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Ex-Head of Troubled Health Insurance Site May Sue, Citing 'Cover-Up'
itwbennett writes "Carolyn Lawson, the former CIO for Oregon's troubled health care insurance website, is alleging that state officials engaged in a 'substantial cover-up' meant to deflect blame away from themselves and onto herself and the project's contractor, Oracle. Lawson, who was forced to resign in December, this week filed a tort claim notice, which is a required precursor to filing a lawsuit against the state."
Claims are made that the state was the typical bad client, refusing to articulate "business requirements" effectively and repeatedly increasing the scope of the project. But then again Oracle was involved.
Everyone knows the first thing you do in a government contract situation is document what you did so you can cover your ass later. I can't wait to see what dirt she has on Oracle sandbagging Oregon.
How a Web Design Goes Straight to Hell - The Oatmeal.
Get free satoshi (Bitcoin) and Dogecoins
I can can comment without reading the article or lawsuit claims at all... Oracle is at fault. Those folks might do great database but they haven't a clue about usability or stability of user facing components. I can't imagine anybody hiring them to build any aspect of website (other than hidden from site back end database -- and even then only if i was getting kick backs).
and hope she has everything in writing.
I think a Bayesian analisys is in order here.
Basically the prior probability of Oracle delivering crap and screwing up a contract while collecting a vast fee approaches one, let's say P(oracale == shit) = 0.99999.
Given that prior, we really need overwhelming evidence in favour of Oracle before I'll believe it wasn't their fault. Actually I think 0.99999 is rather generous. That means they've probably delivered at least one system which didn't utterly fuck over a customer. That seems like a really dubious claim to me.
So, I'm gonna go with "bet you 50 bucks it was Oracle's fault".
SJW n. One who posts facts.
Oracle was involved. Need we go any further?!
At a certain point, "refusing to articulate "business requirements" effectively and repeatedly increasing the scope of the project" becomes the primary reason for project failure.
This invariably gets blamed on the project people and the contractors by the client, but the reality is if the client makes it impossible to get the job done through their own stupidity, blaming everyone else for that failure is just CYA by those who really caused the project to fail.
You can't force the client to actually do what is required, no matter how you'd like to.
I'm betting the exact same things happened with the Federal one.
And I suspect most of us have been there.
Lost at C:>. Found at C.
Step 1:) Pass legislation
Step 2:) ???
Step 3:) Landslide reelection
Is there a way that both sides can lose a lawsuit?
Obviously, some projects are impossible and some clients just can't be helped. I'm certainly not rushing to judge Ms. Lawson, because I've had my fair share of those.
But ... usually, the blame can be laid at the feet of the project leader (I'd guess, in this case, the CIO). Managing expectations, dealing with a changing business landscape, keeping everyone focused on your vision and strategy ... those are all responsibilities of the project leader.
How often do we have to hear stories like this? Doesn't anyone learn? Virtually all clients are "bad clients" if you define them by the inability to articulate business requirements and a penchant for expanding the scope. This is normal, not exceptional. If you can't deal with that, then you shouldn't be running development projects. Things will change, the world doesn't stand still. Get used to it.
In short, stop complaining and do your fucking job.
This is a total trolling comment.
First, Oracle **is** a large IT development company and they screwed the site up....they have a (well earned) reputation for screwing up projects
IT experience? You mean has she ever hooked up a router?
She knew enough to ask questions that got her fired...and she was told to help in the cover up!
2nd, Lawson was & still is one of the few who speak out about the **actual** problems of the exchange
Thank you Dave Raggett
TFA:
A scathing investigative report recently conducted by the federal Centers for Medicare and Medicaid Services put blame on both Oracle and Cover Oregon officials for the project's woes.
Parent:
You can't force the client to actually do what is required, no matter how you'd like to.
You can, however, make it REAL clear and document that the client was informed about the ramifications of their indecisiveness and scope creep. IF Oracle was doing their job correctly, they would have plenty of documentation to back up that they were in no way at fault or better still, the client was helped in creating clear specs.
They don't.
What I think happened were that the guys in the expensive suits and Rolex watches (Oracle's salespeople) were doing what they do best - getting more revenue by encouraging the client to act against their best interests.
A poorly managed project means more money for the vendor.
And I just have to ask, WTF was the CIO doing? Why wasn't she holding Oracle's feet to the fire and sending letters written by lawyers?
I would give you more credit, if you had the balls to post under your name.
Love,
Another AC with no balls.
insurance rates were going to go up anyways, have a pre-existing condition before OC, you were going to loose your insurance anyways. Quit spreading right-wing fud. With the exchanges I'm free from the shackles of my crappy employee insurance and can not contract on my own and buy insurance on the exchange at about the same rate I paid before.
You want to talk about horrific laws, how about the medicare part - d, or the invasion of Iraq, or the patriot act.
I've read that the Governor is heavily failed to be re-elected. Why is this true given the clearly bad job his administration did here?
and we can start building the single-payer system we should've had 50 years ago.
This just gets more and more entertaining.
Oliver's law of assumed responsibility: If you're seen fixing it, you will be blamed for breaking it.
You can't force the client to actually do what is required, no matter how you'd like to.
In theory, as a contractor you could say "I'm not taking this job unless there is a decent set of requirements". But that will leave you with a very small set of potential employers.
In practice, most people need the money and try to manage somehow.
And then there are the unscrupulous contractors (usually companies, not individuals) who make big promises, knowing that those are not realistic. Or knowing that the requirements are incomplete and fulfilling them will not be sufficient to make a succesful project.
I strongly suspect that this is what happened with Toll Collect (http://en.wikipedia.org/wiki/Toll_Collect) in Germany. Just for instance.
C - the footgun of programming languages
I have a hard time taking anyone serious that doesn't know the difference between "loose" and "lose".
feminists who get to force taxpayers and Catholics to pay for their abortions
There is no rational reason to not pay for abortions. Firstly, it appears that having available abortions does nothing to increase the rate: women who REALLY don't want to have a kid will find a way not to. The results are however dangerous and and much more frequently result in injury.
Therefore from a life preservation perspective, not having abailable abortions does not in fact save babies lives (in fact it serves only to endanger lives). From an economic perspective having them unvailable causes injuries to people who do have them which removes potential workers, increases poverty and that generally leads to more crime.
Hence there is no rational reason to not oay for them, especially as we make people pay for many other things for the greater good (e.g. police, fire department, roads, military, etc).
So please stop whining about imaginary enemies.
SJW n. One who posts facts.
The US has healthcare costs nearly double the next first world country and it was that way before Obamacare. http://en.wikipedia.org/wiki/F... Private healthcare is the villain you are looking for.
Well, yeah, you could have just looked at Massachusetts and known this would happen.
Fun fact: the amount of emergency room treatment went up in Massachusetts when Romneycare passed. Fewer people were seeing their doctors than prior. I personally know people who moved to other states because the health insurance requirement meant that they lost their job.
The hugely ironic thing is that, thanks to Obamacare, there are something like 100,000 people in Massachusetts who are going to lose their Romneycare because of the new Obamacare healthcare connector requirements. And because the new Massachusetts website was made by the same people who made Healthcare.gov, it still doesn't work and the people on Romneycare (like my brother) are flat-out screwed. By the end of the month, they still won't have insurance, and the deadline to sign up will pass.
Ah, hope and change.
You are in a maze of twisty little relative jumps, all alike.
I agree with you, and am willing to bet that amongst this site, you get modded down as either troll or flame bate.
I thought I was the only competent project management person here. Do you have a PMI membership?
Support my political activism on Patreon.
It's now apparent that Obama and the Democrats were lying when they said people could keep their insurance, lying when they said people could keep their doctors, lying when they said families would save $2,500 a year on their insurance, and lying when they said it would extend health care coverage to most of the uninsured (who are largely not signing up). Millions of people have lost their insurance or had huge hikes in their premiums.
The only people the law has been good for are insurance companies, Medicaid bureaucrats who get to expand their budgets, feminists who get to force taxpayers and Catholics to pay for their abortions and people paid to make those insulting "get covered" ads.
As far as I can tell, ObamaCare has not a single defender outside the ranks of Obama's defenders and the Democratic Party.
It's a horrific law that should be repealed in full.
Yes, it should be repealed in full.
Speaking of horrific, what did the trend look like before Obamacare came along for insurance premiums? Oh yeah, that's right...gee, can't wait to get back to that shit.
It's horrific on purpose. The idea is to mangle the healthcare system so badly that the government will need to step in and nationalize it in order to keep it from full collapse otherwise. Too big to fail will spell the end of competition in the fields of health insurance and health care. Some will applaud this move but in the long run I can't help but think the American people will be worse off and medical progress will grind to a crawl because of it.
It will be another episode of the government breaking your legs then giving you crutches to insure that you can't live without their hand outs (that are paid for by you but administered in the most inefficient of methods... Aren't they just a bunch of swell guys and gals?)
In the meantime the economic "bubble" that will break as private industry fails will also have the fantastic side effect of bankrupting more of the middle class just like it happened between 2006 and 2010 by destroying the value of what little they could invest. And again the man on the street who saved for decades to have a few years of his life off before he dies will be forced into filling jobs that use to be made for teens back in the heady days of American prosperity until he physical can't produce another ounce of value for anyone.
The Democrats will blame the Republicans. The Republicans will blame the Democrats. 90% of the voters will fall in lock step with their parties like sheep to the slaughter as the government moves on to the next industry they feel that they should control. Probably energy production. But don't worry, people will invest more time and thought into who'll be winning Super Blow LXXV than will they will invest in their future and the future of their children. The cycle will continue...
And so it goes.
Claims are made that the state was the typical bad client
And yet it's only after you sign the contract that you think to get a lawyer involved.
In a strange world where 15 is nearly double 11, yes.
Here's a theory, and I'd like you to answer thoughts on this since you think private healthcare is the problem. It's a theory no politician will ever answer.
My theory: US healthcare is so expensive because of lawyers. We sue, sue and sue. This suing needs to be paid for somehow. Often, this is done with malpractice hugely expensive insurance (a friends wife of mine is a dentist and she pays over $3,000,000 a year in malpractice insurance though she's not even been sued once!). Now, this isn't to say that people shouldn't be able to sue if a doctor is truly incompetent, but there needs to be limits and reasonable cause. I believe if we limited the suits and also the lawyers who are trying to keep busy, the cost of medical coverage in the US would fall. But I also believe this will never happen since most politicians are lawyers.
Since you're convinced that we need to go socialized, what is your answer to my theory?
Firstly, it appears that having available abortions does nothing to increase the rate
Source?
They'll twist their disaster into a tort victory.
You can't force the client to actually do what is required, no matter how you'd like to.
Call me naive, but I would have thought by now that some of this known behavior by clients would have been worked into contract language that more or less "forces" clients to make decisions, accept the outcomes of scope increases, etc? The contactor can essentially stop work on the project if necessary, mandate that some scope increases will result in increased up-front fees and automatic schedule adjustments, etc.
For better or for worse, these problems exist at small-scale projects and large-scale projects. I do small SMB projects and we run into the same issues, except our owners are too greedy/timid to deal effectively with them.
But I would figure an outfit run by sharks like Oracle would have figured this out long ago and had the leverage and basic schmaltz to make client indecision, scope creep, etc difficult to get away with and very expensive.
In other news, Carolyn Lawson has apparently never worked a large IT development for government before.
I cannot speak for other consultants hired for government projects but I always delivered the solution on-time and on-budget, many times under budget. I witnessed the "too big to fail consulting firms" wasting time and money over and over yet they kept winning these contracts. The fact the State of Oregon hired Oracle to implement a healthcare insurance website speaks volumes about the incompetence of management within the state government. Oracle should have been hired for the database portion while a web development company specialising in software-as-a-service projects should have been awarded the user-facing portion. In all seriousness the entire project should have cost less than one million dollars; with libre and open source software the costs could have been reduced further.
Maybe this is the cause?
Americans demand to shove crap food down their throat like there is no tomorrow and at the same time demand the best healthcare they can buy. It's like taking a Bentley mud-bogging and paying to have the scratches and dings removed then crying about maintenance costs.
And your math sucks too.
Whining about the state, and out much government sucks.
Then bashing a successful business like oracle.
So government sucks, big business sucks!
Woot Maria DB.
Except Maria and MySQL are both lousy databases and very much embarrassments to the F/OSS community, and developers who actually deploy either of those 2 platforms should hand their heads in shame. Just because there's a lot of it out there, doesn't mean it should actually be used-- ever. There's a lot of Access database out there as well. Spend some time and actually do some research--as an architect/lead that's what you're expected to do.
Whatever the validity, or lack thereof, of the rest of the post, I have to love the beauty of this self-fulfilling Catch 22 statement:
"As far as I can tell, ObamaCare has not a single defender outside the ranks of Obama's defenders and the Democratic Party."
Let me guess, how can you tell if someone is an "Obama defender?": they defend "ObamaCare!"
Exactly
Your health insurance is expensive because the doctor has to charge a ton to cover the expense of -his- insurance. Its a feedback loop that, instead of making horrifying squealing noises, funnels money into insurance companies.
For decades the insurance industry has been milking this cow at both ends... theyve milked it to death & now are demanding we put it on life support so they can milk it some more.
At a certain point, "refusing to articulate "business requirements" effectively and repeatedly increasing the scope of the project" becomes the primary reason for project failure.
This invariably gets blamed on the project people and the contractors by the client, but the reality is if the client makes it impossible to get the job done through their own stupidity, blaming everyone else for that failure is just CYA by those who really caused the project to fail.
You can't force the client to actually do what is required, no matter how you'd like to.
I'm betting the exact same things happened with the Federal one.
And I suspect most of us have been there.
Nonsense. A primary obligation of the business analyst is to manage client expectations and gather and analyse the client's needed versus wanted requirements. Having experience as a business analyst and a systems analyst let me say unequivocally CYA is a tactic of the inept and those engaged in fraud. The consulting firms should have been sued by the state and federal governments to get back all money paid thus far for these failed projects.
Except the people who lost their insurance were sold those policies after the ACA was passed and the insurance companies knew they would be canceled when they wrote them.
From 1999 to 2008; before the ACA took effect, my insurance premiums increased approximately 8 fold, my coverage went down. And I have the pay-stubs to show it.
there is no rational reason
I think I found your problem...
This article is so full of equivocation I don't know where to start.
"The insurance plan they enrolled in will not begin for another two weeks, leaving them essentially hanging by a thread."
So he doesn't have the new health insurance until April.
"January- was diagnosed with stage 3 cancer of the esophagus had insurance, but due to a previous heart condition, the insurance did not cover the treatments he needed for his cancer."
So his old crap insurance didn't cover squat.
"The Angrans have until the start of April to pay $7000- their copay under their new Obamacare health insurance plan."
So his NEW insurance under Obamacare has him covered! What's the problem here?!
"It will cost them more than $800 a month." That's not bad compared to what my employer pays for my wife and I as a healthy young couple.
Right, except for the part where when the state brought in outside consultants to try to determine WHY things were so off-tilt, the consulting firms (yes, more than one) told them they didn't have the staff in house to properly scope the project. When Lawson was made aware of this, she simply gave more money to Oracle to provide contractors who could scope it for them. NOW she's claiming it's the state's fault for not scoping... MY HEAD HURTS.
:/
Read a great article on it a couple months ago and am struggling to find it
Your theory of lawyers being the cause of expensive health care has been studied extensively and it is wrong. Malpractice insurance/ lawsuits/ defensive medicine/ etc. only contributes 1 or 2 % to the high cost of health care. If you'd like to read about this, here are some good places to start:
http://theincidentaleconomist....
http://theincidentaleconomist....
I don't read your sig. Why are you reading mine?
"Fun fact: the amount of emergency room treatment went up in Massachusetts when Romneycare passed. Fewer people were seeing their doctors than prior."
Nice "fun fact" but it is wrong.
This has been carefully studied by many authors and ER visits went down, admissions through the ER went down, more people visited their primary care doctors, etc.
Here is a good summary of a real study (not just Fox news "fun facts") with links to the actual studies:
http://blog.academyhealth.org/...
I don't read your sig. Why are you reading mine?
What I find humorous about the current topic and the posts being flung onto the wall like so much feces is that posts like yours good sir, whether I agree or not, add to the discussion and yet are being modded flamebait for no real apparent reason. After this modding, posts such as yours usually have a small flood of ACs follow your commentary with short, witless posts which quite frankly add nothing to the discourse. I'm all for being an AC from time to time, as it serves a purpose. However, at the moment, it feels like it is being abused by one or a few select individuals whose goals seem to be to misrepresent the dialog being built under this topic and burying that which they do not agree with.
Now, mind you my post is off-topic and I will expect it will be modded as such, as the flood of AC seems to be cresting quite the large wave as of late. This AC behavior has been growing as of late, and seems most apparent on politically charged topics. I only hope this pattern is temporary and just wished to say, bravo for having the balls to attach your name to your beliefs.
"Quote me as saying I was mis-quoted." -Groucho Marx
Is that if she has a paper trail showing specific government employees kept screwing the pooch that she likely cannot hit them personally such that they lose their shirts in the lawsuit. It shouldn't be primarily the tax payers who foot the bill, it should be the senior government executives who kept messing up. And if their federal counterparts' compensation is any indication, those responsible here have more than enough salary to be expected to foot the bill here for their malfeasance.
the amount of emergency room treatment went up in Massachusetts when Romneycare passed.
Most studies indicate that after an initial spike, the number of ER visits fell over a period of several years.
I personally know people who moved to other states because the health insurance requirement meant that they lost their job.
So we shouldn't have health insurance for everyone because a few people lost jobs and found different ones elsewhere?
And because the new Massachusetts website was made by the same people who made Healthcare.gov, it still doesn't work
Heathcare.gov works fine. The majority of the people in my company used it to sign up (including myself) and it worked fine. For the few people who did have an issue (weird social security issues) they were able to call the hotline numbers and get enrolled. You do not have to simply rely on the website if it, for whatever reason, is not working for you. There are alternative ways to sign up.
By the end of the month, they still won't have insurance, and the deadline to sign up will pass.
They've had months to sign up. If they haven't by the deadline it is because they didn't put any effort into doing so. I've done it and it isn't hard.
I'm really having trouble figuring out what a heart condition has to do with a guys throat or cancer in general. If this is for real, then this is the kind of crap and nonsense that is driving people to socialized medicine. If true, the insurance companies are running amok and state regulators are not doing their job.
"Big Government" steps in when the market and state governments fail.
Big Government gets a lot of criticism while Big Business gets a free pass and is allowed to act without any oversight or regard to it's customers, it's employees, or society at large.
This situation is a clear example of "Big Business screws the little guy".
A Pirate and a Puritan look the same on a balance sheet.
LOL, I work on the tech side of house ... which means I've seen quite a few projects end up going this way.
Often, the client is the biggest impediment to successful completion -- either because they have no clue what they want, or all of the players are still trying to carve out and preserve their own little fiefdoms and protect their own little patch they've had for years.
Usually, the goal of the project conflicts with the people who want to retain absolute control over one aspect or another, or clients who can't even tell you what the specifications are and should be -- and when they do, you inevitably find out they're all bloody well wrong in the first place.
With government contracts (not exclusively, but often), I find it even worse as every little petty manager insists his little widget is the single most important thing in the world, or the political infighting between departments.
It really becomes impossible to do anything when the client tells you 5 contradictory statements in the same meeting, and changes those in every other meeting.
Lost at C:>. Found at C.
If you ask your consultants to write requirements and scope for you, your project has already failed. You are just covering your eyes and ears. I've been on projects like that.
My impression is that this minor issue cost two hundred million dollars, and prevented anybody from signing up for insurance (as in 0 enrollments) for 5+ months. It also did it in the most public possible way, with a credible case for the Governor not telling the truth about what he knew and when. But I'm not from Oregon and this might only be a false impression. Perhaps someone who's followed this closely can fill in the details.
I can pretty much believe it..
In the Govenmental areas, there are so many people that are used to being able to say "Yes, but wouldn't it be a great idea if...".. And when they're told no, it's not possible in the current scope, they bring in all kinds of political manoeuvers to make life extremely difficult unless it gets added (and these manoeuvers can extend time drastically). So, more gets added that they should have identified initially. Or it can be a 'clarification'. "Oh, we meant this.. In this context.. Sort of. Until we change our minds."
They aren't used to thinking critically. They aren't used to doing specifications (and they actively resist attempts to perform a full specification gather, as "they don't have time for all those useless questions". They have "things to do,don't you know").
That's when it starts out as a big project.. Some smaller ones can actually start with a well defined set of requirements, and be entirely achievable. They other people hear that there's funding attached to a project, so they want a slice of the pie.. Get themselves on the steering groups, have the "bright ideas that weren't there originally that just _have_ to be put in there now", and move things in an entirely different direction. Or at least pull in it, as there are usually a whole bunch of people pulling in different directions, getting opposing things added to the requirements.
Sometimes you get lucky and find that there's someone with clout who is also technically savvy, and they can stamp on internal rubbish and let a project go properly.. Unfortunately, they're reasonably rare, and the voices that understand the reality of it are drowned out by the higher management that haven't touched tech, don't understand it, don't want to understand it, and believe if they have a bright idea, someone will wave a magic wand and the solution will magically appear.
Do you have an non-anecdotal evidence for your theory?
http://content.healthaffairs.o... seems to contradict your claim with actual data - though it's data is getting old, so maybe you have something newer rather than just making up theories in your head with no actual evidence for them?
I live in Oregon. I have been trying to buy health insurance for myself and my family of 4. Because of my income, I am ineligible for any subsidies. My case is a very simple one. I am paying full price for a health insurance plan. However I cannot register on the damn website or buy insurance. The only way for me to register an account on the website is by mailing in a paper application. I have done that. They called me to confirm that they have received the application and are processing it. They have hired 500 people to process paper applications. These people have yet to enter my paper application into the computer.
How did Oracle receive $130 million for developing this website when I cannot even register a damn account on this website, much less select and buy insurance?
You can't force the client to actually do what is required, no matter how you'd like to.
In theory, as a contractor you could say "I'm not taking this job unless there is a decent set of requirements". But that will leave you with a very small set of potential employers.
In practice, most people need the money and try to manage somehow.
And then there are the unscrupulous contractors (usually companies, not individuals) who make big promises, knowing that those are not realistic. Or knowing that the requirements are incomplete and fulfilling them will not be sufficient to make a succesful project. I strongly suspect that this is what happened with Toll Collect (http://en.wikipedia.org/wiki/Toll_Collect) in Germany. Just for instance.
I have yet to meet a 3rd party contractor or consulting firm who bids on a project *not* attempt to extort additional money when it suddenly doesn't meet the scope of the project. That's business as usual for everyone.
Your theory falls on it its face because Texas has had tort reform for years that places severe limits on malpractice lawsuits and the healthcare cost difference between Texas and states that don't have those limits is a pittance.
No MySQL is never a respectable product for any deployment.
You don't want to pay 60K per CPU PostgreSQL, and I don't blame you.
MySQL is nothing but a pile of garbage deployed by people who are too lazy to actually bother do any research.
"Fun fact: the amount of emergency room treatment went up in Massachusetts when Romneycare passed. Fewer people were seeing their doctors than prior." Nice "fun fact" but it is wrong. This has been carefully studied by many authors and ER visits went down, admissions through the ER went down, more people visited their primary care doctors, etc. Here is a good summary of a real study (not just Fox news "fun facts") with links to the actual studies: http://blog.academyhealth.org/...
Except these operating room visits are now covered by insurance. Instead of being uninsured and costing the state the full amount.
I wonder what act they will have next...Flying Monkeys?
Maybe a parade of donkeys Braying about signing up.
So Oracle + government + morons in charge causing scope creep + IT contractors. That's a recipe for a category 5 shitstorm.
Several whistle-blowers came forward and said that this lady, Carolyn Lawson, was "abusing and misusing state resources". Oregon's OHA director Bruce Goldberg thought that these were personality conflicts.
Also, she was accused of and investigated for mismanaging contracts when she worked for the state of California. In one instance she tried to award a no-bid contract to her previous boss.
I don't think she has a leg to stand on.
I'm sorry, but that paper that you posted, did you actually read it? It's written by 3 laywers and one medical person who works at a law school. And let me pull some of my favorites which make me question the paper.
"There is no comprehensive, national repository of information on medical malpractice claims" - in other words, they have to make inferences and aren't basing their work off of hard numbers.
"We took the approach of itemizing indemnity and administrative costs rather than reporting total premium costs for two reasons" - So, they're not actually counting the cost of the insurance, but their viewed numbers on what the actual legal cost is, not the total cost. Total cost is the portion that jacks rates up. They say it themselves, their analysis is arguable at best for it's accuracy.
This one is a bit long
"It is impossible to determine how much of the increase in volume constitutes defensive medicine—services performed primarily to reduce liability risk—as opposed to services performed primarily to enhance revenue. Price may also be affected by a reduced supply of medical services. If rising malpractice premiums lead some clinicians to leave practice or reduce the range of services they offer, the remaining providers may be able to charge higher prices.
Such effects are, however, largely theoretical at this point. We did not include effects on prices in our estimates because we were unable to quantify them reliably" - they say afterward because it might be double counting is why they aren't. They don't know.
I'm sorry, but you've posted an article to debunk a theory which says lawyers might be to blame, that was written primarily by lawyers that says they aren't the problem. Surprise! It's a paper that really does feel like it's trying to minimize costs. If you want to debunk something, take worst case, not best case. If the worst case comes out not being very bad, then you've got a point. If your best case comes out not very bad, well, you've discovered nothing.
It's a soft piece at best being that there's a lot of "theoretical numbers" in the paper by their own admission. I don't argue the need for those, because quite simply, again by their own admission, the numbers DON'T EXIST.
States playing favorites with healthcare providers and giving them the same type of monopolies in their states that they do telcos is the problem. There is zero reason why every insurance provider can't compete in every single market, yet states consistently block providers for participating. There is no free market presently.
Operating room?
Except?
Insurance is a good thing.
I don't read your sig. Why are you reading mine?
That's a communications issue. Communications face noise from everything imaginable: poor understanding of specific vocabulary, implied meanings based on local (down to sub-city) culture, misalignment of context (person A is thinking in one POV and person B is thinking in another, so the words being said have a completely different meaning), and so on. Communicating effectively is a lot more complex than "use good grammar and speak clearly".
Project managers have banked on technical skills for a long time: the production of work breakdown structures, requirements documentation, and requirements traceability matrixes for scope management; risk breakdown structures, schedules, communications plans; charters to ensure authority; and so on. It's recently become apparent that what we need are people skills: negotiation, diplomacy, stakeholder management, and actual communications skills instead of communications management plans. All of these issues you mention stem from poor people skills.
The reason this happened is simple: soft skills are intangible. Pick up a book on soft skills. Your first reaction will probably be to ridicule it for being a book about obvious things that everyone knows, or just full of pointless fluff with no meaning. Even if it's a really good book full of useful information, most people react this way. Why? Because soft skills are a really open field, and can't be nailed down like hard skills.
Hard skills are immediately rational: if I show you how to create classes in Python, you can apply that with predictable results. Soft skills are not rational: if I explain to you concepts like communications channels (verbal, vocal, non-vocal), business acumen, situational awareness, and diplomacy, you'll recognize most of it but see no actual useful processes in there. People gravitate toward rational hard skills, and away from soft skills that can't be readily forced into a repeatable cause-effect framework. People unlike Kevin Mitnick.
And so here we are: crap situations where nobody communicates well and nobody can actually get a project running. Without stakeholder management, demanding people demand attention: they're noisy, so they get resources, and their unimportant shit gets done instead of important project shit. Without diplomacy and vague concepts like awareness, you can neither control these people nor predict when they'll show up and what they'll want--or worse, how some idiot filing clerk can somehow impact your huge IT project even though he has no organizational power. But all the technical plans say the project was managed correctly--how did it fail?
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Dude you're fucking retarded. Oregon is run by Democrats and has been for decades.
This guy was screwed by the very insurance policies that Obamacare stopped, and the article has the audacity to imply that his old plan was better.
Besides which, what gives the Catholics the right to opt out of things they don't like? People who don't support war are "forced to pay" for it anyway. People who don't like corporate welfare are "forced to pay" for it. People who don't like government spying are "forced to pay" for it. etc. Hiding behind your religion like it's more sacred than the Constitution is what makes me, an atheist, arguably a Better American(TM) than you, so get off my lawn!
Why would oracle care? Scope creep and feature requests are profitable for Oracle all the way until the company files for bankruptcy, even more near bankrupt companies will have a difficult time suing, so sharks as they were, will feed.
http://www.oracle.com/us/solutions/enterprise-architecture/state-of-oregon-1864645.pdf
she did just wonderful work and oracle compensated her well with such a wonderful profile of her competence
http://www.oracle.com/us/solutions/enterprise-architecture/state-of-oregon-1864645.pdf
If the demand for this service is as inelastic as you claim, then there is little reason to subsidize it. The folks who want an abortion will find the money.
The CIO is the ultimate authority of what the requirements should be for the contract. The CIO would also keep tabs on how the contract is progressing. In the end, the CIO is the person responsible for the success of the IT project.
What was Carolyn Lawson's position. Oh yea She was the CIO. Did she get the job based solely on her looks?
...when a scapegoat doesn't understand its role.
-Styopa
I believe, unless there is yet another rule change on this, that those seeking subsidies have to go through the exchange.
I set out to use the GDP per capita of Switzerland and the US (the two first on the list given by GP) to show you how you didn't use the numbers correctly. It turned out that the spendings on health care per capita of the two countries are almost the same*, and the joke was on me.
*(8676.91 $US per capita per year for Switzerland and 8272.64 $US per capita per year for the US)
Colour me surprised!
taxpayers AND catholics?
why aren't these catholics paying taxes in the FIRST place!
My God can beat up your God. Just kidding...don't take offense. I know there's no God.
Besides which, what gives the Catholics the right to opt out of things they don't like?
The First Amendment
I'm not really taking Oracle's side on this but having worked on a lot of Government (Local, State, Federal) projects over the years I have seen this sort of thing happen time and time again.
The first problem you encounter is that, almost without exception, government projects are fixed bid rather than time and materials. The procurement system requires them to do it that way. Fixed bid projects can be successful - but only if you tightly control scope and expectations. And in my experience, scope creep is a way of life on government projects.
The second problem is that when scope creep occurs the project manager, being a political position in large part, will invariably agree to the scope creep to "keep the customer happy". That puts pressure on the rest of the team to deliver more in the same amount of time. Often, quality suffers in the name of getting it done on time.
Problem number three - the customer sometimes doesn't know what they want. Or worse, they think they know and ignore the advise of their consulting partner. Or worse yet, the customer listens to the consulting partner and the partner is giving bad advice. If any of these things happens your project is in deep, deep trouble.
Problem four - salespeople will make unrealistic promises (i.e. they will lie through their teeth) to win the contract. In most places, salespeople are paid their commission based on a percentage of the revenue in the contact. Not what it actually costs to implement the product or service. So by the time the shit hits the fan the salesperson has collected their commission and moved on to the next deal. The project team is left to clean up the mess. If the project goes over budget, or gets cancelled, it has no real impact on the salesperson. They get paid either way. In short, the problem is that the commission is tied to revenue rather than profitability.
Now I've worked with Oracle before. Some of them are very good, some of them are very bad. I suspect that by the time this whole thing is investigated there will enough blame for all sides. Sure, Oracle has screwed up projects before but I'd be very surprised if all the blame lies at their feet on this one.
Because then instead getting an abortion from a competent doctor for $X, they try to use a coat hanger, injure themselves, and get treated at an emergency room for $100x. Then they don't pay and the ER passes the costs along to everybody's insurance, including yours.
If you think that's a better outcome -- i.e., if you think paying your share of $100x instead of $x is a good idea -- then you're an utter moron (independently of your ideology).
"[Regarding the 'cloud,'] ownership was what made America different than Russia." -- Woz
So, I write business requirements for a living, and I can say that they're almost impossible to get completely right on the first shot, especially when moving into a space where a company has little experience.
Now, companies certainly can do things that make the whole experience better or worse.
What you can't do is just ask the customer to sign off on requirements on day 1, deliver those requirements and a bill for $1M on day 180, and have a system anybody wants to use.
That's the whole reason that techniques like Agile/etc have sprung up. They help a business to gradually discover requirements while still having some kind of framework to ensure steady progress towards some kind of final goal.
While it is true that most projects fail due to poorly defined requirements, what isn't true is that getting the requirements right is something you can count on. The most you can do is manage risks so that your requirements aren't totally off-base, and be prepared to clean up the inevitable mistakes.
Because then instead getting an abortion from a competent doctor for $X, they try to use a coat hanger, injure themselves, and get treated at an emergency room for $100x.
So? Refuse them treatment.
"So" in reality, hospitals aren't allowed to refuse treatment and there is exactly zero chance in Hell of that policy ever changing, "so" you'd better just fucking deal with it.
Now quit being a dumbass.
"[Regarding the 'cloud,'] ownership was what made America different than Russia." -- Woz
The usual client has no understanding of what they need, demands what they don't need be created yesterday, and changes their minds 5 times before today. The account execs of the contracting firm say "yeah, we can do that, and we'll throw in free pina coladas on fridays", and they'll sign a contract with the client full of nonsensical gibberish that has nothing to do with what needs to be done, and is for the most part ambiguous bs designed to evade precise commitment on either side.
Everyone gets head count, and all the important people get raises and move on to new project before the shit hits the fan.
- except for the law, the Constitution of-course. There is nothing there that allows government to steal money from some people to perform 'free' abortions on others.
Oh but there is. The commerce clause. That little clause effectively gives government carte blanche to "regulate" commerce, as in threaten people with violence.
And that's what government is doing. Government isn't actually stealing your money. Government is pointing guns at insurance companies, telling them to steal your money.
Despite all they've accomplished, you must remember that the US Founding Fathers are also politicians. Every law ever written by politicians is a scam, and that includes the Constitution. They tell you the law is all about benefiting you the people, the society, the "Greater Good", but there's always a catch in there that benefits the government, and give it the excuse to threaten individuals with violence, and give it an excuse to grow itself.
Interstate commerce is one of them. The whole slavery thing is another big one. A person who truly cares for liberty would have never rectified the Constitution. The "United States of America" should have never been born. Had it not been born, the lives and rights of many Americans (native or otherwise) would not have been violated; slavery would have been resolved with less violence; the Federal Reserve wouldn't exist, nor the huge welfare state today.
Sure, but it's being put up against a theory with no numbers or data at all.
I actually used the more-recent numbers for "healthcare spending as % GDP". Arguably, healthcare spending per capita (adjusted for purchasing-power parity) may be more useful, but the gap between the US and other nations is a lot smaller there. Both numbers are available. :-)
Have you ever checked the profitability of private healthcare? It is in a huge boom right now so there is you answer of where all the money is going. Some private healthcare CEOs bonus.
At a certain point, "refusing to articulate "business requirements" effectively and repeatedly increasing the scope of the project" becomes the primary reason for project failure.
And knowing that this problem is endemic among government contracts is one reason why the whole idea of Obamacare should have been rejected out of hand from Day One. Complain all you want about how horrible private insurance companies are to deal with (and they are), but at some point they need to provide some value or they will go out of business. The Federal government is under no such constraint. There is no penalty for failure, except to trade one incompetent political party for the other every 4 or 8 years. The lifers in the middle ranks of the bureaucracy carry on in perpetuity, and the contractors always make out like bandits.
You are in a maze of twisty little passages, all alike.
Call me naive, but I would have thought by now that some of this known behavior by clients would have been worked into contract language that more or less "forces" clients to make decisions, accept the outcomes of scope increases, etc?
If 99% of America hadn't collectively forgotten how to manage anything bigger than a lemonade stand, you'd be right. The problem isn't that these projects are badly managed by both the client and contractor... the real problem is that everything is badly managed by almost everybody. We might be making huge leaps in terms of technology, but in terms of the ability to manage large complex operations, especially in the still relatively new technology industry, we are going backwards. Look at any big software company and the tremendous pool of talent they have working for them and compare it to the usually shoddy, lackluster results. Oracle is a perfect example, but almost any tech company will suffice.
That's the real problem.
You are in a maze of twisty little passages, all alike.
There is nothing there that allows government to steal money from some people to perform 'free' abortions on others.
and it certainly would be terrible if they were doing such a thing. of-course as usual you are ignoring facts and taking instead the word of your religion as substitution. we wonder sometimes what it is really like to live in your fantasy world, but generally we are glad that we don't.