DHHS Preparing 'Tech Surge' To Fix Remaining Healthcare.gov Issues

itwbennett writes "It's no secret that the healthcare.gov website has been plagued by problems since its launch 3 weeks ago. On Sunday, the Department of Health and Human Services said that it's now bringing in the big guns: 'Our team is bringing in some of the best and brightest from both inside and outside government to scrub in with the [HHS] team and help improve HealthCare.gov,' the blog post reads. 'We're also putting in place tools and processes to aggressively monitor and identify parts of HealthCare.gov where individuals are encountering errors or having difficulty using the site, so we can prioritize and fix them.' Other emergency measures being taken as part of what HHS calls a 'tech surge' include defining new test processes to prevent new problems and regularly patching bugs during off-peak hours. Still unclear is how long it will take to fix the site. As recently reported on Slashdot, that could be anywhere from 2 weeks to 2 months."

Comments

How about they just scrap it entirely?

[Anonymous Coward]

Single payer - have everyone buy into Medicare. Done.

Re:How about they just scrap it entirely?

[rubycodez]

you're confused. the whole reason we pay three times or more what more advanced countries do (yes kiddies, U.S. is not #1 for healthcare) is because of the big insurance and big healthcare full of fat cats lining their pockets. that system has to be destroyed. ACA just gives it more money. single payer might be viable solution but it will burn down some huge corporations. however, don't believe the lie that those big corporations are the main contributors or participants in our economy, people and small/medium business are the bulk of it.

Re:How about they just scrap it entirely?

[Unordained]

The ACA exchanges are specifically designed to (a) help people buy in larger pools for discounts and (b) induce competition between insurance companies, to reduce prices.
Where we don't have as much pressure is in healthcare, because people are not naturally inclined to go to a physician billing himself as the cheapest on the block. We as patients don't know how to evaluate the quality of the care we get, or its value, so we cannot effectively price the services we buy.

Re:How about they just scrap it entirely?

[Jeremiah Cornelius]

That's the exact opposite economically to produce affordable healthcare for the whole nation. Sure poor people will have little incentive not to come in for every cough but someone will pay for it. That will tax our whole economy, not including dead weight loss inefficiencies.

Cut the 3 billion sent to Israel's military every year. Why subsidize the Israeli social welfare system, when they have a booming economy and the US has bread lines?
 

Re:How about they just scrap it entirely?

[Salgak1]

Or even better, apply the O'Rourke Circumcision Principle. All budgets get cut, 10%, off the top.

Stop ALL foreign aid. Means-test ALL transfer payments to individuals. And prohibit the use of proprietary software: MANDATE open-source.

And most importantly, Limit ALL Congressmen to 6 terms max, lifetime, and all Senators to two terms max, lifetime. If it's good enough for the President, it's good enough for them. . .

Re:How about they just scrap it entirely?

[mc6809e]

you're confused. the whole reason we pay three times or more what more advanced countries do (yes kiddies, U.S. is not #1 for healthcare) is because of the big insurance and big healthcare full of fat cats lining their pockets.

Saying that they line their pockets with money may be a fact, but it's not a reason.

The reason we collectively spend so much is because we have government spending competing with private spending for a finite amount of healthcare services.

It's this competition for limited services that bids prices up for everything. And as prices rise, some people are priced out of the market, justifying more government spending to help them, which further increases prices.

Re:How about they just scrap it entirely?

[phantomfive]

Where we don't have as much pressure is in healthcare, because people are not naturally inclined to go to a physician billing himself as the cheapest on the block.

The way to make up for that is by allowing customers to know the outcomes for various surgeries in the hospital. Once customers know the price and the outcomes, they can make informed decisions.

Price and outcomes are not always related. For example, a hospital that does many heart surgeries could be very good at them, and also very efficient, so they can do them more cheaply. Whereas another hospital that doesn't do many heart surgeries will need to charge more as a result, and also will have worse outcomes.

Whether prices are published or not, outcomes should definitely be published, because making that information public will be an incentive for hospitals/doctors to improve treatment even if nothing else changes.

Re:How about they just scrap it entirely?

[mc6809e]

Which limited services are you referring to? What's the limit?

How about the time available to doctors and nurses to treat people? They can only treat so many people.

And there are psychological limits, too. Doctors and nurses may have time but not the will to devote 80 hours a week to watching people die.

There are also equipment limits. An MRI requires scarce materials and scarce skills to assemble.

There are countless things that limit the total amount of healthcare available.

Don't think like a mere consumer, where the perceived limit on what's available depends only on the money in your bank account. That's putting all the focus on the demand side of the equation. Try to see the big picture. To do that, you have to look at the supply side, too. The supply of most things is limited (ultimately by physics).

Re:How about they just scrap it entirely?

[dywolf]

1: Nope.
2: Nope.
3: Contributes, but nearly as much as people think.
4: Nope. In fact the opposite. Hospitals can get away with charging more because the insurers act a a shock absorber, insulator, between your wallet and the true cost of care. they dispute some, but not all excessive costs, because they act more as a match maker between patients and hospitals than a representative of the patient. in fact, it can be argued that hte true commodity is the patients, and the customers are the hospitals.
5: Nope. Red herring. It contributes, but negligibly so.
6: Finally got one right. Lack of competition and economic pressure. This single factor is responsible for the majority of high cost of healthcare in this country. Quite simply, healthcare costs so much because it can. Because they can get away with it. Because there is a middleman between our wallets and the caregivers, that sheilds us from direct costs. Because healthcare isnt like a car sale...you're not going to walk away from life saving surgery because it's too expensive.

It's as a simple as that. Number 6 is the single most important factor, all others are either false or negligible.

http://theincidentaleconomist.com/wordpress/what-makes-the-us-health-care-system-so-expensive-introduction/
http://theincidentaleconomist.com/wordpress/what-makes-the-us-health-care-system-so-expensive-red-herrings/

We should have access to fairly priced health care that we can work out the details of paying for it. And choose whether or not it's worth the money to us as individuals.

Again: no one actually does that. No one is ever going to do that. If I tell you you need to take these pills, that cost 100$ per pill, or you will die, you're not going to walk away and just accept death. People just dont do that. and since you care to mention government...the single most cost efficient sector of our healthcare system IS the government run single payer segments: Medicaire/Medicaide.

Re:How about they just scrap it entirely?

[Valdrax]

All budgets get cut, 10%, off the top.

Tell you what -- why don't you apply that at home? Pay 10% less for food. Pay 10% less for clothes. Pay 10% less for luxuries.

Pay 10% less for your rent. Pay 10% less for your utilities. Pay 10% less for your loans. If you get injured, offer to pay your doctor only 90% of the bill. Do it right now, and don't incur any additional expenses in reducing these costs, because that comes out of your total budget too.

It turns out that many government agencies & programs are not only running right at the red line but are actually underfunded. Also, there is often a cost associated with not paying something that makes it more expensive than just paying it. 10% across the board cuts are the kind of thing that sound nice when you're just talking numbers, but there are people and contracts and obligations and Congressional mandates that aren't so easily cut.

Re:How about they just scrap it entirely?

[Xyrus]

Why did you write a wall of text? Here's a brief summary: Poor people deserve to die.

That's really what you want, isn't it? The haves can have health care, the have-nots can die in a gutter someplace. And this will be better for everyone.

Unfortunately for you, other more socially advanced nations have provided strong counter-examples to your Rynd-esque sociopathic utopia.

Re:How about they just scrap it entirely?

[Unordained]

The income redistribution was already happening, except it happened in spurts (when people went to the ER, couldn't pay, and the hospital passed along the loss) or through the courts (when people went bankrupt, and we all paid for it when their creditors passed along the loss.)

Insurance, by its very nature, is always re-distributive. Those who don't need (today) pay for those who do (today). It evens out, eventually (there's no reason to expect those who are currently rich to be naturally healthier over their entire lifetime), but in the short term it's redistribution. We redistribute for basic needs -- food, shelter, and healthcare. We've had a mandate to that effect since 1986, under Reagan. It's not a particularly partisan issue to say that our fellow man doesn't deserve to die of some curable disease just because he can't currently pay for care. And it's not unreasonable to say we'd rather he go see a doctor while the problem is easy to fix, rather than wait until the last minute -- by doing so, he's doing us a favor (if we're footing the bill.) We may subsidize his care today, but if he recovers and thrives, he'll be paying back into that same insurance pool too.

We generally regulate what products people can buy. We do that with securities. With drugs. With food. Weaponry. Animals. ...

We have certification requirements for plumbers, lawyers, electricians, and yes, doctors. Does that increase the cost of the services? I'm pretty sure it does -- but the regulation wasn't done without reason. When you look at the history of deregulation of these industries, you see all sorts of calamities. A cheap self-described electrician can set fire to a whole neighborhood. A quack doctor could easily cause a pandemic. We're all affected.

Self-reliant today, but what about tomorrow? Will you willingly accept to be left in the gutter by the rest of society in your hour of need, because you deserve no better? Money is secondary to me. People come first.

The ACA does not prevent you from paying more, if you want to. So I'm not sure what that's about.

How about this...

[msauve]

Defund the NSA, and repurpose their data center for this. Two birds with one stone.

Re:How about this...

[Capt James McCarthy]

How about defund both and give me my money back. I don't want to pay to listen to phone calls and could care less about paying for someones birth control.

Mythical Man-Month

[Anonymous Coward]

"Our team is bringing in some of the best and brightest from both inside and outside government"

Re:It's a lost cause

[larry bagina]

It's not about helping the poor; it's about feeling good for helping the poor. Whether the poor are helped or not is irrelevant.

Re:Not that interested in the teething problems

[John Jorsett]

Personally, I'm not that bothered by teething problems. Plenty of sites have experienced them. Yes, there are many ways they could have been avoided, but they weren't, and they will undoubtedl be fixed.

Even assuming that to be true, fixed by when? The law has hard-coded dates in it, and insurers have vast sums at stake predicated on the numbers and types of people signing up, the premiums they'll get, and the subsidies they'll receive. If things slip, lawsuits will fly and it's logical to assume that taxpayers will be on the hook for damages. Not to mention the people who are losing their coverage at work who were expecting to be able to sign up via the exchanges. This disaster has knock-on effects that will resonate thru all sectors of the economy and society, and to call them 'teething problems' is far too dismissive.

Government Thinking

[sycodon]

Thirty Million out of 300+ million supposedly don't have health insurance.

So, lets write a plan that affects all 300+ million instead of one that addresses the 30 million.

Brilliant!

Re:Government Thinking

[AlphaWolf_HK]

Yes, because a law that dramatically alters the way your insurance company will do business is just not going to change things for you.

Seriously how naive can you get? I've yet to meet a single person who works in the health care industry who told me that this plan isn't a train wreck in the making, one of them even intends on getting out of the business entirely.

Re:Government Thinking

[GodfatherofSoul]

That's not insightful. The problem is lots of us who have insurance have been getting a raw deal. Including getting dropped when you get sick, having coverage capped, losing a job for being sick and being unable to afford a new plan after you get well (preconditions). The ACA isn't about just those 30 million, or they would've just expanded Medicaid.

Re:Government Thinking

[AlphaWolf_HK]

I like how if you complain about government overreach, it's now fashionable for somebody to suggest somalia, as if there's nothing in between this mess and that mess.

Really you have to be a total moron to not be able to understand the difference between anarchists and libertarians. Libertarians want a government, the difference is they want a government that protects you from others rather than you from yourself. Liberals want the later, such as banning trans fats and soft drinks.

And this change for the sake of change is stupid. Personally, when I look at the prices for services that people pay for out of pocket, I notice how cheap yet good they are. Two months ago I paid $40 to get a full dental exam, x-rays, cleaning, and scaling. Meanwhile that same place bills insurance companies $250 for the same service. Why is that? Because when people shop around, they save. Insurance gets rid of the shopping around part because you don't even need to concern yourself with the cost.

Look in other areas traditionally not insured as well - some places offer Lasik for less than it costs to get a new pair of eyeglasses in some cases. I'm not eligible for Lasik (due to keratoconus) but an eye exam usually runs me about $30, whereas insurance companies typically pay about $50.

This is why health care costs are so expensive in the US - and the solution, according to people like you, is more insurance?

Re:Government Thinking

[GodfatherofSoul]

Insurance IS redistribution!

I would never call this bill mere tweaks. I can't believe *anyone* would call this bill mere tweaks. Now, as for costs, there are some things that the ACA does. For one, it caps profiteering by the healthcare insurance industry by forcing at least 80% of expenditures to be used on actual healthcare. Second, it makes healthcare checkup plans far cheaper so that people don't ignore small health problems, then run to the ER when their pancreas explodes. I'd google for some of the other cost control measures.

Personally, I wanted a whole-hog UK healthcare system completely run and funded by the government and making doctors and nurses federal employees. What we've got is the best compromise that we could get through Congress. People are criticizing features of the ACA like they slept through the 2 years of rancorous public debate. It's a miracle that we got as much passed as we did.

In the future, when the idiots in this country crying about socialized healthcare understand what it actually means, I foresee a government-run public option being dropped into Obamacare. I also see other future changes like larger penalties for the John Waynes who declare they don't want insurance, but run to the ER when their pancreas explodes.

Re:Brooks

[rubycodez]

then it is truly screwed, he is out of his depth on this. Those dreamy eyed fools who made the ACA did not realize the implications of it needing an massive IT infrastructure that cannot be crapped out in 3 years and tested for all of ONE FREAKIN DAY when it was completed this month (!!!!). pop up the popcorn kids, this train wreck will be worthy of a Fugative sequel

Not unlike a big-bang private sector project...

[ErichTheRed]

I'm sure there's tons of people salivating at the chance to jump all over this topic and say things like "classic government inefficiency at work." But the reality is that these kinds of projects happen every day in private sector companies. You only hear about them when they make the news. I've seen many companies throw out millions in sunk costs because they couldn't get an ERP system massaged enough to fit their business processes. Often, the companies realize too late that they're getting bled dry by outsourcing "partners" and getting nothing in return, then make the hard decision to just dump everything and try again.

Some of it may be leadership incompetence (analogous to CIOs getting swindled by consulting salesmen over copious rounds of golf and strippers) but HHS doesn't have hundreds of web developers on staff, and there would be a monster backlash if they actually did go out and hire them as permanent employees. IN the real world, they're forced to outsource to be "good stewards of the taxpayer's dollar" and end up getting crap. I can't believe that no one over the last 30 years has come to the realization that outsourcing always costs more, and results are not guaranteed no matter how much money gets flushed. What probably happened is that the project got awarded to the lowest bidder of the big consultancy firms, who promptly replaced all the super-geniuses they promised with new grads, and just kept collecting money.

A lot of private firms get fed up and just insource the whole thing, but I don't think the government has that option right now. Given the political climate, I'm sure every paper clip purchased is tracked by certain right-wing groups, and hiring hundreds of Federal employees certainly won't go over well. So, we'll just see the same consultancies who screwed up get rewarded to "fix" the problem. Just like in the private sector...

Government is moving digital

[EMG at MU]

I think this might be the first goverment case of a large organization trying to execute a publicly facing software project and failing. For decades the goverment didn't do public facing benefit projects. If this all happened in the 90s you would have to sign up using paper forms and although it may have been slow and inconvenient by today's standards that's what the goverment had experience in doing, it probably would have worked just fine.

I think software/web centric failures like this are going to keep happening. Few organizations, especially those whose primary business isn't software, are good at implementing huge software projects. Most management doesn't know how to run software projects, budget departments dont know how to account for software projects. If the Social Security administration has a huge backlog of applications they just add more people to the workforce until they work through it. Now everything is different, it doesn't matter how many people and how much money you throw at it, it's going to talk a while to fix. Very few people in goverment, and very few members of the electorate understand how a software project is run, hence a "surge" to fix the problem. People understand that concept, they imagine tons of nerdy looking guys flowing into some building and typing furiously at a keyboard until the problems go away. Good imagery, not really accurate.

I'm actually really amused by all this, it's my job playing out on a national stage. Terrible software estimates, contractors failing to live up to contracts, unrealistic timelines, poorly understood requirements, angry management demanding all hands on deck, and unhappy users. Maybe now software management will become an academic subject and mandatory study for MBAs and such.

Re:Should not be a federal program

[SJHillman]

The Articles of Confederation have not been in use since 1789... so I think we can safely discard them in any discussion about modern states. One of my professors pointed out an interested change in linguistics after the Civil War. Prior to the war, "United States" was almost always a plural ("The United States are...") but after the war, it became a singular noun ("The United States is..."). The Civil War was basically the end of the question of state sovereignty in the US. It's also one of the reasons the Confederate States were a confederation (and not a federation)... confederate states are independently sovereign and can freely secede from the confederation, but in a federal government, they have shared sovereignty with the federal government at best.