excuse not to treat someone. People's lives are more important than figures in a ledger book!
Serious question: Who pays the bill then? Where does the money come from to treat these people?
I'm not a heartless bastard. These are questions that nobody can answer and nobody can agree on.
"A plan fiendishly clever in its intricacies"- Homer Simpson
based almost entirely on a bill that Mitt Romney and his Republican friends
You mean Mitt Romney and his Democrat friends, don't you? Massachusetts is one of the most blue States in the country. The State legislature is composed of 127 Democrats and 30 Republicans.
The problem here is that your knowledge and consideration is shallow, mindless, ignorant, stupidfuck. There is no polite way to put that.
The serving Democrats got what they wanted in Massachusetts, and then the serving Democrats got exactly what they wanted on the Federal level. I realize that its hard for you to swallow that your beloved Democrats are so firmly sucking corporate cock, but they have always been the actual pro-corporate party in spite of the lies they continue to tell you. They used to just transfer tax money to their corporate friends.. now they are forcing you to directly transfer money to their corporate friends.. These facts are in evidence and are undeniable, but you continue to deny them. There is no polite way to describe the kind of dumb fuck you are. .
"His name was James Damore."
The reason for the mandate is cost sharing. Also known as the basics of insurance. When you pay for homeowners insurance and your house doesn't burn down, your premiums go to your neighbors whose house did burn down. Same idea with health insurance. Treatment for the sick is paid by the healthy. And this is the case whether you're talking about single-payer systems or private health insurance.
Let's pretend there's no mandate. You're young and healthy. Why buy health insurance? It's very unlikely that you will be hit by a bus, and you don't have any chronic conditions that require treatment. If you get unlucky and get hit by a bus, you can buy insurance then. Because there's no "pre-existing conditions" anymore, so you can't be denied.
Result? No healthy people in the insurance pool. Which means no cost sharing. So insurance gets expensive. So people in "OK" health stop buying it because it's no longer a good price for what they receive. So insurance gets even more expensive. So people in "moderate" health stop buying it. So insurance gets even more expensive. And so on until there isn't insurance anymore.
The technical term for this is "adverse selection".
The mandate keeps the healthy in the insurance pool to keep the individual costs down. Works just like in single-payer countries, except their mandate is called "Taxes".
fiat: a formal authorization or proposition; a decree.
Since the delay of the employer mandate was literally done via a formal decree from President Obama, I'm not sure why you're objecting to the OP's language choice...
The party of stupid and the party of evil get together and do something both stupid and evil, then call it bipartisan.
Well said.
Whoosh!
Should have hired me, punks.
thank you, said what I wanted to say, but much better.
Fast forward to about 3:00, if you cant watch the whole thing.
http://www.youtube.com/watch?v=926bPZiQhgY#t=200
He did some reading. Well, a lot of reading. He has been voting for Democrats ever since.
Because of two senators ceasing to live.
I should use this sig to advertise my book ISBN-13 : 978-1501515132.
I am flabbergasted by people's ability to forget things in the age of the internet.
http://thehill.com/homenews/house/66721-pelosi-no-house-vote-on-single-payer-plan
Or if The Hill is not acceptable
http://prescriptions.blogs.nytimes.com/2009/11/06/democrat-gives-up-a-pet-issue-to-streamline-house-vote/?_r=0
Not joking, I could have built it in less than a month from the design process to completing the code front-end and back-end. I don't get what's so difficult about building a site like that. They didn't even build it with scalability in mind, and doesn't make sense. Not to mention if you look at some of their code it looks very amateurish. I'm not really shocked, I've seen how the government works with bids and it's a shame that the system works the way it does. Now, we the taxpayers have to pay more into the system because they were too cheap to hire a professional company but instead hired someone's nephew to do the work.
Well, if deficits really don't matter, then a sensible compromise would be to ax the medical device tax and add it to the government's annual operating deficit. The tax is projected to bring in $2.9 billion/year over the next decade (the source of the "30 billion" figure that's been thrown around), which is about a 0.1% reduction in federal revenues. That's a lot of moolah in absolute terms, but not relative terms.
I think deficits do matter, but it *depends* on the economic context, which means right away we've lost most of the people in this conversation.
Post may contain irony: discontinue use if experiencing mood swings, nausea or elevated blood pressure.
So you're going to ask the guy being wheeled in on a gurney to show proof of insurance before the doctors try to resuscitate him? Or maybe you try to help him and once he's stable and you realize he's got no insurance, you stop his heart and let him die?
One of the problems with emergency medicine is that it's often an emergency situation that doesn't allow for proof of insurance. Short of implanting a chip in everyone who has insurance that can be scanned to verify eligibility for treatment, I'm not sure how you get around the problem that you have to help someone long before you know whether they're going to be able to pay the bill.
http://www.moneyunder30.com/health-insurance-deductible-co-pay-out-of-pocket-maximum
Your insurance pays everything after you hit your annual out-of-pocket-maximum. For instance the lowest-end plan offered by my employer:
Lowest premium with highest deductible
No office visit co-pays, but member is responsible for full cost of care until $6,000 (individual) or $12,000 (family) deductible is met
No co-insurance responsibility - After $6,000/$12,000 deductible/out-of-pocket max is met, plan pays 100% for covered services
Certain preventative care is covered at 100%
Prescriptions have the same co-pay amounts as other PPO options ($10 for generic, $40 for formulary).
As an individual, my total yearly cost beyond the premium payments is capped at 6,000.
Note a lot of plans have a higher out-of-pocket-max than the deductible.
When Wal-Mart rolled out wal-mart.com it asked the vendors to guarantee the website would work without a hitch for a month or they would get it free.. The vendor then scrapped the Microsoft servers and went with unix servers. The vendor had to get its board of directors to approve the deal, but the site stayed working. And it cost 500 million similar to Obamacare.
Having worked both sides, the B ooze guys have no legal authority to do what you tell them. They only have legal authority to do what the contract tells them, as clarified by the contracting officer through a PCOL. And, if you didn't do it that way, then they're right to ignore you like an idiot, because you're an idiot to take personal legal liability by trying to tell them how to do it.
We already have a coalition government. GOP consists of god squadders, anarcho capitalists, and warmongers. DNC has organized labor, various minorities, and feminists. Currently we have a schism in the GOP coalition that is being at least partially egged on by the DNC coalition.
Jesus was all right but his disciples were thick and ordinary. -John Lennon
There has never been a roll out of that size go smooth.
It is usually you can fall back to something else until you figure it out.
Young people will eventually sign up in droves and subsidize the rest without complaint.
A government bureaucracy, that answers to no one, will provide excellent service.
Without the historical benefits of a free market prices will go down.
Advancements in medicine, without financial incentives, will continue.
You like how the website turned out? You'll love how well the U.S. government does healthcare - just visit and reservation and see the future.
I bet once people realize what happened they're going to be pissed off.
My only hope is the individual mandate - employees should be weaned from this fantasy that the employer provides healthcare. People with insurance don't give a shit what anything costs and because of that there are no market forces at work to keep the costs in line with earnings. Once the wreckage is cleared things will right themselves, if the market is given a chance to provide services people need, want and desire.
Adam Smith - you beautiful bastard. You may be dead, but eventually everyone has to sing your song.
'I don't know what it's called. I just know the sound it makes, when it takes a man's life.' ~ Four Leaf Tayback
A single republican may have not voted for the individual mandate, but they had input in writing this bill to be sure: http://www.finance.senate.gov/issue/?id=32be19bd-491e-4192-812f-f65215c1ba65 June 17th, 2009 Three Democratic and three Republican Finance Committee Members hold the first of 31 bipartisan meetings to discuss the development of a health care reform bill. Over the course of the next three months, this group, Baucus, Grassley, Kent Conrad (D-N.D.), Olympia Snowe (R-Maine), Jeff Bingaman (D-N.M.), and Mike Enzi (R-Wyo.), met for more than 60 hours and the bipartisan principles they discussed became the foundation of the health care reform law. I am shocked the site is still up actually. Anyway, I haven't looked into this, but I heard from someone more informed than I was that the individual mandate was not in the original bill, but was subsequently added when the insurance lobby got a hold of the original bill.
let's try it again with better spacing shall we?
A single republican may have not voted for the individual mandate, but they had input in writing this bill to be sure:
http://www.finance.senate.gov/issue/?id=32be19bd-491e-4192-812f-f65215c1ba65
June 17th, 2009 Three Democratic and three Republican Finance Committee Members hold the first of 31 bipartisan meetings to discuss the development of a health care reform bill. Over the course of the next three months, this group, Baucus, Grassley, Kent Conrad (D-N.D.), Olympia Snowe (R-Maine), Jeff Bingaman (D-N.M.), and Mike Enzi (R-Wyo.), met for more than 60 hours and the bipartisan principles they discussed became the foundation of the health care reform law.
I am shocked the site is still up actually. Anyway, I haven't looked into this, but I heard from someone more informed than I was that the individual mandate was not in the original bill, but was subsequently added when the insurance lobby got a hold of the original bill.
That nice, but this law was not written by 6 people. That is physically impossible.
http://www.usnews.com/opinion/blogs/doug-heye/2010/01/05/c-span-demands-democrats-open-secret-health-reform-talks
The bill was passed almost a year later than your article was written. Your article is too old.
Fool. Medicare is so complicated any provide can be charged with Medicare fraud. It's a big pain for the providers.
The dirty secret is that in recent auctions, the Federal Reserve bought 90+% of those - nobody else wants them.
What the heck are you talking about? Even in the most recent auction, in the middle of the government shutdown, there were still bids for 2.75 times the amount of debt the Treasury was actually offering in 1-month T-bills, which are the most volatile. For longer-term T-bills, the numbers are much better. In recent years, you often tend to see bids for at least 4 times the value of securities at auction.
Claiming that "nobody else wants them" is pure BS. There is no "dirty secret" here. The Fed often gets "first dibs" at auctions because of their role in managing the money supply, so they do buy up a lot of T-bills, but that doesn't mean there weren't lots of people waiting in line to buy that debt.
Admittedly, the numbers are down in terms of the numbers of bids in recent auctions (and we'd expect short-term bids to be down given the craziness in Washington), but your implication that the Fed is buying them up because no one else would is completely and utterly bogus.
It's not like the US government makes a habbit of failure. I think it's pretty racist of people to blame Obama when he didn't have the same privillages that white heterosexual males have.
It is plainly sabotage!
the Tea Party of their day: racist, xenophobic, religious fundamentalists
You should actually attend one of the Tea Party rallies sometime instead of parroting media nonsense.
The Tea Party rallies I have seen all have a far greater minority participation than any Occupy rally ever. They also love immigrants - legal ones - which again, attend Tea Party rallies because they don't think it's fair that illegal immigrants get to skip the paperwork and jump lines to get in.
As for religion - sure some people are religious, but plenty of others are not. That's what happens when you have REAL diversity, so have people that are actually different. Unlike any group you hang out with politically.
"There is more worth loving than we have strength to love." - Brian Jay Stanley
Highly insightful, imo.
My apologies, but my perception of time somehow placed the vandalism of the memorial before the shutdown by over 2 months. To clarify the Lincoln Memorial was spray painted earlier this year on July 26, 2013, and the shutdown was like around October 1, 2013? So, by chance are you smoking some Mary-Jane laced with synthetic tachyon speed boost? If so, did you get that drug through the Affordable Care Act website when it was working long ago in the distant future? :)
It could be that the old Lincoln Memorial got tagged again, but I could not resist having a little fun.
I pay attention to what the tea party candidates actually DO, versus what they SAY.
They SAY they're about fiscal responsibility and small government. What they actually DO when they're elected is work to enact far-right social policy.
Why is it that the proponents of "one nation under God" are so eager to get rid of "liberty and justice for all"?
I was once an employee of CGI, and honestly I think they outright steal good income from the people they employee as contractors, but that being said, working on government contracts is ALWAYS a nightmare.
Anyone, and I mean anyone who has ever had a contract position with a company for any project for the US government knows quite well how the US government will ask for the sky but will only pay for a twin engine prop from the 1950s to get the sky.
The US government has never learned how to handle business life-cycles on projects. They start out with vague scopes and extremely intense schedules, they talk in circles and never say what they really want and then once development has started the creep of scope begins and it's not like a snail slowing moving the requirements around, they add thousands and then when the possibility exists that the original schedule will slip, contractors who are project managers are literally crucified for saying a project is at risk.
I speak from direct experience.
I remember when I received a PM role as a contractor on a Government project that was already in dire straits. I asked my manager how I would succeed where he couldn't and he simply laughed and said you won't. I said, "So if I fail I succeed?" and his response was "yes". Well I managed to make a doomed project succeed, but was kicked off the project 1 month before it was completed simply because I communicated that there was a risk that one part of the project would not be implemented from a lack of US Government decision at such a late date in the project. I was crucified for saying that, but only after there was a big meeting and I was asked what needed to be decided on to succeed. I provided 3 options and explained the amount of work. They chose the cheapest in time and workmanship, and then kicked me from the project. It was only because I put my concerns for the project in writing that we succeeded, but in the end my reputation was crushed by the those that feared the US Government.
Today, on my resume, I can in good consciousness say I managed a project to completion, on time and under budget. But given the opportunity to help the US Government again as a contractor, I'd turn down the $ and walk away.
Businesses can't afford to be blamed for the US Government's inability to get its Shit together.
Life takes interesting turns, but the most interest is when you're off the beaten path.
I normally do not complain but you are killing me here bro:
You must me invested in the means of production
I doubt people would but precious metals
Perhaps I am getting old but fitting several words into the sentences to ensure which exact word is correct is getting to be painful for me. I assume the words are, "be" and "buy" but with so many people making the same mistakes, I am getting to the point where I just do not care to decipher the meaning any more.
I guess what I am saying is proofread or have your comment, no matter how insightful, ignored. Thank you.
"Someone needs to talk to the tree of liberty about its ghoulish drinking problem." by ohnocitizen
That nice, but this law was not written by 6 people. That is physically impossible.
http://www.usnews.com/opinion/blogs/doug-heye/2010/01/05/c-span-demands-democrats-open-secret-health-reform-talks
The bill was passed almost a year later than your article was written. Your article is too old.
Never said the law was written by 6 people. You just said that republicans had no input in the bill when my link confirms that they actually did. My link is not an article, it is a timeline from the senate's own references, releases, and video hearings of the process this bill took to become law.
The secret meetings go both ways: http://www.youtube.com/watch?v=WWLeabRedMM
I'm sorry democracy didn't work out for you this time.
I'm looking for the part in your rebuttal, where you show that Republicans helped write the ACA. I can't seem to find it.
They violated just about every rule in the book regarding the development of large computer systems. If the Apollo space program had been managed like this, it is conceivably unlikely we would've gotten an astronaut to orbit the earth, let alone get him to the moon. Maybe Obamacare should be run by NASA.
Too much Java and not enough COBOL.
I'm looking for the part in any of your posts that says that non-Republicans wrote it. I can't seem to find it. Just because you say it happened, doesn't mean it is true.
They SAY they're about fiscal responsibility and small government. What they actually DO when they're elected is work to enact far-right social policy.
Example? It sure sounds like you are parroting again.
The tea party candidates were all for the sequester, which is about small government. Pretty much all of them have voted along libertarian lines, reducing government control over citizens - which is for smaller government.
You are just trying as hard as you can to believe a made-up story because it's what you want to believe.
"There is more worth loving than we have strength to love." - Brian Jay Stanley
Now, we're getting somewhere. If we look at who benefits the most from this law, it becomes apparent that it is the Insurance industry. My guess would be that the insurance industry wrote the bill that Nancy Pelosi just managed to pull out of her back pocket one day.
Gosh a giant complicated software project that falls behind schedule. Could only happen under Obama. God knows every private/for profit organization's projects end up on time and under budget, every time. And certainly anything a Republican administration has developed, except for the occasional war.
Star Trek transporters are just 3d printers.
The Fed often gets "first dibs" at auctions because of their role in managing the money supply
The Federal Reserve Act says that they have to buy them on the open market. Are you saying they have a "more open" market? That would contravene the purposes of the Act, but not surprise me.
http://www.federalreserve.gov/faqs/money_12851.htm
They say that there's a line to buy them, but if the market actions are open, then the Fed would not be able to grab 90% of there really was such a line. I tend to trust the numbers more than the claims, but if the market is cooked, then that's different.
http://www.bloomberg.com/news/2012-12-03/treasury-scarcity-to-grow-as-fed-buys-90-of-new-bonds.html
My God, it's Full of Source!
OUTSIDE_IP=$(dig +short my.ip @outsideip.net)
I think it is hard to deny that this the insurance industry did a number of this bill, but it is also false to say that Republicans didn't have any say in what went into it.
The problem with that is it gives power to the greens, who are worse then useless.
John McAfee 'It was like that time I hired that Bangkok prostitute; to do my taxes, while I fucked my accountant'
Give me examples of amendments proposed by Republicans that were adopted.
http://lmgtfy.com/?q=obamacare+amendments+written+by+republicans the Chuck Grassley one is pretty funny: http://www.huffingtonpost.com/2013/08/02/obamacare-congressional-coverage_n_3697021.html
The Federal Reserve Act says that they have to buy them on the open market. Are you saying they have a "more open" market? That would contravene the purposes of the Act, but not surprise me.
I'd suggest you re-read the links you posted. The Fed buys treasuries through "primary dealers," who are basically the banks that show up for every treasury auction and deal directly with the Fed. Also, note that it is actually an "auction," in the sense that different people make different "bids." If you look at stats from various auctions at the Treasury, you'll see "high bid" and "low bid" and "median bid" listed at each auction. These usually get summarized by one number in media reports, but that doesn't mean there aren't different bids. If the primary dealers (who sell to the Fed) put in lower bids, they get the T-bills first... at least, that's how I understand it. I imagine that primary dealers are usually instructed by the Fed to bid as low as necessary to acquire the amount of debt that the Fed wants... which is how they can decide to buy up 90% of the market -- they just bid lower.
But that doesn't mean other people aren't interested or aren't bidding almost as low.
They say that there's a line to buy them, but if the market actions are open, then the Fed would not be able to grab 90% of there really was such a line.
It's not so much that the market is "cooked" or "not open," as much as these Treasury "auctions" are NOT like the old floor of the NY Stock Exchange. It's not a bunch of bankers screaming prices at some Treasury official. Instead, these meetings are quiet affairs with only small groups of people in the room, mostly representing huge banks and financial firms. These people have clear ideas of what they are supposed to (and allowed to) bid before they come into the room, and if the Fed's primary dealers bid lower, the rest of the people may not get all the T bills they want.
But the price of the auction is still determined by the bidders, so it's not that the Fed is cooking the market exactly. If the rest of the bidders don't bid rates down very far, the primary dealers won't either. So even in cases where the Fed acquires 90% of the Treasuries auctioned, the price the Fed buys this stuff at is still set by what the other 10% of the market is willing to bid to (along with the other 150-300% of people who don't even buy any T bills at all).
Lesson #1 - Never trust the government to actually accomplish anything. Lesson #2 - This goes doubly for anything that has to do with technology. Lesson #3 - Forget #1 and #2. The government excels at being inept and will not listen to reason.