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Obamacare and Middle-Wheel-Wheelbarrows 199

Posted by timothy
from the well-here's-where-your-problem-is dept.
davecb writes "The Obamacare sign-up site was a classic example of managers saying 'not invented here' and doing everything wrong, as described in Poul-Henning Kamp's Center Wheel for Success, at ACM Queue." It's not just a knock on the health-care finance site, though: "We are quick to dismiss these types of failures as politicians asking for the wrong systems and incompetent and/or greedy companies being happy to oblige. While that may be part of the explanation, it is hardly sufficient. ... [New technologies] allow us to make much bigger projects, but the actual success/failure rate seems to be pretty much the same."
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Obamacare and Middle-Wheel-Wheelbarrows

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  • Shock! (Score:4, Insightful)

    by the eric conspiracy (20178) on Saturday December 21, 2013 @10:56PM (#45757877)

    Actual rational commentary unencumbered by raving political partisanship.

    How is this legal?

    • Re:Shock! (Score:4, Interesting)

      by immaterial (1520413) on Saturday December 21, 2013 @11:53PM (#45758101)
      The article doesn't actually seem to say much of anything (insights into stupid European wheelbarrow design notwithstanding). And there's this:

      I looked at one of the actual laws that make up Obamacare ... After a few pages I ran into this definition of patient decision aid:

      (1) PATIENT DECISION AID—The term patient decision aid' means an educational tool that helps patients, caregivers, or authorized representatives understand and communicate their beliefs and preferences related to their treatment options, and to decide with their health care provider what treatments are best for them based on their treatment options, scientific evidence, circumstances, beliefs, and preferences. ...

      Unless Congress thinks of teachers as "educational tools," I think we can take it as written here that they expect this to be some kind of computer program. ... These paragraphs legislate that Obamacare will fund research in heavy-duty state-of-the-art artificial intelligence—I somehow doubt that is what Congress intended it to say. I posit that Congress worried about having enough doctors and nurses for this new health care, so they wanted to use computers to cut down the talking and explaining. In other words, they want to save manpower—by replacing the front man on the handbarrow with a wheel.

      It looks to me like his interpretation of the law is extremely ridiculous. As I read it, it applies just as well to a simple brochure, ie. "Your Treatment Options for Prostate Cancer..." that is required to be understandable to the patient or caregiver (in their native language and not overly technical) so they can make an educated choice about their own treatment.

      The author of the article is the one attaching the unnecessarily complicated wheel to this particular example.

      • Re:Shock! (Score:4, Informative)

        by Jane Q. Public (1010737) on Sunday December 22, 2013 @12:18AM (#45758163)

        "It looks to me like his interpretation of the law is extremely ridiculous."

        You're pulling only part of what he wrote, out of context. He also quoted several other sections that referenced (1), and described some of the other things it must do... greatly expanding on that one paragraph.

        Having said that, I agree that he doesn't say much of anything that hasn't already been said. His analogy with the Chinese wheelbarrow is certainly interesting (and rather funny, really). But I think all of his points were made before in The Mythical Man-Month and other writings.

        • You're pulling only part of what he wrote, out of context. He also quoted several other sections that referenced (1), and described some of the other things it must do... greatly expanding on that one paragraph.

          I used the summary portion and skipped the details for brevity, but here they are. Feel free to point out the parts that require an advanced artificial intelligence system instead of a properly targeted brochure or pamphlet:

          "(2) REQUIREMENTS FOR PATIENT DECISION AIDS—Patient decision aids developed and produced pursuant to a grant or contract under paragraph (1)—
          "(A) shall be designed to engage patients, caregivers, and authorized representatives in informed decision making with health care pro

          • ". Feel free to point out the parts that require an advanced artificial intelligence system instead of a properly targeted brochure or pamphlet:"

            Why should I, when TFA already did? It's right there: "engage patients, caregivers in informed decision making...", "present up-to-date clinical evidence in a form and manner... can be adapted for patients, caregivers..."

            Etc. These points were already made in TFA. Asking me to repeat them serves no purpose. But since we're repeating things here anyway, I will point out that even some human doctors I have known did not effectively do these things. Asking a for a computer program to do them is a pretty tal

            • "engage", "present", "be adapted"

              Why do any of these require a technological solution? AFAICT these terms are still perfectly applicable to a brochure or a paragraph.

              • "Why do any of these require a technological solution? AFAICT these terms are still perfectly applicable to a brochure or a paragraph."

                A brochure does not "adapt" itself to the individual needs of patients and caregivers. Unless, of course, they meant something like 100,000 different brochures, because otherwise there is no way it could cover all the information listed in the requirements.

                • by Velex (120469)

                  That's the problem with the passive voice where the verb "adapt" appears. We don't know who's responsible for adapting it. It could be the author of the brochure (i.e. requiring somebody authoring a brochure to create several different adaptations), or it could be the brochure itself as you and TFA's author read. It's an assumption to say that the brochure is adapting itself simply because the law used the passive voice. The passive voice leaves who the actor is utterly vague.

                  I don't know how you arrive

      • by whoever57 (658626)

        The article doesn't actually seem to say much of anything (insights into stupid European wheelbarrow design notwithstanding).

        I'm not sure that the "insights" into European wheelbarrow design are actually insights. Like most designs, wheelbarrow designs are a mix of compromises and I can think of a number of advantages that the European design has.

  • by Joe_Dragon (2206452) on Saturday December 21, 2013 @10:57PM (#45757883)

    To many middle man get in the way of the people doing doing the tech work and it's like that part is being worked on by team X and you need to wait for them to do there part and no you can't talk directly to them.

    • by pepty (1976012) on Sunday December 22, 2013 @12:30AM (#45758201)
      Just out of curiosity: How many super-jumbo IT projects, whether the clients are public or private, are up and running within two months of the original deadline? If Oracle had taken the job wouldn't we be expecting the site to be up and running sometime in early 2015?
      • Re: (Score:2, Insightful)

        by Runaway1956 (1322357)

        You're simply pointing out the administration's ineptitude. They insisted that the system be put into place, they insisted that it meet a firm time schedule, insisted on putting incompetent "managers" in charge of everything, and further insisted on hiring incompetent "technical" advisors and "engineers".

        There was no compromise in any portion of the planning or implementation. On the day of the Grand Opening, it became appallingly obvious that the Emperor had no clothes.

        If anyone in a position of authorit

        • by peragrin (659227) on Sunday December 22, 2013 @07:07AM (#45759171)

          Here is the trick. something like 80% of large projects fail on the first try.

          From business linux deployments, to website creations, to new weapon systems for the military(M-16 anyone)

          The federal government does nothing but large projects so it gets lots of failure, but the every large company in the USA has at least one large boondogle project fail annually. Or at least fail the first couple of times.

          BING, FBI database, iphone 4 (you're holding it wrong) all suffered from design failures of the real world.

          Forget cronyism, bureaucrats are the real issue with every large project. Real leaders can reign them in and control them. unfortunately real leaders can't get elected very often.

      • by Imrik (148191)

        And how many of those projects get launched on schedule despite not being ready?

  • No dude... (Score:4, Interesting)

    by BringsApples (3418089) on Saturday December 21, 2013 @11:02PM (#45757895)
    ...The website "roll-out" was an utter failure, plain and simple. There are so many websites out there that do far more complex operation, and they seem to have very little problem. I wasn't involved in the "roll-out" of the government's healthcare website, so I know jack-diddly about the problems that they faced. But from what I know about websites, especially ones like that one, is that it's a simple matter of input from the user, and then a matter of storage of that input, and maybe some calculations along the way - all very basic stuff for today's world. I went to the website and the damn thing had major problems that made me think that it was trying to do a lot of on-the-fly operations behind the scene that wasn't syncing up correctly, maybe I'm wrong, but that was my feeling.

    However, that being said, I cannot see why the website "failure" had such an impact on the "unrolling" of the actual healthcare change. They had a toll-free number to call and operators that would do everything over the phone, very nice people I might add. Why the site didn't simply display the toll-free number is a good question. Hell, maybe they could have simply had an online-chat window pop up. Again, I wasn't a part of the staff that was tasked with this website, so there are things that I don't know.
    • Re: (Score:2, Insightful)

      by Anonymous Coward
      No, your metric of success is just different from theirs. Government bureaucracy exists to obfuscate where your money goes and to provide channels for wealth to transfer. To control these channels, you hire people with specialized knowledge of the inner workings of the complex and byzantine procedures. Then you get money, lots of it.

      You think along naive lines of getting things to work correctly, efficiently, to help people and at a fair price. These values, nice as they are, simply can't compete against t

      • by tibman (623933)

        I think you're way off. The private sector did all the colluding by itself. US medical bills are just crazy. Sky high prescription prices because "the market" can pay it. Lol, they'll pay it or be in agony.

      • The article you cited did not say that. It said it went down shortly after Obama told America on TV to flood it. That isn't "down a lot of time".
    • Re:No dude... (Score:4, Insightful)

      by BradMajors (995624) on Saturday December 21, 2013 @11:41PM (#45758065)

      The worst part is the government website is totally unnecessary.

      There already exists perfectly good working websites for buying insurance (such as einsurance). All that was required was to add the government subsidy feature.
         

    • Re:No dude... (Score:5, Insightful)

      by Sir_Sri (199544) on Sunday December 22, 2013 @01:10AM (#45758351)

      There are so many websites out there that do far more complex operation, and they seem to have very little problem.

      Not really at least not that worked at this scale from day one. The closest you're going to get to needing to support millions of unique users on the first day, and hundreds of thousands simultaneously are things like MMO launches and WoW expansion packs or something like google+. And most of those can scale by replication and sectioning people off so it's highly parallel, or are built on already substantial infrastructure. If you crunch the math, there were only 90 days from launch to end date, and you need to enrol about 25 million people or something in that time (the uninsured who don't live in states with their own exchanges), so the daily load is actually quite high, particularly with a large number of people hitting the site to browse and decide. It's also quite likely that they gambled on more states setting up their own exchanges... and lost.

      The backend of games and google+ of those is trivial compared to healthcare.gov, which not only needs to talk to databases from federal agencies, but it needs to connect to dozens of insurance companies with multiple sets of rules and regulations. Sure an MMO needs to do math, but one designer with no technical training can decide what equations to use and if they get it wrong no big deal. When you're dealing with money - and we're talking about healthcare that's going to be worth a couple of hundred billion dollars bought through this site, even a 1% error rate is going to cause no end of problems.

      is that it's a simple matter of input from the user, and then a matter of storage of that input, and maybe some calculations along the way - all very basic stuff for today's world.

      Input from the user that needs to be checked against multiple databases that aren't yours, that have private information in them. Then talking to multiple insurance companies in multiple jurisdictions with slightly different rules etc.

      I'm not saying that excuses about 2 months of failure, but one should not assume this is a simple project, that they somehow did not realize that this would require probably 10x the server capacity they had is a complete failure. But other projects that are huge and stable have spent a lot more than 500 million dollars to get to that point, over a lot of years. These guys were trying to solve a problem no one else has ever had to solve on this scale. That they didn't recognize that is pathetic, but we shouldn't suppose this is an easy project.

      • by Imrik (148191)

        Except unlike an MMO the people don't need to interact with each other so it is trivial to scale by replication and sectioning people off while being completely parallel.

    • by Kijori (897770)

      "[I]nput from the user, [..] storage of that input, and maybe some calculations along the way" describes almost any web-based application, and an awful lot of non-web-based applications. But big applications often have massive problems, budget overruns and enormous delays - whether they are private sector or public sector applications.

      "Input", "storage" and "calculations" are not always the same. In a complicated project, all three are difficult and complicated.

      Don't get me wrong - the exchange website was

    • Re:No dude... (Score:4, Informative)

      by phantomfive (622387) on Sunday December 22, 2013 @11:31AM (#45760205) Journal

      . But from what I know about websites, especially ones like that one, is that it's a simple matter of input from the user, and then a matter of storage of that input, and maybe some calculations along the way - all very basic stuff for today's world.

      The problem was 'some calculations along the way' because the site was designed to be integrated with several other systems.

      If you don't understand why integration with other systems can be so difficult, you should read Mythical Man Month because it explains it in detail.

  • "The Obamacare sign-up site was a classic example of managers saying 'not invented here' and doing everything wrong, as described in Poul-Henning Kamp's Center Wheel for Success, at ACM Queue."

    I mean, you folks at Slashdot should have called it the Affordable Care Act website then reminded us that it's also known as Obamacare. But to call it what it isn't in the first sentence of introduction is [very] unfortunate!

    Disclaimer: I am neiter Democrat nor Republican.

    • by Okian Warrior (537106) on Saturday December 21, 2013 @11:14PM (#45757961) Homepage Journal

      I mean, you folks at Slashdot should have called it the Affordable Care Act website then reminded us that it's also known as Obamacare. But to call it what it isn't in the first sentence of introduction is [very] unfortunate!

      Is this a misdirect?

      I'm only asking because I'm on the lookout for techniques to derail a discussion. A "misdirect" is calling attention to something irrelevant but intended to provoke an emotional response. It's used to push more-relevant posts down the page - hopefully below the fold.

      Already got a +3 rating, it takes up a full two column-inches. I'm curious to see how many respond, and whether they get modded up.

      (No one publishes guidelines for this sort of thing, so I have to ask.)

      • I don't see what the point of misdirect the discussion on this topic would be, unless a rationale examination of IT project failure is something some group would prefer to be avoided. Accenture maybe?

        Besides, both parties have embraced the name Obamacare - the republicans started it thinking it was pejorative and then the democrats must have run a few test groups on the name and decided to try and "take it back" before the last election. At this point, I don't think the name is controversial at all. It c

      • by girlintraining (1395911) on Sunday December 22, 2013 @12:12AM (#45758149)

        I'm only asking because I'm on the lookout for techniques to derail a discussion. A "misdirect" is calling attention to something irrelevant but intended to provoke an emotional response. It's used to push more-relevant posts down the page - hopefully below the fold.

        You must be new here. The majority of the intelligent and thoughtful discourse evaporated when Slashdot was bought out by Dice. If you want to see what the future looks like, punch in beta.slashdot.org. Then vomit in your mouth. It's been replaced with paid schills and hobbyists. There are a few of us left from the old guard, but we're only here because, frankly, there's nowhere else to go. Every promising new forum website seems to be shortly after swallowed whole by "Web 2.0" and it promptly goes to shit in an effort to look trendy and hip, at the expense of actual content and relevant discourse.

        The post you're replying to was not accidental. It was quite deliberate. Like all things Web 2.0, very little of what is passed off as original or user-contributed content actually is. About a third of the posts here on Slashdot are now by 3rd parties who may or may not be affiliated with Dice, who in turn are just subcontractors for larger business ventures; Shell companies within shell companies.

        It's part of a new "dark net" of small companies in quiet office complexes filled with nothing but a few cubes and employees who show up and are handed a 3 ring binder with pre-cooked posts and responses to "criticism" of whatever position they're being paid to represent under a pseudonym.

        Welcome to the real Web 2.0.

        • by taiwanjohn (103839) on Sunday December 22, 2013 @08:59AM (#45759469)

          punch in beta.slashdot.org. Then vomit in your mouth

          Damn you, girlintraining! I just checked out the new "beta" site and now I'm choking back the bile. Holy shit, does that ever suck! It's like a satanic spawn of HuffPo and FB... Painful.

          I wonder how long the "legacy" version will remain available after the changeover? Heaven help us.

        • If you want to see what the future looks like, punch in beta.slashdot.org. Then vomit in your mouth.......because, frankly, there's nowhere else to go.

          Yeah. After that beta goes live (assuming they don't fix things), I'll be switching to pianoforums.com to find people to talk with. I don't know what I'm going to do to keep up on programming trends.

      • Obamacare is easy to say and remember. Why not use it?

        Star Wars is easy to say and remember, so it stuck. Hardly anyone ever calls it Strategic Defense Initiative anymore.

        • Also, Reagan EMBRACED the term "Star Wars" (which was originally a slur) and the term was popular among the public.

          Just like when the Obama administration embraced the phrase Obamacare.

          Of course, the Obama administration and its allies in the media have been going back and forth between embracing the term Obamacare and calling anyone who uses it a racist.

    • by the eric conspiracy (20178) on Saturday December 21, 2013 @11:18PM (#45757987)

      Obamacare was originally the government heathcare plan designed to be an alternative to the public offerings in the PPACA. This was so broadly perceived as government interference in the private sector that enough Democrats declined to support it to make passing the bill impossible.

      Later the PPACA was called Obamacare as a way to disparage it and to try to attach blame for the unpopular aspects of it to the President as a political ploy.

      However even Mr. Obama now calls it Obamacare, so I guess if you call it by its official name you will are likely to just confuse people.

    • Re: (Score:3, Funny)

      by JoeMerchant (803320)

      But, virtually all I know about the topic I learned on Fox news, if you called it the Affordable Care Act website I would have no clue what you are talking about.

      My neighbor is much more knowledgeable on the topic, he listens to Rush Limbaugh all the time.

       

      • Re: (Score:3, Interesting)

        by LordLimecat (1103839)

        Ive heard it called Obamacare on NPR too, but no-- continue your rant.

    • by Runaway1956 (1322357) on Sunday December 22, 2013 @01:19AM (#45758377) Homepage Journal

      Bullshit. Even Obama was proud to call it Obamacare - until it failed. Democrats owned the damned thing all along, and Obama is the major shareholder. Screw the politically correct claptrap. There isn't a person in the United States (minus immature juveniles and senile old bastards) who doesn't know what is being referred to when Obamacare is mentioned.

    • by scotts13 (1371443)

      I mean, you folks at Slashdot should have called it the Affordable Care Act website then reminded us that it's also known as Obamacare. But to call it what it isn't in the first sentence of introduction is [very] unfortunate!

      Disclaimer: I am neiter Democrat nor Republican.

      Actually, I prefer "Colossal, Unconstitutional F*ck Up" as being completely descriptive... but I think we have far larger problems than nomenclature, don't you?

    • by rubycodez (864176)

      Even the White House press secretary's news emails call it "Obamacare."

      You lose.

    • by roc97007 (608802)

      "The Obamacare sign-up site was a classic example of managers saying 'not invented here' and doing everything wrong, as described in Poul-Henning Kamp's Center Wheel for Success, at ACM Queue."

      I mean, you folks at Slashdot should have called it the Affordable Care Act website then reminded us that it's also known as Obamacare. But to call it what it isn't in the first sentence of introduction is [very] unfortunate!

      Disclaimer: I am neiter Democrat nor Republican.

      Um, even Obama calls it Obamacare. Not so much now, of course.

  • Article is +1 (Score:5, Informative)

    by noh8rz10 (2716597) on Saturday December 21, 2013 @11:05PM (#45757915)

    Most articles linked to on slash dot aren't very interesting or are pushing something, but this article was interesting and a good use of my time . +1

    • by pikine (771084)
      Poul-Henning Kamp is probably best known for his phkmalloc used in FreeBSD, and Varnish http cache. He's one of the few who understood [acm.org] that virtual memory under stress essentially behaves like a block device, so he writes software to exploit that.
  • by Todd Knarr (15451) on Saturday December 21, 2013 @11:17PM (#45757979) Homepage

    A problem with business, that is, not a problem of business. All too often I see business requirements for software that specify how things must be done, rather than specifying what is to be done. The problem is that the business requirements are being written by businessmen who have no training or experience in writing software, so they no more know how things should be done when writing software than (according to those self-same businessmen) the software developers know how things should be done when running a business. The solution is always the same: let the business people lay out what they want done, and let the software developers figure out how to do it.

    • by AK Marc (707885)
      I've seen more than one company build/buy a CRM with the first requirement be "It must be on The Oracle" because someone heard their competitors (who were doing better financially) were using it. No mention or idea what they wanted it to do (technically or from a business perspective)
  • by tpstigers (1075021) on Saturday December 21, 2013 @11:28PM (#45758025)
    This isn't the only place we've seen this. The Pentagon and FEMA have been up to their necks in it for years. The process of getting government contracts is so bizarre and complicated that companies have evolved with "getting government contracts" as their only business model. So the companies that actually get the contracts are the companies that are good at getting government contracts (because they focus so much of their resources on the process), NOT companies that are good at delivering what the contracts specify. This is a natural by-product of bureaucracy.
  • by nbauman (624611) on Saturday December 21, 2013 @11:31PM (#45758033) Homepage Journal

    Kemp is being unfair. I understand what this section is about, and he doesn't. A patient decision aid could just be a well-written article or web page. The UK NHS has patient information pages that would satisfy these requirements. There's no requirement for artificial intelligence.

    "(1) PATIENT DECISION AID—The term patient decision aid' means an educational tool that helps patients, caregivers, or authorized representatives understand and communicate their beliefs and preferences related to their treatment options, and to decide with their health care provider what treatments are best for them based on their treatment options, scientific evidence, circumstances, beliefs, and preferences."
    "(2) REQUIREMENTS FOR PATIENT DECISION AIDS—Patient decision aids developed and produced pursuant to a grant or contract under paragraph (1)—
    "(A) shall be designed to engage patients, caregivers, and authorized representatives in informed decision making with health care providers;
    "(B) shall present up-to-date clinical evidence about the risks and benefits of treatment options in a form and manner that is age-appropriate and can be adapted for patients, caregivers, and authorized representatives from a variety of cultural and educational backgrounds to reflect the varying needs of consumers and diverse levels of health literacy;
    "(C) shall, where appropriate, explain why there is a lack of evidence to support one treatment option over another; and
    "(D) shall address health care decisions across the age span, including those affecting vulnerable populations including children."

  • Naive (Score:2, Insightful)

    by Anonymous Coward

    Charmingly naive, but naive.

    The author of that article asks, several times in several ways, why the government always gets it wrong and the lasting solutions always come from the little guys.

    The answer has less to do with the size of the organization than the number of organizations all pitching competitive solutions. Yes, a thousand 10-person companies are probably going to do a better job in the long run than a single 10,000-person company or government entity, on problems in the right scale. But you'll

  • by Yxven (1100075) on Sunday December 22, 2013 @12:22AM (#45758173)

    As interesting as it is to guess why another waterfall government IT project failed, I'd rather know why we aren't using wheelbarrows with wheels closer to the center. As a guy who has mostly used wheelbarrows for moving concrete, having the wheel support the majority of the load instead of half (or whatever) sounds like a huge advantage.

    The Wikipedia article on wheelbarrows suggests "However, the lower carrying surface made the European wheelbarrow clearly more useful for short-haul work." Does that reason really pan out? Can anyone think of any other reasons?

    • by Animats (122034)

      A wheelbarrow is a specialized tool, for moving loose material a short distance and then pouring it out. For most other applications, a wagon, hand truck, or dolly is more useful. There's also the Gardenway cart, which has two large wheels on an axle slightly forward of the center. It's dumpable, but less work to move. Horse barns usually have a few of those around.

      Modern wheelbarrows [tractorsupply.com] have the single wheel much closer to the CG, so you're only lifting a fraction of the weight. You want some weight on the

  • by PaddyM (45763) on Sunday December 22, 2013 @12:25AM (#45758185) Homepage

    But I think we all know that a car analogy is needed to explain the healthcare.gov mis steps. Namely, the Democrats drove the law through all obstacles, but then after the elections, they ran out of gas. The Democrats wanted to buy more gas, but the Republicans said the engine is broken and should be replaced. The Democrats asked what engine to buy, but the Republicans had no idea except not from Solyndra. While they were arguing about it, Obama said that the midnight train of 2014 was approaching. The Democrats asked the Republicans to help push the car because it at least helps some people get healthy, but the Republicans said it would be faster if they spilled oil on the road and got rid of taxes on oil. Then the wheels came off the healthcare.gov website.

  • There are already lots of US laws and regulations that mandate how IT is supposed to be procured and implemented by the US Government (see, e.g., the Clinger-Cohen Act [wikipedia.org].)

    Each of these mandates came about because Congress became tired of funding IT projects where the money just vanished and no IT system was stood-up.

    The botched implementation of the ACA website raises questions not of "wheelbarrows," but how and why EOP/DHHS managed to bypass or ignore existing mandates.

  • by epine (68316) on Sunday December 22, 2013 @05:34AM (#45758989)

    I'm sympathetic to PHK, but I could never have written this piece myself without commenting on a single disadvantage of the Chinese wheelbarrow.

    You seem to be stuck with one of three problems:
    * using a small wheel that won't easily roll over path obstructions
    * having the wheel intrude into the barrow, obstructing tending or shifting the load
    * having a large wheel under the barrow with a high center of gravity (what could possibly go wrong?)

    The large carts at my nearby Costco are set up so that they won't pivot at the front (only at the middle). This is fine if you can find space to make a 90 degree turn on the spot. It's not at all good for creeping around a tight bend. Moreover, you've got both the front and back end swinging at the same time—which is the number of places you can visually attend plus one—so your chances of taking down some rickety display item are fairly decent if try to wing it.

    Furthermore, nothing prevents two people from grabbing different handles on the European wheelbarrow. Also, PHK is wrong about the weight distribution. With a heavy load, it's customary to pile as much as possible up against the lip that protrudes over the front wheel in many front-wheel designs. I'd guess an European wheelbarrow front-loaded with wet clay has about a 4:1 lever arm in vertical displacement of the handle compared to vertical displacement of the load.

    Wouldn't a Chinese wheelbarrow be something like a small unicycle with saddlebags and a trailer hitch? If you need to clear some brush (where only your wheel fits the path), you've got no way to jack the suspension under the load, either.

    And wouldn't it be much harder for short and tall people to share the Chinese design unless equipped with some sort of adjustable handle. Somehow I'm just positive that the Chinese design from 1000 [BC|AD] comes replete with ergonomic dongles for the comfort of whatever schlep needs it next.

    But then, with a billion identical people growing rice on ten million identically manicured terraces, I'm sure the Chinese design is a total win.

  • or at least permit states to set up their own single payer systems. Problem solved.
    • by plopez (54068)

      States are already permitted to do so. If a state has a system that exceeds or meets coverage of medicare or medicaid they can do so. See MediCal as an example.

  • There was no "wiggle room" for incremental development, prototyping, or staged roll outs. Congress is a perfect example of rule by a committee of unqualified managers. And the public officials in charge? Many were in over their heads as well. The few who may have had a clue were constrained by the law. As public employees, in fact Federal Officers, they took an oath of office to uphold the laws of the U.S. The good ones did the best they could but they had little choice. The law said it would go live on a c

  • I see this phenomenon a lot. Corporate executives tend to be unimaginative when they envision new technology, they look at a job someone is doing and try to imagine ways technology can replace the person. Sometimes they do it backwards, the take a new technology and ask "what existing product can we replace with this or add this to?"

    Then you get idiotic products like driverless cars. Most of the design decisions that went into cars had a lot to do with the fact they were going to have a human driver, could

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