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Obamacare and Middle-Wheel-Wheelbarrows
davecb writes "The Obamacare sign-up site was a classic example of managers saying 'not invented here' and doing everything wrong, as described in Poul-Henning Kamp's Center Wheel for Success, at ACM Queue."
It's not just a knock on the health-care finance site, though:
"We are quick to dismiss these types of failures as politicians asking for the wrong systems and incompetent and/or greedy companies being happy to oblige. While that may be part of the explanation, it is hardly sufficient. ... [New technologies] allow us to make much bigger projects, but the actual success/failure rate seems to be pretty much the same."
Actual rational commentary unencumbered by raving political partisanship.
How is this legal?
To many middle man get in the way of the people doing doing the tech work and it's like that part is being worked on by team X and you need to wait for them to do there part and no you can't talk directly to them.
...The website "roll-out" was an utter failure, plain and simple. There are so many websites out there that do far more complex operation, and they seem to have very little problem. I wasn't involved in the "roll-out" of the government's healthcare website, so I know jack-diddly about the problems that they faced. But from what I know about websites, especially ones like that one, is that it's a simple matter of input from the user, and then a matter of storage of that input, and maybe some calculations along the way - all very basic stuff for today's world. I went to the website and the damn thing had major problems that made me think that it was trying to do a lot of on-the-fly operations behind the scene that wasn't syncing up correctly, maybe I'm wrong, but that was my feeling.
However, that being said, I cannot see why the website "failure" had such an impact on the "unrolling" of the actual healthcare change. They had a toll-free number to call and operators that would do everything over the phone, very nice people I might add. Why the site didn't simply display the toll-free number is a good question. Hell, maybe they could have simply had an online-chat window pop up. Again, I wasn't a part of the staff that was tasked with this website, so there are things that I don't know.
Politics; n. : A religion whereby man is god.
"The Obamacare sign-up site was a classic example of managers saying 'not invented here' and doing everything wrong, as described in Poul-Henning Kamp's Center Wheel for Success, at ACM Queue."
I mean, you folks at Slashdot should have called it the Affordable Care Act website then reminded us that it's also known as Obamacare. But to call it what it isn't in the first sentence of introduction is [very] unfortunate!
Disclaimer: I am neiter Democrat nor Republican.
Most articles linked to on slash dot aren't very interesting or are pushing something, but this article was interesting and a good use of my time . +1
A problem with business, that is, not a problem of business. All too often I see business requirements for software that specify how things must be done, rather than specifying what is to be done. The problem is that the business requirements are being written by businessmen who have no training or experience in writing software, so they no more know how things should be done when writing software than (according to those self-same businessmen) the software developers know how things should be done when running a business. The solution is always the same: let the business people lay out what they want done, and let the software developers figure out how to do it.
This isn't the only place we've seen this. The Pentagon and FEMA have been up to their necks in it for years. The process of getting government contracts is so bizarre and complicated that companies have evolved with "getting government contracts" as their only business model. So the companies that actually get the contracts are the companies that are good at getting government contracts (because they focus so much of their resources on the process), NOT companies that are good at delivering what the contracts specify. This is a natural by-product of bureaucracy.
Kemp is being unfair. I understand what this section is about, and he doesn't. A patient decision aid could just be a well-written article or web page. The UK NHS has patient information pages that would satisfy these requirements. There's no requirement for artificial intelligence.
"(1) PATIENT DECISION AID—The term patient decision aid' means an educational tool that helps patients, caregivers, or authorized representatives understand and communicate their beliefs and preferences related to their treatment options, and to decide with their health care provider what treatments are best for them based on their treatment options, scientific evidence, circumstances, beliefs, and preferences."
"(2) REQUIREMENTS FOR PATIENT DECISION AIDS—Patient decision aids developed and produced pursuant to a grant or contract under paragraph (1)—
"(A) shall be designed to engage patients, caregivers, and authorized representatives in informed decision making with health care providers;
"(B) shall present up-to-date clinical evidence about the risks and benefits of treatment options in a form and manner that is age-appropriate and can be adapted for patients, caregivers, and authorized representatives from a variety of cultural and educational backgrounds to reflect the varying needs of consumers and diverse levels of health literacy;
"(C) shall, where appropriate, explain why there is a lack of evidence to support one treatment option over another; and
"(D) shall address health care decisions across the age span, including those affecting vulnerable populations including children."
http://townhall.com/tipsheet/christinerousselle/2013/10/21/obamacare-call-center-down-as-president-encourages-phone-registration-n1728960
The toll free number was also down a lot of time.
Charmingly naive, but naive.
The author of that article asks, several times in several ways, why the government always gets it wrong and the lasting solutions always come from the little guys.
The answer has less to do with the size of the organization than the number of organizations all pitching competitive solutions. Yes, a thousand 10-person companies are probably going to do a better job in the long run than a single 10,000-person company or government entity, on problems in the right scale. But you'll never hear about 9997 of those solutions because half of them are dumb and the other half, while not obviously dumb, are inferior in some critical way.
(Then why do we have big companies and governments? Because some projects are simply too large for a ten-person outfit. That, the author got right.)
So a massive goverment take over of insurance regulation, with tens of thousands of pages of regulations, with constantly changing rules because what they came up with originally isn't working is "capitalism".
I think you need a dictionary.
As interesting as it is to guess why another waterfall government IT project failed, I'd rather know why we aren't using wheelbarrows with wheels closer to the center. As a guy who has mostly used wheelbarrows for moving concrete, having the wheel support the majority of the load instead of half (or whatever) sounds like a huge advantage.
The Wikipedia article on wheelbarrows suggests "However, the lower carrying surface made the European wheelbarrow clearly more useful for short-haul work." Does that reason really pan out? Can anyone think of any other reasons?
But I think we all know that a car analogy is needed to explain the healthcare.gov mis steps. Namely, the Democrats drove the law through all obstacles, but then after the elections, they ran out of gas. The Democrats wanted to buy more gas, but the Republicans said the engine is broken and should be replaced. The Democrats asked what engine to buy, but the Republicans had no idea except not from Solyndra. While they were arguing about it, Obama said that the midnight train of 2014 was approaching. The Democrats asked the Republicans to help push the car because it at least helps some people get healthy, but the Republicans said it would be faster if they spilled oil on the road and got rid of taxes on oil. Then the wheels came off the healthcare.gov website.
True, the code for that ill-fated website was really out-of-this-world in term of lousiness, but in the whole scheme of things the developers play but a very minor role in that disaster.
The ones who should shoulder the most blame are the people who awarded the entire project (without proper bidding process) to a totally incompetent company due to political reason ( read: cronyism )
The ones who should shoulder the second largest portion of the blame are those who, despite receiving untold millions in funding, they hired totally incompetent people to be in charge of that project.
Muchas Gracias, Señor Edward Snowden !
I'm sympathetic to PHK, but I could never have written this piece myself without commenting on a single disadvantage of the Chinese wheelbarrow.
You seem to be stuck with one of three problems:
* using a small wheel that won't easily roll over path obstructions
* having the wheel intrude into the barrow, obstructing tending or shifting the load
* having a large wheel under the barrow with a high center of gravity (what could possibly go wrong?)
The large carts at my nearby Costco are set up so that they won't pivot at the front (only at the middle). This is fine if you can find space to make a 90 degree turn on the spot. It's not at all good for creeping around a tight bend. Moreover, you've got both the front and back end swinging at the same time—which is the number of places you can visually attend plus one—so your chances of taking down some rickety display item are fairly decent if try to wing it.
Furthermore, nothing prevents two people from grabbing different handles on the European wheelbarrow. Also, PHK is wrong about the weight distribution. With a heavy load, it's customary to pile as much as possible up against the lip that protrudes over the front wheel in many front-wheel designs. I'd guess an European wheelbarrow front-loaded with wet clay has about a 4:1 lever arm in vertical displacement of the handle compared to vertical displacement of the load.
Wouldn't a Chinese wheelbarrow be something like a small unicycle with saddlebags and a trailer hitch? If you need to clear some brush (where only your wheel fits the path), you've got no way to jack the suspension under the load, either.
And wouldn't it be much harder for short and tall people to share the Chinese design unless equipped with some sort of adjustable handle. Somehow I'm just positive that the Chinese design from 1000 [BC|AD] comes replete with ergonomic dongles for the comfort of whatever schlep needs it next.
But then, with a billion identical people growing rice on ten million identically manicured terraces, I'm sure the Chinese design is a total win.
> It was awarded to a company that specialized in landing government contracts. To the person in the bidding process, it would appear to be awarded to a company with a proven track record.
In other words, the entire system is corrupt just as the OP implied.
A Pirate and a Puritan look the same on a balance sheet.
But as this chart shows, the total has quintupled in the past seven weeks, and has more than doubled in the past four, thanks mainly to brisk uptake in the state-run marketplaces. If these trends continue, the projection for March 31 is still well within reach.
Quintupling every 7 weeks, if these trends continue, there will be 200 billion enrollees by the end of 2014.
Let's see what the naysayers say then!
How can we continue to believe in a just universe and freedom to eat crackers if we have no ale?