Slashdot Mirror
Emails Cast Unflattering Light On Internal Politics of Healthcare.gov Rollout
An anonymous reader writes with this report from The Verge linking to and excerpting from a newly released report created for a committee in the U.S. House of Representatives, including portions of eight "damning emails" that offer an unflattering look at the rollout of the Obamacare website.
The Government Office of Accountability released a report earlier this week detailing the security flaws in the site, but a report from the House Committee on Oversight and Government Reform released yesterday is even more damning. Titled, "Behind the Curtain of the HealthCare.gov Rollout," the report fingers the Centers for Medicare and Medicaid Services, which oversaw the development of the site, and its parent Department of Health and Human Services. "Officials at CMS and HHS refused to admit to the public that the website was not on track to launch without significant functionality problems and substantial security risks," the report says. "There is also evidence that the Administration, to this day, is continuing its efforts to shield ongoing problems with the website from public view."
Writes the submitter: "The evidence includes emails that show Obamacare officials more interested in keeping their problems from leaking to the press than working to fix them. This is both both a coverup and incompetence."
Someone didn't do their job.
But it really isn't a surprise those responsible are now in CYA and finger pointing mode.
If you think it's limited to government, you must be very, very young.
Pain is merely failure leaving the body
I feel sorry for Rollo. He seems to get all the blame ever since he stated working for that website project.
Trust the Computer. The Computer is your friend.
US politics at its finest. We select the most popular people around to lead, and then act surprised when it turns out that they're not necessarily the best leaders...
There is no failure to see here - move (on) along - the websites have brilliantly served their purposes - they've managed to transfer $5 billion so far from taxpayers to the carefully selected chosen ones - who will carefully contribute to the next group of chosen ones. http://www.thefiscaltimes.com/...
So what you're saying is that: 1) The administration didn't knowingly force people to use a badly designed, insecure web site that wasn't ready for prime time. That's just something the administration's critics made up, out of context. 2) The administration has fixed all of the security concerns, and that the whole platform is now working as they promised it would, and that anyone saying otherwise is lying and spinning the glorious real facts on the ground. I see.
Don't disappoint your bird dog. Go to the range.
In your foaming response, please describe _exactly_ what you find so objectionable about the Affordable Care Act. Discuss the 12 million previously uninsured Americans who were able to obtain health insurance and health care in 2014 and what you believe should happen to them. If you were extended on your parents' plan for at least a year post-2011 state how many additional years on your parents' plan you used. If you have corporate health insurance, describe exactly how the ACA affected your coverage. If your response is that premiums went up, you had to change doctors, etc list how many times that happened to you in the 10 years prior to the ACA being passed.
sPh
1) The administration didn't knowingly force people to use a badly designed, insecure web site that wasn't ready for prime time. That's just something the administration's critics made up, out of context.
That is correct. The administration did not force anybody to use the website at all during the period it was non-functional. There were alternative ways of signing up, and the enrollment periods were extended to allow time to use the system once it was in better shape.
2) The administration has fixed all of the security concerns, and that the whole platform is now working as they promised it would, and that anyone saying otherwise is lying and spinning the glorious real facts on the ground.
I'm sure that not all security concerns have been addressed. I'm sure that 20 years from now they won't be addressed. In fact, I doubt there is a single government or corporate website functioning anywhere where all security concerns are addressed.
I think the issue here is unrealistic expectations. This is an incredibly large undertaking, and problems with large undertakings are fairly common.
If it were up to me I'd greatly simplify the whole mess which would make rollout much less complex. I'd start by simplifying medicare so that there is just one deductible, coinsurance rate, and out of pocket limit for everything. Then I'd just start ratcheting down the eligibility age a few years at a time until everybody is eligible from birth. No new systems to deal with, etc. Then I'd start fixing the provisioning of healthcare services (start opening public providers and gradually transition the system to one where the coverage network is government-run). But, the various vested interests don't want to buy into something like that, so we end up with the affordable care act instead of a system like one of those that has already been tried and tested elsewhere.
To be fair... I have worked on many software projects in my life and have also worked with government software projects. A simple fact of life is that government funded software projects are only given to blood sucking leeches that intentionally underbid and lie their asses off about delivery schedules. Legitimate software houses who actually can plan projects and meet schedules are never evaluated.
From what I can tell, the site is up and running "mostly" only a year late and not nearly as over budget as I expected. What do you expect from a project initiated by uneducated people like politicians and sales people. They of course ask "computer experts" for help, but let's be honest... Politicians wouldn't know a qualified computer programmer from a Barbie doll.
I support ObamaCare aka ACA on a federal level simply because it requires one big ass database system to be made by one company with a whole nation of people to kick the crap out of the company making it. And let's be honest... Whether the system is for all of America or just a state, the system is almost the same.
Imagine if a state like Mississippi or Oklahoma had to get a system made? They'd hire a guy named Jom Bob from church to do it. They'd piss away the entire budget before they even found Jim Bob. They'd run it on index cards and toilet paper in type writers with no correction ink.
Is there anyone dumb enough on Slashdot to think :
A) a government sponsored software project can be done without corruption, delays and major budget problems?
B) all 50 states in America could actually manage to get a system up and running at a state level... Why not ask Florida about their prepaid college project and how bad that for screwed up. I worked at the company writing that one and that project was doomed to fail before it even started. They built the damn thing on Tandem computers with Thomas Conrad ArcNet and had a total of one guy who even knew how to boot the machine.
In my city, one company owes 80% of the hospitals and doctors. The other 20% are owned by another company. The 80% company is now not letting the 20% insurance plans to use their facilities, to drive that one out of town. So in fact, if you want good health care choices, you have no real choice which insurance plan you use.
Also, 30% of the city has an ISP choice between fiber and cable; the rest has DSL or cable. Get a bit outside of town and DSL goes away. So there is almost no choice in ISPs, and when they have horrible policies they don't care at all what I say.
On the other hand, with government I can vote to change the people and policies. It's not perfect, and it doesn't always work (especially when most people whine about the govt but don't vote), but it often does work. We've gotten rid of a senator who ran on religious bigotry and hatred, for example.
There are hundreds of EDI-type transactions behind every one of those "simple" actions. Plus verification, cross-matching with multiple insurance carriers (each with their own system), testing all the interconnections. Just to scratch the surface.
sPh
A site intended to serve up to 30 million people execute complex financial changes in a 90-day window was three months late, went live at ~80% capability, and will probably be close to 95% capability at the beginning of its second year of operation is a "disaster"? Perhaps you don't remember the early days of, say, Amazon?
sPh
> BTW, this is emblematic of the Obama administration
It's emblematic of EVERY administration going back thousands of years. Right wing present that this is something new but their world view seems to be completely uninfluenced by an appreciation of human nature or history.
For example:
Augustus was a shrewd and effective manager of his own public image. Itâ(TM)s now easy to take for granted that images of political leaders decorate our currency â" Augustus was among the first rulers to widely disseminate images of his own face on coins.
Itâ(TM)s hard to imagine even the most ardent Democrats supporting the literal deification of Barack Obama or erecting small shrines in his honor throughout Washington DC. By contrast, after Julius Caesar was posthumously declared a god, Augustus, as his adopted son, became known as the son of god. Along with the other gods, he received dedications at small crossroads shrines throughout Rome.
http://www.csmonitor.com/Books...
Let's assume that 12 million estimate is correct, that due to Obamacare, 12 million people who weren't insured before are now insured. Of course, other people give different estimates, but let's give Obama the benefit of the doubt.
The net cost of Obamacare to the federal taxpayers is $1.3 trillion (CBO). $1.3 trillion / 12 million people covered = $11.3 million per person.
I don't think we got a good deal.
The $11 million per person covered is of course just the direct cost to the federal government. In 2013, we saw the following rate increases due to Obamacare:
Connecticut: 37% average rate increase
Florida: 42% average rate increase
Illinois: 33% average rate increase
Michigan: 39% average rate increase
Minnesota: 35% average rate increase
The trend accelerates in 2014:
Delaware 100%
New Hampshire 90%
Indiana 54%
California 53%
Connecticut 45%
Michigan 36%
Florida 37%
Georgia 29%
Kentucky 29%
Pennsylvania 28%
So there's another trillion dollars it cost average Americans, in the form of much higher premiums. A couple TRILLION dollars to (maybe) cover $12 million people. At a cost of around $20 million per person covered, I don't think I'd trumpet that as a victory if I were a Democrat. (And in fact Democrat most candidates are distancing themselves from the mess.)
My complaint? My family health cost has tripled. That's 3 times what it did cost. Oh yeah, the level of service we get for that extra is not only missing but the quality has gone down dramatically. I suppose you cold say my problem is with the Education Department, somehow they forgot to teach people about the failures, corruption and down right misery of socialism.
Umm.. The numbers are not even close to 12 million.
http://www.forbes.com/sites/th...
http://www.nbcnews.com/health/...
Obamacare seems to have only helped a little under 3% of the people who did not have coverage previously. Even now, there are still problems with it as one of the largest insurance companies in Minnesota is pulling out of the exchange.
http://www.nbcnews.com/health/...
Now before you get all pissy, this isn't a swipe at obamacare, it's the facts surrounding it that you seem to have missed and evidence of the GP's statement that "they simply do not have any clue to anything that they are involved with". Evidently, neither do you unless you were listening to them.
My mother's deductibles wouldn't change if she switched to one of the 'ObamaCare' plans. They're already in the triple or quadruple digits (depending on what services she's needing.) It's actually so bad that both my parents have decided to sit on their hands until their SSI/Medicare kicks in within the next year or two. And this is coming from people who had 150/mo and no more than 300 dollar deductibles at the turn of the millenium. THAT is how fucked up the current medical situation is in the US.
Their provider was Kaiser btw.
2. Verify your identify;
And how do you propose to do that?
3. Show you available health care plans in your area;
Unless the list is 100% based on geography, this is not a straightforward problem. Also, where does this list come from? What data describes a plan for comparison purposes?
5. Help you pay for it.
How much does it cost? I imagine that has a bunch of rules behind it.
The problem is that the website itself could be relatively simple, but there are layers and layers of systems behind it, and those cost a lot more to build.
You really don't believe me? Wow.
Pittsburgh. UPMC has decided that Highmark (and thus all Blue Cross/Blue Shield insurers) can no longer use their facilities because Highmark is threatening UPMC's near-monopoly status in Western PA. UPMC is trying to crush all competition in this area.
If you think being able to vote for the people and policies in government is worthwhile, why does your city have the problems you have described?
So you dislike the government but believe that it should be used to solve every company-vs-company dispute? Huh. No, the local government is finally trying to clean the mess up but they can't really do much to interfere with private contracts between companies. Turns out that anti-competitive behavior is mostly legal, and the state and federal governments haven't gotten involved.
These problems exist because being anti-competitive is a good way to make money. Seriously, you are blaming a company-vs-company problem on the government... how does that make any sense? If I get mugged, I should blame the police and not blame the mugger?
Politics? Darn, I should have read the article - I thought this was about http://obamacare.com/
My point is that democracy doesn't put competent people in charge most of the time. That's just the nature of the beast.
Do you think that anybody else who has been elected in the last 20 years would have pulled off Obamacare? Heck, put Obama in a different period of time and he probably couldn't have done as well as he did either. The forces that move the nation are far bigger than the president.
You haven't worked much as a developer. Having built systems used by tens of millions of users I guarantee you that every time Amazon rolls out an update to the store or cloud software there's an ops person biting their nails hoping the system doesn't die. When Google released Gmail they only allowed each user to invite a certain number of friends in order to slowly ramp up the system. Writing any software that is made to have millions of users on day one is really fucking hard.
On top of that steps 2 and 3 require interacting with external systems who may also not be able to handle load well, and probably use a combination of buggy and poorly documented interfaces, and step 5 requires reading a bill so long that the people who voted for it didn't bother to read it. You're grossly trivializing the problem.
I don't know what the AC's situation is, but some plans that were once available are not. Some people can afford to have what Obama considered "junk plans" but can no longer get them and must pay higher rates for plans they don't want or including coverage for events that can't happen to them. What does a woman who has had her tubes tied (and would happily have an abortion if somehow the operation wasn't really successful) or a post-menopausal woman want with coverage for pregnancy?
It is almost always better to self insure portions of risk if you can reasonable do do -- why pay middlemen? Do you buy the "extended warranty" on every USB cable you buy from BestBuy or NewEgg? No, because you can easily absorb the cost of replacing it OR, perhaps, you only expect to be using it a few weeks by which time you are pretty sure you will accidentally leave it in a rental car or at a Starbucks by accident so you just don need long term protection.
Why is there an "insightful" mod and why isn't it "-1"? If I wanted insight, I wouldn't be reading
What I find ironic is that supposedly one big reason for Obama's electoral success was due to his team's deep understanding of technology, the internet, and social media compared to Republicans and yet they couldn't get a website running properly nor did they have the smarts to hire an industry leader to develop it.
Is 12 million the number this week? You can never tell. It goes up and down willy nilly depending on the talking head.
I bet the reality is they have NO CLUE how many people signed up, paid, or used it.
When Fascism comes to America, it will call itself Anti-Fascism, and tell you to give up your guns.
My numbers don't work. Now I'm not sure how I got that number. Perhaps I should use paper and pencil when calculating Obama-sized costs.
I'm going to show my work like this is fourth grade, so if I blew it again someone can easily point it out.
Direct federal cost: 1 300 000 000 000
people covered: 12 000 000
(roughly double the cost once you include premium increases, but let's start with just the cost we'll pay as federal taxes).
Cost:
1 300 000 000 000
_______________
12 000 000
Start dropping zeroes from both to get reasonable sized numbers for numerator and denominator:
1 300 000 000 000 dollars to cover
_______________
12 000 000 people
1 300 000 000 dollars to cover
___________
12 000
1 300 000 dollars to cover
________
12 people
108 333 dollars to cover
______
1 person
With premium increases, maybe $200,000 per person. So that's expensive, but not nearly as expensive as I had first calculated.
You forgot to include the economic boost from the people now able to return to work faster/not dying/getting preventative care so they never get sick. Also the lowered cost of care for people who now can get treated before it becomes an emergency. Most of the cost of Obamacare is recognizing costs that were, until now, hidden.
If video games influenced behavior the Pac Man generation would be eating pills and running away from their problems.
$1.3 trillion (US) federal tax cost / 12 million people = $11.3 million per person covered. Does that look right so far, or did I fat-finger the calculation? That's US trillion, which is different from UK trillion, I believe.
As has already been pointed out you were off by a factor of 100 and that's assuming the basis of your calculation is correct. It isn't.
Here is the actually CBO report: https://cbo.gov/publication/45...
They estimate 1.4 trillion over the next __10 years__ with a net cost of $36 billion in 2014. 36 billion for 11 million people is approximately $3300 per person per year. Without considering inflation that is about $33,000 per person over 10 years.
For comparison the US goverment in 2012 spent $4075 per person on healthcare (http://stats.oecd.org/index.aspx?DataSetCode=HEALTH_STAT#).
On a side note, European nations providing free healthcare to their entire population spent about $3500 (Purchasing Parity USD) per person in 2012. Adding in private expenditures and the US spent about 2~2.5x the amount per person on healthcare as comparible nations in Western Europe / Australia / Japan and generally achieved worse out comes in pretty much all categories.
Do you think that anybody else who has been elected in the last 20 years would have pulled off Obamacare
They were smart enough not to try.
Heck, put Obama in a different period of time and he probably couldn't have done as well as he did either
Obama is hands down the worst president so far in my lifetime. Even Jimmy Carter was better and that's saying something.
The forces that move the nation are far bigger than the president.
What a lame excuse. President Obama is a pompous, preening and vainglorious windbag, in the best Harvard tradition, who doesn't know a damned thing about how to run anything, least of all the United States. The only bright spot is that the people who voted for him are still taking it on the chin economically while the rest of us enjoy our stock profits. Maybe they'll learn their lesson this time and think more carefully about it before they vote in 2016, but I'm not holding my breath. After all, the working class seem to be suckers for self imposed economic punishment with their recent election choices.
That the F-35 isn't a perfect warplane is well established. On the other hand the "Affordable Care Act" is absolutely useless against the latest Russian and Chinese combat aircraft. Even the elderly Iranian air force is more than a match for the ACA.
much of left-wing thought is a kind of playing with fire by people who don't even know that fire is hot - George Orwell
Wow, yourself. You presented a plausible scenario with essentially no information, it is less than anecdotal evidence, indistinguishable from fantasy. With a city and the parties identified, it actually becomes meaningful and verifiable (or disprovable).
I didn't say government should be involved in any dispute between companies, so where do you come off claiming I advocate its involvement in all such disputes? You're trying to paint me as being extreme, and I may be, but on the other side from that you accuse me of being.
You paint UPMC as the villain, but I do not accept your contention. I think you've been watching too many Highmark commercials that have been attacking UPMC. What I see is two companies which are each involved in activities they should have been barred from by state (not federal) regulators. UPMC has been a healthcare provider for a long time, in 1998 it was allowed to offer healthcare insurance, Highmark has been a healthcare insurer for a long time and last year purchased West Penn Allegheny (which had sued both Highmark and UPMC for acting together to stifle hospital competition) to became a healthcare provider. I see two governmental agencies, the Pennsylvania Insurance Department and the Division of Acute and Ambulatory Care, failing to represent the interests of the people of Pennsylvania by failing to prevent the obvious conflict of interest involved in allowing integrated delivery system providers (particularly in companies which already dominated one aspect of that system). The solution is for government to take actions to eliminate its need for further involvement, and the state went the other way, reminiscent of our" too big to fail" banks.
You portray UPMC as the bully using its position to dominate the market for healthcare when Highmark is a much bigger company in both revenues and profits that dominates the region in providing health insurance, which purchased the plaintiff in the antitrust suit against it to kill the suit, and is in the catbird seat as it has the revenue up front and can direct business to itself for its customers who would have little choice while UPMC can merely cut off its nose to spite its face by not accepting Highmark insurance thereby turning away business, I hardly think that is the abusive position you suggest. It was not the local government that dealt with the mess, it was the Pennsylvania Insurance Department which should have prevented the issue 26 years ago.
The US government have made it clear that we have no inalienable rights; any we do not defend vigorously will be taken.
What's the difference between Bush's illegal wars and Obama's illegal wars?
In terms of the economy, Obama has done at least as much damage over time, based on his own administration's charts, even. Remember all those rosy predictions?
The party of stupid and the party of evil get together and do something both stupid and evil, then call it bipartisan.
Also, the "economic mess" at the end of Bush's term was in large part due to the collapse of securities based on bad mortgages that were encouraged by Democrat members of Congress, in particular Barney Frank. In particular, they wanted to call it racist to deny loans to people who clearly had no ability to pay them off, using the race card by claiming it was "redlining". And it is also possible that they expected the timing of these loans imploding to happen at the end of Bush's term. While you can blame Bush for our presence in the mid-east because he was actively leading that, it's a much farther stretch to blame the economy on him. However, I do put the blame that we are still in such a bad economy almost six years later on Obama's policies. And now he wants his own "illegal wars".
Are you talking about the War in Iraq, which Obama boasted continuously about ending, despite loud criticism at the time that he was creating the conditions for what's going on right now with ISIS?
I wouldn't be boasting about that anymore, his related words are now one of those things his opponents publish on Twitter so as to illustrate how incompetent he is.
The party of stupid and the party of evil get together and do something both stupid and evil, then call it bipartisan.