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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.
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
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!
Is this a misdirect?
I'm only asking because I'm on the lookout for techniques to derail a discussion. A "misdirect" is calling attention to something irrelevant but intended to provoke an emotional response. It's used to push more-relevant posts down the page - hopefully below the fold.
Already got a +3 rating, it takes up a full two column-inches. I'm curious to see how many respond, and whether they get modded up.
(No one publishes guidelines for this sort of thing, so I have to ask.)
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.
Obamacare was originally the government heathcare plan designed to be an alternative to the public offerings in the PPACA. This was so broadly perceived as government interference in the private sector that enough Democrats declined to support it to make passing the bill impossible.
Later the PPACA was called Obamacare as a way to disparage it and to try to attach blame for the unpopular aspects of it to the President as a political ploy.
However even Mr. Obama now calls it Obamacare, so I guess if you call it by its official name you will are likely to just confuse people.
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."
I'm only asking because I'm on the lookout for techniques to derail a discussion. A "misdirect" is calling attention to something irrelevant but intended to provoke an emotional response. It's used to push more-relevant posts down the page - hopefully below the fold.
You must be new here. The majority of the intelligent and thoughtful discourse evaporated when Slashdot was bought out by Dice. If you want to see what the future looks like, punch in beta.slashdot.org. Then vomit in your mouth. It's been replaced with paid schills and hobbyists. There are a few of us left from the old guard, but we're only here because, frankly, there's nowhere else to go. Every promising new forum website seems to be shortly after swallowed whole by "Web 2.0" and it promptly goes to shit in an effort to look trendy and hip, at the expense of actual content and relevant discourse.
The post you're replying to was not accidental. It was quite deliberate. Like all things Web 2.0, very little of what is passed off as original or user-contributed content actually is. About a third of the posts here on Slashdot are now by 3rd parties who may or may not be affiliated with Dice, who in turn are just subcontractors for larger business ventures; Shell companies within shell companies.
It's part of a new "dark net" of small companies in quiet office complexes filled with nothing but a few cubes and employees who show up and are handed a 3 ring binder with pre-cooked posts and responses to "criticism" of whatever position they're being paid to represent under a pseudonym.
Welcome to the real Web 2.0.
#fuckbeta #iamslashdot #dicemustdie
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.
Here's what Obama himself said about that - "And once it's working really well, I guarantee you, they'll not call it Obamacare. Here's a prediction for you - a few years from now, when people are using this to get coverage, everybody's feeling pretty good about all the choices & competition that they've got, there are going to be a whole bunch of folks saying "I always thought this provision was excellent, I voted for that thing".
You watch, it will not be called Obamacare," -
http://www.youtube.com/watch?v=7aN2iuIhcx0
Pain is merely failure leaving the body
Bullshit. Even Obama was proud to call it Obamacare - until it failed. Democrats owned the damned thing all along, and Obama is the major shareholder. Screw the politically correct claptrap. There isn't a person in the United States (minus immature juveniles and senile old bastards) who doesn't know what is being referred to when Obamacare is mentioned.
"Windows is like the faint smell of piss in a subway: it's there, and there's nothing you can do about it." - Charlie Br
HE also said if you like your insurance you can keep it, if you like your doctor, you can keep him. Something about period too.
It seems to me that Obama is just like any other politicians and lieing out his ass to get whatever he wants done and it wouldn't surprise me if that statement wasn't concocted with the knowledge of trying to get rid of the Obamacare name simply to make it appear to be working better than it is.
I mean seriously, he set up the perfect scam with that line, he says when it works good, they will not call it obamacare and if he gets it called something else, it must be working good then right?
There have been informal surveys that ask if you prefer Obamacare or the Patient protection and affordable care act and they pick either one based on emotions rather than facts.
I spoke with a girl just the other day who said she didn't know much about it when I asked if you got her government mandated insurance yet. She was outraged when I told her she was facing a penalty if she didn't have insurance by the end of the year.
The bottom line is that people just don't pay enough attention. Sometimes, they hear something that sounds good and like it, sometimes they hear a person is associated with it and like it. Sometimes, you are better off trying to guess what color any random woman's underwear might be then expect people to know about this stuff.
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 !
It's a Republican plan but it's his signature bill.
It's not a Republican plan. ABSOLUTELY ZERO Republicans voted for this monstrosity in the House, and ABSOLUTELY ZERO voted for it in the Senate.
The fact that two guys who worked at the Heritage Foundation 20 years ago wrote a white paper saying "Hillarycare won't work without an individual mandate" doesn't make Obamacare a Republican plan. You guys screwed this up on your own.
punch in beta.slashdot.org. Then vomit in your mouth
Damn you, girlintraining! I just checked out the new "beta" site and now I'm choking back the bile. Holy shit, does that ever suck! It's like a satanic spawn of HuffPo and FB... Painful.
I wonder how long the "legacy" version will remain available after the changeover? Heaven help us.
XML is like violence. If it doesn't solve your problem, you're not using enough of it. --AC
Not only is Obamacare solidly based on Romneycare - (remember Tim Pawlenty referring to it at Obamneycare during the debates?) - but it's not much different from Bob Dole's plan from the '90 and it's pretty much the Nixoncare proposal of 1974.
Pain is merely failure leaving the body
> 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.
Not really.. There are two ways an existing plan can remain, one is if it does not change at all and the other is if there is some hardship.
There is a hardship exception that allows insurance providers to keep or even create the barebones plans and the plans that do not meet the requirements under the ACA, but in order to qualify, the insurance provider has to show how changing the plan will create an economic hardship for them or a class of people defined by the actuaries. Now class is defined by an actuary group and not what we would think like with working class, poor middle and so on.
It should be noteworthy that the DHHS just recently (within the last week or so) released new guidelines on the hardship exceptions that they claim "clarified the law" that expanded the ability to use the hardship exceptions. If it was squarely on the insurance providers, we wouldn't have seen that.
The true grandfather clause meant that if no changes were made, the policy could remain until any change is made, then it would have to follow all the new rules. A subsidy given by the government would qualify as a change and so would changes in the risk pools made by the actuary (which would by default have to be made with people moving to subsidized plans and medicare/medicaid roles).
So yes, you can blame the insurance providers if you ignore the fact that they would be penalized for not updating their policies to meet the new guidelines despite the class pools changing and the penalties they would face. But all this is sort of like arguing if the room is painted white or eggshell. This stuff was being brought up before Obama made any of the statements and the statements were specifically to address those situations. You act as if it is not Obama's fault for making the claims when the claims were specifically made to counter the reality that materialized. Add to that that Obama knew before he said it once that it wasn't true but kept on saying it in order to sell the product. In fact, the delay he put for the employer coverage mandates was specifically to address the fact that "66 percent of small employer plans and 45 percent of large employer plans will relinquish their grandfather status by the end of 2013," and "156 million Americansâ"more than half the populationâ"was covered by employer-sponsored insurance in 2013."
Please stop repeating party line BS and either look into the facts or be quiet about it. There is no real reason why we are even having this conversation right now. The bottom line is that Obama knew before he ever mumbled those words that they were not true and he said them specifically to counter punch the people who claimed it was going to happen only for the American people to be deceived and then shocked when it is happening. I don't trust what most other politicians say either, but rarely do we have such obvious examples as to why we should be skeptical of them.
I see you are optimistic but facts simply do not pan out for you. First, the HMOs BS that we said was the cause of need to reform healthcare was largely the fault of the federal government in the first place. The HMO acts was created in the 1960's and signed into law in 73 I believe in order to address the costs of medicare which is constantly being changed to this day to do the same. Senator Kennedy was instrumental in both, title VII of the social security acts (medicare) and the HMO acts and leading the charge of needing to fix his failings of the past with health care reform yet again.
But to claim this was a Republican plan is just another lie that will blow back in their faces. Sure, republicans thought most of it up and passed it around, but it was rejected by large margins both when it was created and when it was passed into law. That is a bit like saying segregation is a democrat idea since they largely were behind it but rejected it since then. Of course the lie can go on and some people will not bother fact checking, but those who are impacted by the changes of the ACA will likely look deeply into the claims this time around. You don't get too many changes to burn the people and keep your job unless you have a lot of blind support. For the most part, the burning only effects small factions of people- except this time around.
NO, not really. You see, the people who are supposed to sign up in order to pay for the sick and so on are likely not to sign up. When the penalties increase to the point they force people to sign up, there will be resentment among the masses working against the democrats. As for claiming it is a republican law, that is easily dispelled and with the trust issues stemming from if you like your plan, it won't be hard to get the truth out. The fact of the matter is that the plan was developed as an alternative to other plans being purposed in the past and it was largely rejected by republicans then. Bill Clinton would have signed it into law had the republicans ever pushed for it to become law when they took the majority of the house and senate during his tenure. The republicans had possession of the house, senate, and presidency during G.W, Bush's term and rejected the plan. But when the democrats take it up, they magically claim it is a republican plan despite all this rejection and the continued rejection it saw during passage and implementation of law which absolutely no republicans voted for.