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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.
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.
Considering testing was slated to BEGIN the day before launch, I doubt it.
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.
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.
"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? "
$75 a month doesn't get you insurance that's worth anything or almost nobody is eligible.
More like $750 for a single person for coverage even partially comparable to single payer.
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?
Hmm, they've been developing the software for the last two or three years, and the shutdown began the day the site went live, it's extremely unlikely that the one impacted the other.
Or are you suggesting that Obama decided to treat Healthcare.gov like the WW2 memorial, and deliberately sabotage it? Hint: making your biggest achievement as President look bad is NOT a way to build a legacy....
"I do not agree with what you say, but I will defend to the death your right to say it"
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.
>> 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.
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.
The regulations surrounding insurance products are dealt with by the relevant insurance providers just like any other industry. Amazon doesn't have to bother with insurance regulations any more than they have to deal with the FCC regulations on your phone or computer.
The problem of privacy is not even interesting. It's purely a matter of policy and whether or not you are willing to enforce a certain set of rules.
There is nothing special about health insurance.
YOUR attitude is precisely the problem here. Idiots like you are making this situation far more complicated than it needs to be.
A Pirate and a Puritan look the same on a balance sheet.
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.
I learned that most people fail to understand the importance of a good software architect.
The problem is worse than that. Most folks don't understand how hard and expensive good software is to develop and deploy.
Remember, most folks only see the stuff that works. Nobody remembers Yahoo, Google or Amazon when they where struggling to keep the servers alive. We barely hear about Netflix when they are down... This stuff just works and most don't have a clue the effort that goes into making that happen.
Obama's administration was in *WAY* over their heads trying to put the infrastructure in place for the marketplace. NOBODY tries to field a complicated website at full capacity on a single day, at least nobody who's actually been successful at this. You ALWAYS soft start and ramp up to production goals. The whole idea is as unworkable as the website implementation turned out to be. But that's politics. Make confident assertions about things you have no clue about.
But that's government for you. Doing STUPID things in a big and expensive way then throwing money at the problem to fix it.
"File to fit, pound to insert, paint to match" - Aircraft Maintenance 101
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."
What hostile minority? It is the executive branch that was âoeexecutingâ the plan. Considering that this is seen as Obama's greatest achievement and Obama gets the pick the staff I can't think of a minority opposed.
If you are talking about the backseat drivers - the Republicans - well congress has oversight but no powers in this case. Sigh. No. This falls squarely on the shoulders of Obama.
I buy individual insurance for $165 a month. That is with a $500 deductible, and 0% coinsurance. My plan will be illegal on jan 1st, because it does not cover maternity care amongst other things. My plan is the equivalent of a platinum plan on the exchange. I just got quotes for a platinum plan with the same deductible, and quotes ranged from $420-$700 a month. Fuck you, and everyone else who thinks this law is a good thing. It just destroyed my ability to buy insurance. BTW, I am not even eligible to use the exchange. I applied, and my application was denied because my income was too low. I was told my only options for healthcare, was to enroll in medicaid or buy insurance on my own outside the exchange. It just so happens my income is very low right now, because I am starting a business and living off a capital loan.
You really think the President is going around shutting down just vet memorials to make some kind of a point? A shutdown means government services are shut down. Just because a handful of congressmen stand outside of the most controversial ones, doesn't mean that's all that our government has stopped doing. Pretty clueless for people to start taking a strategy one wing of the Republican House has bragged about for MONTHS now and blame it on the President.
I swear to God...I swear to God! That is NOT how you treat your human!
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!
The other $650/month of that premium is probably paid for by his employer as part of his benefits package.
If only "common" sense was actually that common...
...wasn't the whole "dot bomb" crash about doing stupid things (pets.com) in an expensive way (all those Aeron chairs) and throwing more money at the problem to fix it? The notion that "government" is a worse bureaucracy than other large bureaucracies like, oh, a healthcare insurer, say... has never clicked with me; I've tried to get service from (or worked in) too many large private bureaucracies.
...that socializing a major part of the US economy isn't easy?
Oh wait, that's probably not what you meant to say.
-Styopa
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."
What production website do you know of where development stopped and the product had no issues?
Development is an ongoing process that goes up to and beyond the day of product release. There will always be security holes to patch, bugs to fix, changes to be implemented, new features to be added.
If you think you can release a product on day x and lay off / fire / furlough all the developers the same day and have a good product you are part of the problem not part of the solution.
A individual plan for a healthy individual with adequate benefits and a reasonable deductible is somewhere between $175-$350. I used to pay $60 a month several years ago for the cheapest plan. I only go to the doc if I'm very sick or need stiches. $750 is a bit excessive unless you have some medical needs. Obama care does cover significantly more things than I use.
The memorials are open air lawns and monuments. The administration actually had to spend money to bring in fencing and armed guards to "shut them down". If the administration had wanted to, they could have simply put up a sign saying "Monuments closed. No security present. Use at your own risk." Then let American citizens and foreign visitors walk on the grass and take pictures of statues just like every other day.
You can make the argument that the shutdown is the sole fault of the Republicans. You are delusional if you think the same applies to lawns and monuments.
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.
Considering testing was slated to BEGIN the day before launch, I doubt it.
The contractors were too busy designing all of the "Due to the government shutdown, this website is closed" websites for all of the other government sites, so they didn't have enough time to work on the launch of the new site.
The numbers you cite are very unusual, and only found among the youngest applicants and particularly what you would call the working poor, in some select states. Waiting lists to get insurance at $75 a month through state governments can have 18 month delays, or worse. My own native state of Tennessee tried to implement a system called Tenncare, which had prices in that range, but had to force many poorer applicants off the system and throttle it back, and they now have a situation where they announce once or twice a year that there are openings, to be filled on a single date, only to see up to forty times as many people apply as can be added (makes me glad I moved - even though I'm making a lot more than $100 a week and now paying a state income tax, the thought of being uninsurable by the private sector, in Tennessee, should be scary to just about anybody without a trust fund to fall back on.).
But, even if that price was common for white collar or skilled blue collar workers, your ratio would be about 3/16ths of total income. For a married couple, with one of them already unable to work because of illness, that price would approximately double to about 6/16ths, and a single parent with one or two children could similarly expect to see it double or worse. Older people could expect to see numbers double or quadruple that while still being years from retirement, and for older married couples, the risk that one of them would become ill would become a constantly increasing nightmare. In other words, if the numbers you suggest were widely true, it would still be financially extremely foolish for two young, healthy people to marry, even with deliberately, carefullyy postponing having children in hopes of moving up into an income bracket that could afford them, for fear that one might become to sick to work and put all the burden of insuring both on the other one. What's wrong with a system that was made by people who want the poor to do the "responsible" thing, but actually makes the risks for people who do the "responsible" thing so great that the penalties for irrisponsibility are effectively no worse? That sums up many state health care policies quite well.
Who is John Cabal?
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.
Remember SimCity early this year? Yeah, EA and Maxis should know how to do this stuff, they should live and breathe this stuff, but that was a big giant failure for weeks, too.
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.
These facilities always have security to prevent vandalism and stupid, irresponsible people doing stupid, irresponsible things on them. We're not going to risk our monuments especially at a time when there's a lot of hostility towards this shutdown. Google for what JUST happened to the Lincoln memorial getting spray painted.
I swear to God...I swear to God! That is NOT how you treat your human!
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?
How does one go from having top notch insurance for $165 a month, to being forced to enroll in medicaid? I will say it again, fuck anyone who thinks this law is a good thing.
The contractors were too busy designing all of the "Due to the government shutdown, this website is closed" websites for all of the other government sites, so they didn't have enough time to work on the launch of the new site.
Hardly. More along the lines they hired a company with a poor reputation, that other governments had already experienced. See the "eHealth" scandal.
Om, nomnomnom...
The base rate for health insurance used to be quite different from one state to another.
Now, all prices will be higher because of the extra coverage required by the ACA.
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.
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?
Most of the problems aren't on the website, and many may not be due to scaling. The problems occur when the website has to query IRS, VA, DHS, state, and other databases for for information about the user and receive information back in a short period of time or quit the process. Speculation is that the company that created the data hub that all of the queries go through didn't adequately design for failed queries and that the government databases themselves couldn't handle the load.
These facilities always have security to prevent vandalism and stupid, irresponsible people doing stupid, irresponsible things on them. We're not going to risk our monuments especially at a time when there's a lot of hostility towards this shutdown.
Security of national monuments is a law enforcement function. The fact that the various government agencies have furloughed their law enforcement personnel means that law enforcement is not considered an essential function at any of those agencies. Think about it.
The local lighthouse is a BLM operation. The gates are closed and locked. There is plenty of parking outside the gates, and people can easily walk past the gates to access the lighthouse and the other facilities. Bikes could get past those gates easily. I've heard the rumor (unsubstantiated) that the state police and local cops are stopping by every so often. I was there for a couple of hours and saw neither, nor were any of the cars towed or ticketed.
On their best day, the BLM rangers wouldn't catch anyone vandalizing a lot of the facility. They run the interp center. They stand at the lighthouse telling people they can't go in. They take the money at the front gate. Of all the places they are supposed to be, the only one you can be sure they are at is the front gate.
It was a disaster from the beginning!!!!
So the logical thing would have been to install those fences and station armed guards every evening after the memorial was vandalized. Not all day a couple months later to keep daily visitors out.
Keep defending it if you want, but the people of this country know when someone is acting like a spoiled child, taking his toys and pouting in the corner. This has nothing at all to do with the shutdown, and everything to do with an ego.
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.
15% shutdown of the government.
May I ask where you got that percentage? It seems much higher to me.
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
I think the fact that the Lincoln Memorial was just so easily defaced is contrary to your argument and I get the impression you've never visited D.C.. I've walked through the WWII memorial in the middle of the night with no guards or cameras around. President Obama has practically admitted to making the Govt Shutdown and Sequester hurt because he's for larger government. Shutting down the WWII memorial, and the Nordmandy beaches in France, and State/Federal co-sponsored monuments ARE political acts.
When Google.com opened you could use it to search. When ebay.com opened you could bid on items. When Amazon.com opened you could buy products. How is this simply a glitch or issue and not a fundamental problem that is inherent to the cronyism of Obamacare?
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.
It's pointless comparing those costs without a more detailed comparison of benefits. The claim that the insurers somehow found a way to provide the same benefits for triple the price under the new regulations is quite silly.
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
Well, no. The Dot Bomb was caused by wild irrational exuberance. I have yet to meet a government bureaucracy that was characterized as having âoewild irrational exuberanceâ.
And I think there is an important difference. If a company has poor customer relations people will go elsewhere or start up their company. The old companies will go bankrupt. The amount of damage is limited.
Government bureaucracies are different. If they fail they don't go out of business. Often another layer of regulation and bureaucracy are laid on top of the old so the whole thing grows. (I also think it ties to incentives and who chooses to work for government. In business risk generally have huge upsides with limited downsides. In government that is reversed. Risk taking is meet with limited upsides and serious downsides.)
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.
Yes, it is silly. It is also reality. The ACA compliant plans, actually are slightly worse than what I have now, with higher yearly caps on out of pocket expenses. I am single male and childless. Why do I have to buy maternity care coverage?
My employer is me.
That's what you pay with group insurance - where your eligibility and rates are set by you being part of a large and diverse group. Insurance companies don't consider "the entire US" as a group, and now the individual rate is even higher than signing up as an individual was before the mandate. The assumption by insurance companies is that if you decide to sign up for insurance outside of a group plan, it's because you are expecting a major medical expense.
But Mr. Obama promised that anyone who liked his current insurance plan would be able to keep it. I don't understand. Exactly what are you saying?
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'
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?
Basically, I am saying Fuck Obama. Every promise that he made was broken in my case. Every single one.
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'
Under the new plan the young and healthy subsidize the old and sick.
Not in the 'that's insurance' sense. In the sense that young peoples premium is above market and old peoples premium is below.
Not unlike social security, where the young and relatively poor subsidize the old and relatively wealthy.
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)
No one has their own country anymore. They can't even get all the white people out of South Africa.
now we need to go OSS in diesel cars
Because there was not enough support from Democrats to pass a single-payer bill.
> In addition, our borders have allowed in a third of the population of Mexico without restriction
EH? There are have been about 11 million Mexican immigrants to the US. The population of Mexico is about 112 million.
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/
True, but remember the government is not blessed with the profit motive that EA had. EA may have messed up, but you can bet they where motivated to FIX the problem. Healthcare.gov is government run and what's their motive to get it fixed? Somebody might get "blamed" and not elected sometime in the future?
"File to fit, pound to insert, paint to match" - Aircraft Maintenance 101
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.
Well, yes. This is the basic problem solved by mandatory health insurance (Obamacare) - you generally don't need expensive healthcare until you've lost your health, and thus can no longer pay for it. As you said, a very similar situation to SS, where the problem is that many don't save for retirement unless forced to. If you want you can think of it as a subsidy of the old by the young, but it's no less correct to think of either as a form of forced savings. (Not that "your" gold coins are sitting somewhere in a vault, because they aren't, but that doesn't really change anything).
If a project is screwed up in the private sector, you generally won't hear about it in the press. The company simply takes a charge against earnings, buries it and moves on.
A government project like this can't avoid the scrutiny because it's taxpayer funded.
TL;DR: Your politically biased rant makes no sense.
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.
Fine, kick them all out of office for malfeasance. But the problem with you partisan idiots is that you are blinded to your own side's actions.
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.
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".
"How good insurance *could* be if politicians of both parties (at the state level) would let go of it."
Let's see how good.
"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."
What does amazon know about insurance? Nothing. What would amazon analytics do about insurance if they put their minds to it without any of this government regulation business?
It would make things extraordinarily awful for you and very profitable for them. There's extremely good reasons for the regulation.
Health insurance is entirely different from property and casualty insurance. An accident or fire is a point event in time on the timescale of insurance, they can't do anything in the middle of the event. Suppose, contrary to fact, insurance companies had very inexpensive drones with infrared cameras flying over all their covered areas and monitored for fires. If they saw one and geolocated it, if you were the policyholder you and your mortgage company gets a tweet that the policy is canceled as of YYYY-MM-DD-HH-MM-SS, just a few seconds before the fire truck rolls up. How well would that work? It would be amazingly profitable and extremely scummy. Oh yeah, you still owe the mortgage on the burnt down house, and gee the bank is upset that the value of their collateral was destroyed. That equivalent happens in health insurance.
Insurance companies are extremely motivated to be obtuse and make it difficult to pay out claims with arbitrary difficulties. Amazon wants to do everything to get you your package efficiently. How would it be if Amazon Insurance was motivated to be the opposite on claims? (as all insurance companies are). Look how some banks already were intentionally deceptive about acknowledging loan modification documentation, and this despite massive Federal regulatory intrusion. How would it be WITHOUT that regulation?
Now, in health insurance, your life can depend on it, literally.
What Republicans are pushing for is "buying insurance across state lines" which sounds nice, until you realize what that means: regulatory arbitrage. In an instant the only place from which insurance will be written will happen to be the one state which has the least regulation and investigative capacity. Why is North Louisiana's insurance commissioner going to be motivated to investigate the tremendous abuses against California policyholders? When the little state capital has a very large Hike-Co Insurance headquarters, and they've paid for the football stadium and all the local politicians?
No, it was the reverse.
The GOP tried to delay this fiasco a year as part of funding the 18% or whatever of the government that is "discretionary". The Senate and President shot that attempt down.
BTW, none of the funding for this website implementation was part of that discretionary funding. So no effect there, either.
The party of stupid and the party of evil get together and do something both stupid and evil, then call it bipartisan.
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!
Have you even applied for enrollment on the exchange? If you have, you will be the only person other than myself that I know of. I'm sick and tired of people saying how great this law is for people that need to use the exchange. It just completely fucked my healthcare. Completely. Until you have enrolled, shut your fucking face.
I have the Dean 500 plan, with prescription rider. Go ahead and research to your heart's content.
There is no employer contribution because I am self employed and founded a startup last year. This is pretty funny if you saw the slashdot article last week, on how great this law is for people involved in startups. I am just besides myself with laughter right now.
"There is nothing special about health insurance."
Other than
a) If you don't buy some of the underlying product you might well be dead
b) you don't have a choice when to buy much of the product
c) the cost is so extreme that one health event can bankrupt you
d) there is almost no competitive substitutability
e) the health insurance itself gets you access to only extremely high health care prices instead of unbelievably gouging health care prices
it's just like every other consumer purchase, i.e. it's entirely and completely different.
And you missed the part where I said I buy insurance on my own, because I started a business. I can categorically say this law is a disaster for people starting a business.
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
You're eligible for Medicaid and you're complaining? Medicaid is pretty damn cheap seeing as it's for poor people. The only problem is that you may have trouble finding doctors who will be willing to see you.
But yes, you're probably a reasonably healthy white male in his 20s or 30s. You're getting the shaft on this one so that sickly folks with tons of pre-existing conditions can pay $420-$700/mo instead of simply being denied coverage. Really, it sucks to be you, but that was the intent of the law. Do I think it's a good thing? On the balance, I'll give it a very tepid yes. So fuck me, I guess.
I'm lucky in that my wife works for the state and is in a union, so our coverage is really good and cheap. In fact it's probably too good compared to what most people get. If you were to take this idea to car insurance, I'd be in the same boat. I've never had so much as a speeding ticket. My premiums would skyrocket if car insurance was guaranteed issue and required community rating, and then all the other people who have a half dozen DUIs would have their premiums decrease by just as much.
In short, your plan is more expensive so other folks' plans are less expensive (or simply available). That's socialization of risk, and you're on the short end. Why do you have to buy maternity coverage? So women's plans are less expensive. The way I see it, I'd be happy to have my premiums tripled if it meant that someone with a blood factor disorder could get affordable insurance. If you don't see it that way, that's ok. Best of luck in your new business, BTW.
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
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.
And when someone spraypaints a crude penis on the Washington monument, how much does your "Use at your own risk" sign help?
How much does it cost to clean, and how does that cost compare to temporary fencing?
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.
Yep and the problem is the system of contracting and privatisation they created. With contractors spending more and more on lawyers to find holes in tenders documents and contracts to ensure they do as little as possible, in as dysfunctional way as possible in order to charge more and more and more to fix it up and thus by corporate law make the maximum amount of profit possible, seriously it is a real surprise when ever any government privatised and contracted computer system works. In house is the only realistic method by which a government computer can succeed. Once it is contracted it is down to the lawyers not the coders and those for profit private lawyers are paid to make it cost more and do less.
Chaos - everything, everywhere, everywhen
You really think the President is going around shutting down just vet memorials to make some kind of a point?
Yes. Definitely, yes. It's the first rule of making budget cuts hurt: cut the areas most painful to the most people (policeman and fireman and maybe teachers) and cut the esoteric services last.
Any guest worker system is indistinguishable from indentured servitude.
Really? So the argument is that a $400 million website (that's a budget many multiples that of, let's say, startup capital of Facebook) was not enough to withstand a 1-week absence of the upper management. Ok, then. Can't wait until the same business methods are used to design workflow of surgeons and EMT's. Oh, small question: why is it that NYSE exchange can have (literally) billions trades occurring every day? How many people signed up for the whole healthscare thing? A million? That's 1000 times less than a billion. I mean, hell, NSA can listen to all of their phone calls and not even come close to its upper capacity. But sign up for a web form (a much more structured data than voice recording) and noooo.... look over there... look!!! birds! You put your trust into a guy who can sell the "just bear with us and everything will be ok" line. That's the whole presidency of this guy. He is a clueless empty suit. But don't worry, I am sure his incompetence is only manifesting because I must be a racist.
Any guest worker system is indistinguishable from indentured servitude.
Or are you suggesting that Obama decided to treat Healthcare.gov like the WW2 memorial, and deliberately sabotage it?
I think he was suggesting that Obama, bitter at the people who are frustrated with his incompetence, closed down the memorials to pay the Americans back for calling him on his bull shit. The healthcare.gov would be part of the incompetence in this scenario -- not part of the payback.
Any guest worker system is indistinguishable from indentured servitude.
You are making two points here.
1) You are an idiot. As GodfatherofSould stated above, even with 'normal' routine, memorials can be vandalized. The barricades are not to stop vandalism.
2) Really, what more is needed to be pointed out?
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.
To help you out, here is the plan I currently have.
http://www.ehealthinsurance.com/ehi/ifp/plan-details?planKey=53109200:200119&productLine=IFP
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
Does the rate of vandalism increase when unguarded? Who pays for the repairs, when the government is shut down?
I believe Obama has other things on his schedule and the web site was probably delegated to others- maybe to contractors. I don't think that congress or the president is directly involved in managing the web site, so an absence of that level of management doesn't seem like a contributing factor. I suspect the problem lies in the absence of $ due to the shutdown. Contractors don't usually work unless they get paid.
The NYSE trading system is continually being upgraded to handle increasing traffic and contractors get paid to keep it all working. I would bet that if you stopped paying the people who keep it running you'd quickly see similar problems.
None of the monuments were shut down during the last government shutdown. The fact that they were shut down this time was just President Obama trying to make your life more difficult.
They don't grade fathers, but if your daughter's a stripper, you fucked up. --Chris Rock
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.
Except, I still have my health, and because of this albatross of a law, I can no longer afford to insure it. The ACA in my case is not affordable and doesn't care,
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.
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.
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
They didn't shoot themselves in the foot, the GOP blew their whole fucking leg off!
I have never seen more inept, pathetic, and idiotic political posturing in my whole life.
Obamacare is in full implode mode and the Republicans fight to get rid of it is actually going to help it survive!
The Republicans in the house are fucking morons!!
You don't honestly believe the fences and armed guards are to prevent vandalism, do you?
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.
Highly insightful, imo.
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
This is not true.
The 1995-1996 shutdown also closed all National Parks, including most memorials on the Mall. What is different from last time is that there are now established procedures for what closure of the park means, as well as the post 9/11 security atmosphere. In 1995, monuments without steps (e.g. Vietnam Memorial (WWII Memorial did not exist yet)) were not gated up, but those with steps (e.g. Lincoln Memorial) were.
What you don't seem to understand, is that "unguarded" is the normal state of affairs when the government isn't "shut down".
Only during a "partial shut down" did the guards and fences appear, in order to inconvenience the large amount of tourists that visit the National Mall on a daily basis.
Slashdot still doesnâ(TM)t support Unicode after it was added to the HTML standard in 1997.
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.
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.
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.
Would it 'change anything' if it was an insurance company that had sold you an annuity? Aside from the fact that they aren't going to arrest congress and the president.
We will all be paid back with freshly printed, devalued dollars. It is a tax transferring money from the young and poor to the old and wealthy. It is not forced savings.
John McAfee 'It was like that time I hired that Bangkok prostitute; to do my taxes, while I fucked my accountant'
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.
The website is literally 1,000,000 times less complicated. You are arguing "in principle", when what matters here is the the scale. You are insane if you think they are even remotely competent. Movie theaters sell tickets around the country on a lesser budget. This is incomparable simple. And they still fucked it up. You are just trolling if you are still a Democrat.
Any guest worker system is indistinguishable from indentured servitude.
I believe Obama has other things on his schedule and the web site was probably delegated to others- maybe to contractors.
and completely disregarding the beginning of my post which said this:
So the argument is that a $400 million website was not enough to withstand a 1-week absence of the upper management.
say anything other than that you are trying to defend the indefensible (the Democratic Party)?
Any guest worker system is indistinguishable from indentured servitude.
Chill out. The R's finally realized that no amount of jerrymandering will save them from the backlash from this in the next election and they voted to fund the govt. Guess what? Obamacare is still happening...
I guess we are now a banana republic. Every foreigner I spoke to who like that Obama was elected only liked him because he saw him as the PUNISHMENT US deserved. I am just not sure why we chose to punish ourselves.
Any guest worker system is indistinguishable from indentured servitude.
Don't kid yourself about gerrymandering, by the way. It's as much a bipartisan tool as filibuster. Democrats are just mad that they weren't in charge in 2010 (when the last census was conducted) so they didn't get to gerrymander to their advantage.
Any guest worker system is indistinguishable from indentured servitude.
Banana republics don't pay their bills. Now we do.
If you're unhappy with last night's vote, I suggest you do as I do and vote against idiots in the next election.
No, we don't pay our bills. We "pay" with money which we "borrow" from a little black box which sits in a wall somewhere. FED's holding of the Bonds went up by 4 trillion in the last 5 years. That's a year's worth of federal budget. That money will be repaid with more bonds sold to the FED. We are using "debt" to print money by borrowing from an abstraction. We are a banana republic without bananas.
Any guest worker system is indistinguishable from indentured servitude.
I don't know what to say. Good luck!