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Old 10-24-2013, 11:08 AM   #451
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This whole thing is just an overly-complicated train wreck...as we knew it would be.

The government is very poor at implementing technology. I work with government website teams quite often, and they are getting bottom of the barrel talent and project management.

And Irvine, there is NO WAY this is the most complicated web site history. I've helped implement some supply chain B2B sites that tracked everything to the pebbles of raw materials sitting in a pile in Africa to the to inventory of the finished goods sitting on a shelf - which also included just-in-time manufacturing, demand forecasting, regional sales tracking, marketing campaigns...in one system.
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Old 10-24-2013, 05:25 PM   #452
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This whole thing is just an overly-complicated train wreck...as we knew it would be.

The government is very poor at implementing technology. I work with government website teams quite often, and they are getting bottom of the barrel talent and project management.

And Irvine, there is NO WAY this is the most complicated web site history. I've helped implement some supply chain B2B sites that tracked everything to the pebbles of raw materials sitting in a pile in Africa to the to inventory of the finished goods sitting on a shelf - which also included just-in-time manufacturing, demand forecasting, regional sales tracking, marketing campaigns...in one system.
I think there's quite possibly a difference in scale (at least regarding necessary bandwidth) between your sites and healthcare.gov.

Not many sites are able to handle the kind of load that healthcare.gov needs to handle. From what I've been reading from the IT world, failures like this are fairly common in new sites that want to be able to handle thousands of hits/minute.
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Old 10-24-2013, 05:34 PM   #453
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There's also this:

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The classic definition of chutzpah is the child who kills his parents and then asks for leniency because he's an orphan. But in recent weeks, we've begun to see the Washington definition: A party that does everything possible to sabotage a law and then professes fury when the law's launch is rocky.

On Tuesday, Rep. Paul Ryan became the latest Republicans to call for HHS Secretary Kathleen Sebelius to step down because of the Affordable Care Act's troubled launch. "I do believe people should be held accountable," he said.

Okay then.

How about House Republicans who refused to appropriate the money the Department of Health and Human Services said it needed to properly implement Obamacare?

How about Senate Republicans who tried to intimidate Sebelius out of using existing HHS funds to implement Obamacare? "Would you describe the authority under which you believe you have the ability to conduct such transfers?" Sen. Orrin Hatch demanded at one hearing. It's difficult to imagine the size of the disaster if Sebelius hadn't moved those funds.

How about congressional Republicans who refuse to permit the packages of technical fixes and tweaks that laws of this size routinely require?

How about Republican governors who told the Obama administration they absolutely had to be left to build their own health-care exchanges -- you'll remember that the House Democrats' health-care plan included a single, national exchange -- and then refused to build, leaving the construction of 34 insurance marketplaces up to HHS?

How about the coordinated Republican effort to get the law declared unconstitutional -- an effort that ultimately failed, but that stalled implementation as government and industry waited for the uncertainty to resolve?

How about the dozens of Republican governors who refused to take federal dollars to expand Medicaid, leaving about 5.5 million low-income people who'd be eligible for free, federally-funded government insurance to slip through the cracks?

The GOP's strategy hasn't just tried to win elections and repeal Obamacare. They've actively sought to sabotage the implementation of the law. They intimidated the people who were implementing the law. They made clear that problems would be exploited rather than fixed. A few weeks ago, they literally shut down the government because they refused to pass a funding bill that contiained money for Obamacare.

The Obama administration deserves all the criticism it's getting for the poor start of health law and more. Their job was to implement the law effectively -- even if Republicans were standing in their way. So far, it's clear that they weren't able to smoothly surmount both the complexities of the law and the political roadblocks thrown in their path. Who President Obama will ultimately hold accountable -- if anyone -- for the failed launch is an interesting question.

But the GOP's complaints that their plan to undermine the law worked too well and someone has to pay border on the comic. If Republicans believe Sebelius is truly to blame for the law's poor launch, they should be pinning a medal on her.
Wonkbook: The GOP’s Obamacare chutzpah

Implementation was bound to be rocky (note that it was also a rocky start in Massachusetts under Romney). The Obama administration and the teams working towards implementation of the healthcare.gov site clearly underestimated the scope of potential issues, and should be held accountable for that. But let's not pretend that Republicans are actually concerned that the law isn't getting implemented as smoothly as it should.
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Old 10-24-2013, 06:31 PM   #454
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From what I've been reading from the IT world, failures like this are fairly common in new sites that want to be able to handle thousands of hits/minute.
Which is why such projects go through a development cycle which includes stress testing and possibly a slow, controlled roll-out.

This will be a great example of "what not to do" for IT execs.
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Old 10-24-2013, 08:48 PM   #455
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Which is why such projects go through a development cycle which includes stress testing and possibly a slow, controlled roll-out.

This will be a great example of "what not to do" for IT execs.
Agreed (though some of the obstacles thrown up by Republican governors certainly would have made an attempt at controlled rollout difficult regardless).

Full disclosure: my original reply a couple posts up to you was going to say "Were your sites designed to handle thousands of hits/minute?" until I realized the punchline: "neither was healthcare.gov."

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Old 10-24-2013, 11:33 PM   #456
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Originally Posted by Diemen View Post
Implementation was bound to be rocky (note that it was also a rocky start in Massachusetts under Romney). The Obama administration and the teams working towards implementation of the healthcare.gov site clearly underestimated the scope of potential issues, and should be held accountable for that. But let's not pretend that Republicans are actually concerned that the law isn't getting implemented as smoothly as it should.
http://takingnote.blogs.nytimes.com/...ts-for-failure
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The rollout is bumpy, and inexcusably so. It appears that the federal exchange Web site wasn’t fully tested until two weeks before it opened. As today’s Times story put it, the online health insurance marketplace “is still limping along after three weeks.”

Lawmakers can and should hold the administration to account. But given that House Republicans have done everything in their power to try to dismantle the Affordable Care Act — including shutting down the entire government — it’s understandable that House Democrats expressed suspicion about their motives.

“I wish I could believe that this hearing is above board, but it’s not,” said Representative Frank Pallone, Democrat of New Jersey. “The Republicans don’t have clean hands coming here. Their effort is obviously not to make this better, but to use the website glitches as an excuse to defund or repeal Obamacare.”
Maybe it's an idea to start holding Republicans accountable for the success of the ACA. If it becomes a success, then votes for them, if not then votes for someone else. Maybe then they'll finally start doing their job.
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Old 10-25-2013, 11:25 AM   #457
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Agreed (though some of the obstacles thrown up by Republican governors certainly would have made an attempt at controlled rollout difficult regardless).

Full disclosure: my original reply a couple posts up to you was going to say "Were your sites designed to handle thousands of hits/minute?" until I realized the punchline: "neither was healthcare.gov."



You're a good sport. I hope this debacle leads to a simple, single-payer system in the long run. The ACA is way too complex and will create more bureaucracy - which is almost never a good thing. With each layer of middle men, the costs will go up. That's the nature of the beast.
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Old 10-25-2013, 12:29 PM   #458
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Somebody else already asked this, but how on earth do any of you see single payer happening anytime soon?

The entire Republican Party stands in opposition, while the Tea Party is completely irrational on this point. And you have a number of conservative Democrats who aren't much better.
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Old 10-25-2013, 12:42 PM   #459
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Somebody else already asked this, but how on earth do any of you see single payer happening anytime soon?

.
If we see 8-12 years of Democratic control of the WH and Congress - I can see it happening.
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Old 10-25-2013, 01:05 PM   #460
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If we see 8-12 years of Democratic control of the WH and Congress - I can see it happening.
I envy your optimism. I think the only way it could happen in the near future is if there is a concerted and successful effort from the "Establishment" Republicans to shut down the Tea Party's current grip on the party and its base. I suppose if the Dems do capitalize on the current national animus towards the Tea Party and ride it to electoral victory in Congress, they could just push ahead and go for single payer anyway, but I shudder at the thought of how much further that would push the level of vitriol from the far right.
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Old 10-25-2013, 01:11 PM   #461
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Here's an interesting read regarding the Obama administration's reaction to the roll out of the ACA so far:

Level With Us, Mr. President � The Dish

Quote:
The administration is still behaving like it is trying to get Obamacare enacted, and therefore its top public relations task is to bury negative stories about the law and emphasize the upside, like heavy consumer interest. But this is a mistake. Obamacare is already the law, and its long term political success is going to be determined by its substantive policy success — including whether consumers are able to sign up and get the health coverage they want.

...

Perhaps spooked by the 2010 Congressional elections, the president pocketed his controversial domestic win and then laid low. Healthcare was not one of his rallying cries in the election – because it was not the most popular part of his agenda. But over the long haul, legitimizing his healthcare law and reminding us of its core gains – lower costs, no bar on pre-existing conditions, and an end to free-riding – was more important than simply securing re-election the least difficult way. Then, too defensively, the Obama team waited until the website roll-out to make their case – hoping, presumably, to capitalize on what they imagined would be a great online experience. Then came the mismanaged disaster, followed by ever more defensive – and somewhat opaque – public statements. Kathleen Sebelius’s appearance on the Daily Show (a key demographic for the law) was one of the worst performances I’ve ever seen of a public official defending her own work. It was a textbook case in how not to talk to the public. It has gone downhill from there, including the president’s super-lame Rose Garden mix of ebullience and defensiveness.

What we need is candor. We need the president first of all to take personal responsibility for this failure. He needs to apologize to the country for what was either terrible executive branch management or negligence. And he needs to fire those responsible as a simple matter of accountability. If he had no clue of the train-wreck, his administration is not functioning correctly. The problems were foreseen as long ago as this spring by Max Baucus. He wasn’t clairvoyant about the website, but he presciently warned of a looming train-wreck because the exchanges would not be ready on time and because the administration had done such a piss-poor job of communicating the core provisions to the public. He was in constant touch with Sebelius, and regarded their exchanges as futile.

...

I’m sure many are working furiously to fix the website problems. Things may work out in the end, as they did in Massachusetts and with Medicare D, after early choppy waters. But competence also requires confidence. Confidence requires extreme candor from the top. Stop trying to sell a product people cannot easily buy. Explain why this happened, and who has taken responsibility. Fire them. Apologize. Be totally forthright about everything you know. Explain the plan to fix it – clearly. Reiterate the core goals of the law – with an emphasis on its many popular aspects. If some kind of delay is needed, say so now. Don’t stumble back into it later. Or do it in embarrassing half-ass stages.

This is basic public relations. It should be reflexive for a president who told us he would admit error when he has screwed up, unlike his predecessor. Instead, we have defensive acknowledgments of the bleeding obvious, and a drip-drip-drip of bad news leaking from congressional hearings and reporters. At this point, the president is behind the ball. He needs to get ahead of it – and fast. Or he will begin to look like George W Bush spinning his Iraq fiasco. Unlike Bush, Obama has many supporters prepared to confront and criticize him publicly, which is a help. The president now needs to rise to this occasion or have his own singular policy choice, like Bush’s, become a synonym for government incompetence. Confess, Mr President. Americans forgive failures explained forthrightly. They rightly never forgive those who cannot plainly and clearly admit error and take responsibility.
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Old 10-28-2013, 11:08 AM   #462
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Well, I was hoping I would be able to avoid having to use the VA healthcare system, but looks like Im going to have to. This is absolutely ridiculous. I am in the low income class this bill in college, and cannot afford the absurd new prices for healthcare in Vermont. I have virtually no income, and an unable to work right now. I get 80% disability from the VA. Between that and money from the GI bill, that's my only income. The health plan I've been on was a $300 something a month plan, however the state subsidized most of it, leaving me with a bill of $60 a month. My annual max-out of pocket expense was $1000. I require a lot of physical therapy, so that figure is very important. I pay 80% of all medial expenses, until around $400, at which point the insurance pays 80% and I pay 20%, until the $1000 is hit, at which point the insurance pays 100%.

But contrary to what the President promised, not everyone gets to keep their current health plans. Mine will no longer exist after the end of 2013. So now, I'm looking at a much higher premium, not quite sure how much higher, but anywhere between $100-$300 higher. It doesn't help that the website doesn't work. But more importantly, the medical deductible is going to skyrocket to at least $4000. There is no way I can afford my medical expenses with a deductible that high.

What a load of shit.

I have no idea what I'm going to do.
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Old 10-29-2013, 12:11 AM   #463
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Sorry, I posted this on the entropy thread... But here's Krugman's OpEd column today:

NYT OpEd: The Big Kludge

Quote:
But while we wait for the geeks to do their stuff, let’s ask a related question: Why did this thing have to be so complicated in the first place?

It’s true that the Affordable Care Act isn’t as complex as opponents make it out to be. Basically, it requires that insurance companies offer the same policies to everyone; it requires that each individual then buy one of these policies (the individual mandate); and it offers subsidies, depending on income, to keep insurance affordable.

Still, there’s a lot for people to go through. Not only do they have to choose insurers and plans, they have to submit a lot of personal information so the government can determine the size of their subsidies. And the software has to integrate all this information, getting it to all the relevant parties — which isn’t happening yet on the federal site.

Imagine, now, a much simpler system in which the government just pays your major medical expenses. In this hypothetical system you wouldn’t have to shop for insurance, nor would you have to provide lots of personal details. The government would be your insurer, and you’d be covered automatically by virtue of being an American.

Of course, we don’t have to imagine such a system, because it already exists. It’s called Medicare, it covers all Americans 65 and older, and it’s enormously popular. So why didn’t we just extend that system to cover everyone?

The proximate answer was politics: Medicare for all just wasn’t going to happen, given both the power of the insurance industry and the reluctance of workers who currently have good insurance through their employers to trade that insurance for something new. Given these political realities, the Affordable Care Act was probably all we could get — and make no mistake, it will vastly improve the lives of tens of millions of Americans.

...

And Republicans still dream of dismantling Medicare as we know it, instead giving seniors vouchers to buy private insurance. In effect, although they never say this, they want to convert Medicare into Obamacare.

...

No, the assault on Medicare is really about an ideology that is fundamentally hostile to the notion of the government helping people, and tries to make whatever help is given as limited and indirect as possible, restricting its scope and running it through private corporations. And this ideology, at a fundamental level — more fundamental, even, than vested interests — is why Obamacare ended up being a big kludge.

In saying this I don’t mean to excuse the officials and contractors who made such a mess of health reform’s first month. Nor, on the other side, am I suggesting that health reform should have waited until the political system was ready for single-payer. For now, the priority is to get this kludge working, and once that’s done, America will become a better place.
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Old 10-29-2013, 09:30 AM   #464
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Well, I was hoping I would be able to avoid having to use the VA healthcare system, but looks like Im going to have to. This is absolutely ridiculous. I am in the low income class this bill in college, and cannot afford the absurd new prices for healthcare in Vermont. I have virtually no income, and an unable to work right now. I get 80% disability from the VA. Between that and money from the GI bill, that's my only income. The health plan I've been on was a $300 something a month plan, however the state subsidized most of it, leaving me with a bill of $60 a month. My annual max-out of pocket expense was $1000. I require a lot of physical therapy, so that figure is very important. I pay 80% of all medial expenses, until around $400, at which point the insurance pays 80% and I pay 20%, until the $1000 is hit, at which point the insurance pays 100%.

But contrary to what the President promised, not everyone gets to keep their current health plans. Mine will no longer exist after the end of 2013. So now, I'm looking at a much higher premium, not quite sure how much higher, but anywhere between $100-$300 higher. It doesn't help that the website doesn't work. But more importantly, the medical deductible is going to skyrocket to at least $4000. There is no way I can afford my medical expenses with a deductible that high.

What a load of shit.

I have no idea what I'm going to do.


i really am taking an extended break from FYM, but i did want to say that this really sucks and i'm very sorry for your situation. i hope you can get the help that you need and i wish you the best of luck.
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Old 10-29-2013, 10:56 AM   #465
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You're not alone, Pac Mule.

http://www.usatoday.com/story/news/2...?csp=fbfanpage
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