Obamacare and Middle-Wheel-Wheelbarrows 199
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."
Shock! (Score:4, Insightful)
Actual rational commentary unencumbered by raving political partisanship.
How is this legal?
Re:Shock! (Score:4, Interesting)
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)
"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.
Re: (Score:2)
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:
Re: (Score:2)
". 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
Re: (Score:2)
"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.
Re: (Score:2)
"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.
Re: (Score:3)
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
Re: (Score:2)
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.
Contracting and subcontracting (Score:4, Insightful)
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.
Re:Contracting and subcontracting (Score:4, Insightful)
Re: (Score:2, Insightful)
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
Re:Contracting and subcontracting (Score:4, Informative)
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.
Re: (Score:2)
And how many of those projects get launched on schedule despite not being ready?
No dude... (Score:4, Interesting)
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)
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
Re: (Score:2)
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.
Toll Free number also down (Score:3)
http://townhall.com/tipsheet/christinerousselle/2013/10/21/obamacare-call-center-down-as-president-encourages-phone-registration-n1728960 [townhall.com]
The toll free number was also down a lot of time.
Re: (Score:3)
Re:No dude... (Score:4, Insightful)
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: (Score:3, Insightful)
Wake up Amerikka - that subsidy is a temporary, fleeting thing. And, once you are registered, once you're in the system, you can never again be without insurance.
Well, yes. That's the point -- universal healthcare through universal insurance. Not really all that different from what we've done with auto insurance for years, and that works well enough.
Admittedly it's not as efficient or reliable as a single-payer system, but it's nevertheless preferable to our previous "just wait until you're at death's door, then go to the emergency room and run up an amazing tab on somebody else's dime" healthcare model.
Oh well - maybe they won't have Big Macs at the relocation and reeducation camps
Dystopian fantasies, cute. Not a good approach if you want t
Re: (Score:3, Insightful)
Well, yes. That's the point -- universal healthcare through universal insurance.
Will you be so calm and matter of fact about it when there is a law that every citizen must own a gun?
Because making a law that requires citizens to purchase something from private companies means that the government can make you buy ANYTHING (or pay a fee).
P.S. If " universal healthcare through universal insurance." was really the point, why were unions and many other organizations who contributed to Democrats given a waver for
Re:No dude... (Score:4, Interesting)
That shipped sailed long ago.
Everyone has to pay for trash disposal. You have no choice. You can't burn it, you can't pile it on your property.
You either haul it to a private landfill and pay them. Or you pay a private hauler to take it away. Or you pay taxes that pay a private hauler with a government contract to haul it away.
Anything else is illegal.
Re: (Score:2)
Everyone has to pay for trash disposal. You have no choice. You can't burn it, you can't pile it on your property.
You either haul it to a private landfill and pay them. Or you pay a private hauler to take it away. Or you pay taxes that pay a private hauler with a government contract to haul it away.
Anything else is illegal.
Ah yes, the old "voluntary" part about taxes. You're not paying diddly to government. They're taking it from you, whether you need trash disposal or not.
And no, if you really think about it. Those people can't choose to hire a private company, because they would be screwing themselves over. In essence, those that choose to do things privately are DOUBLE taxed by virtue of not getting the benefit they already "paid" for.
Re:No dude... (Score:4, Interesting)
It seems like a small detail, but it's essentially the central debate the country has been having since 1776 or before. How much power should the national government have compared to local governments (and citizens)?
Re: (Score:3)
Re: (Score:2)
Done correctly it would be far more efficient, unfortunately it would never actually happen. The government is unwilling to do anything to damage current jobs so they can only add inefficiency.
Re:No dude... (Score:5, Insightful)
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.
Re: (Score:2)
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.
Re: (Score:2)
"[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)
. 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.
Why not call it its actual name? (Score:2, Insightful)
"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.
Re:Why not call it its actual name? (Score:4, Interesting)
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.)
Re: (Score:2)
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
Re:Why not call it its actual name? (Score:5, Insightful)
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.
Re:Why not call it its actual name? (Score:4, Insightful)
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.
Re: (Score:2)
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.
Re: (Score:2)
Re: (Score:2)
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.
Re: (Score:3)
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.
Re:Why not call it its actual name? (Score:4, Insightful)
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)
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)
Ive heard it called Obamacare on NPR too, but no-- continue your rant.
Re: (Score:3)
Or, in short, SEO.
Re:Why not call it its actual name? (Score:4, Insightful)
There have been informal surveys that ask if you prefer Obamacare or the Patient protection and affordable care act and they pick either one based on emotions rather than facts.
I spoke with a girl just the other day who said she didn't know much about it when I asked if you got her government mandated insurance yet. She was outraged when I told her she was facing a penalty if she didn't have insurance by the end of the year.
The bottom line is that people just don't pay enough attention. Sometimes, they hear something that sounds good and like it, sometimes they hear a person is associated with it and like it. Sometimes, you are better off trying to guess what color any random woman's underwear might be then expect people to know about this stuff.
Re: (Score:2)
Sometimes, you are better off trying to guess what color any random woman's underwear might be then expect people to know about this stuff.
ummmm...... white?
Re: (Score:2)
There have been informal surveys that ask if you prefer Obamacare or the Patient protection and affordable care act and they pick either one based on emotions rather than facts.
I liked the survey where they asked people, "Which do you think is more expensive, Obamacare or the Affordable Care Act?"
Best answer: "The Affordable Care Act. It's affordable. Duh."
Re: (Score:2)
Re:Why not call it its actual name? (Score:4, Insightful)
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.
Re: (Score:2)
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?
Re: (Score:2)
Even the White House press secretary's news emails call it "Obamacare."
You lose.
Re: (Score:2)
"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.
Re:Why not call it its actual name? (Score:5, Informative)
Here's what Obama himself said about that - "And once it's working really well, I guarantee you, they'll not call it Obamacare. Here's a prediction for you - a few years from now, when people are using this to get coverage, everybody's feeling pretty good about all the choices & competition that they've got, there are going to be a whole bunch of folks saying "I always thought this provision was excellent, I voted for that thing".
You watch, it will not be called Obamacare," -
http://www.youtube.com/watch?v=7aN2iuIhcx0 [youtube.com]
Re:Why not call it its actual name? (Score:4, Insightful)
HE also said if you like your insurance you can keep it, if you like your doctor, you can keep him. Something about period too.
It seems to me that Obama is just like any other politicians and lieing out his ass to get whatever he wants done and it wouldn't surprise me if that statement wasn't concocted with the knowledge of trying to get rid of the Obamacare name simply to make it appear to be working better than it is.
I mean seriously, he set up the perfect scam with that line, he says when it works good, they will not call it obamacare and if he gets it called something else, it must be working good then right?
Re: (Score:2)
I don't think that it's a statement he ever should have made but it's not like he promised Americans eternal life and now is casting them in carbonite.
http://www.washingtonpost.com/blogs/wonkblog/wp/2013/10/29/this-is-why-obamacare-is-cancelling-some-peoples-insurance-plans/ [washingtonpost.com]
Re: (Score:2)
> I don't think that it's a statement he ever should have made but it's not like he promised Americans eternal life and now is casting them in carbonite.
Um, it seems more like promising Americans eternal life and then tossing them to the Sarlacc. Casting them in carbonite would have at least technically been keeping the promise.
Ok, I'm geeked out now...
Re: (Score:3)
It's a bit of neither if you paid attention to when and why it was being said. It isn't a matter of Obama simply not understanding what would happen, people were making the charge for much the same reasons as outlined in your linked article, that people would lose their insurance and access to their doctors and that plans were going to cost more. The claim was that no it is not, if you like your insurance plan, you can keep it, if you like your doctor, you can keep him, and the average family would see a $1
Re:Why not call it its actual name? (Score:4, Informative)
Not really.. There are two ways an existing plan can remain, one is if it does not change at all and the other is if there is some hardship.
There is a hardship exception that allows insurance providers to keep or even create the barebones plans and the plans that do not meet the requirements under the ACA, but in order to qualify, the insurance provider has to show how changing the plan will create an economic hardship for them or a class of people defined by the actuaries. Now class is defined by an actuary group and not what we would think like with working class, poor middle and so on.
It should be noteworthy that the DHHS just recently (within the last week or so) released new guidelines on the hardship exceptions that they claim "clarified the law" that expanded the ability to use the hardship exceptions. If it was squarely on the insurance providers, we wouldn't have seen that.
The true grandfather clause meant that if no changes were made, the policy could remain until any change is made, then it would have to follow all the new rules. A subsidy given by the government would qualify as a change and so would changes in the risk pools made by the actuary (which would by default have to be made with people moving to subsidized plans and medicare/medicaid roles).
So yes, you can blame the insurance providers if you ignore the fact that they would be penalized for not updating their policies to meet the new guidelines despite the class pools changing and the penalties they would face. But all this is sort of like arguing if the room is painted white or eggshell. This stuff was being brought up before Obama made any of the statements and the statements were specifically to address those situations. You act as if it is not Obama's fault for making the claims when the claims were specifically made to counter the reality that materialized. Add to that that Obama knew [forbes.com] before he said it once that it wasn't true but kept on saying it in order to sell the product. In fact, the delay he put for the employer coverage mandates was specifically to address the fact that "66 percent of small employer plans and 45 percent of large employer plans will relinquish their grandfather status by the end of 2013," and "156 million Americansâ"more than half the populationâ"was covered by employer-sponsored insurance in 2013."
Please stop repeating party line BS and either look into the facts or be quiet about it. There is no real reason why we are even having this conversation right now. The bottom line is that Obama knew before he ever mumbled those words that they were not true and he said them specifically to counter punch the people who claimed it was going to happen only for the American people to be deceived and then shocked when it is happening. I don't trust what most other politicians say either, but rarely do we have such obvious examples as to why we should be skeptical of them.
Re:Why not call it its actual name? (Score:4, Insightful)
I see you are optimistic but facts simply do not pan out for you. First, the HMOs BS that we said was the cause of need to reform healthcare was largely the fault of the federal government in the first place. The HMO acts was created in the 1960's and signed into law in 73 I believe in order to address the costs of medicare which is constantly being changed to this day to do the same. Senator Kennedy was instrumental in both, title VII of the social security acts (medicare) and the HMO acts and leading the charge of needing to fix his failings of the past with health care reform yet again.
But to claim this was a Republican plan is just another lie that will blow back in their faces. Sure, republicans thought most of it up and passed it around, but it was rejected by large margins both when it was created and when it was passed into law. That is a bit like saying segregation is a democrat idea since they largely were behind it but rejected it since then. Of course the lie can go on and some people will not bother fact checking, but those who are impacted by the changes of the ACA will likely look deeply into the claims this time around. You don't get too many changes to burn the people and keep your job unless you have a lot of blind support. For the most part, the burning only effects small factions of people- except this time around.
NO, not really. You see, the people who are supposed to sign up in order to pay for the sick and so on are likely not to sign up. When the penalties increase to the point they force people to sign up, there will be resentment among the masses working against the democrats. As for claiming it is a republican law, that is easily dispelled and with the trust issues stemming from if you like your plan, it won't be hard to get the truth out. The fact of the matter is that the plan was developed as an alternative to other plans being purposed in the past and it was largely rejected by republicans then. Bill Clinton would have signed it into law had the republicans ever pushed for it to become law when they took the majority of the house and senate during his tenure. The republicans had possession of the house, senate, and presidency during G.W, Bush's term and rejected the plan. But when the democrats take it up, they magically claim it is a republican plan despite all this rejection and the continued rejection it saw during passage and implementation of law which absolutely no republicans voted for.
Re: (Score:2)
Yet Obama himself calls it Obamacare.
Re: (Score:2)
It's a Republican plan but it's his signature bill.
Better for him to make sure it's implemented well and the flaws get fixed rather than obsess about the name. If it's better known as Obamacare, so be it.
We still talk about Reaganomics.
Re:Why not call it its actual name? (Score:4, Insightful)
It's a Republican plan but it's his signature bill.
It's not a Republican plan. ABSOLUTELY ZERO Republicans voted for this monstrosity in the House, and ABSOLUTELY ZERO voted for it in the Senate.
The fact that two guys who worked at the Heritage Foundation 20 years ago wrote a white paper saying "Hillarycare won't work without an individual mandate" doesn't make Obamacare a Republican plan. You guys screwed this up on your own.
Re:Why not call it its actual name? (Score:4, Informative)
Not only is Obamacare solidly based on Romneycare - (remember Tim Pawlenty referring to it at Obamneycare during the debates?) - but it's not much different from Bob Dole's plan from the '90 and it's pretty much the Nixoncare proposal of 1974.
Re: (Score:2)
Re: (Score:2)
It's not a Republican plan. ABSOLUTELY ZERO Republicans voted for this monstrosity in the House, and ABSOLUTELY ZERO voted for it in the Senate.
That's not a very solid argument: There are measures that the Republicans would have approved 20 years ago that they would never accept today.
The argument that it's a Republican plan is easy: The Heritage Foundation, very much part of the intellectual apparatus of the Republican Party, came up with this exact plan back in 1993 (yes, to oppose the Clinton plan, but the point is that this was their proposal in the first place). Bob Dole ran on it as the Republican presidential nominee in 1996. Newt Gingrich t
Re: (Score:2)
Until it launched, then he (and most/all Democrats) started calling it the Affordable Care Act.
Re: (Score:2)
I like this one better Obamacare Then, Affordable Care Act now [youtube.com]
Re: (Score:2)
http://www.youtube.com/watch?v=xBFW_2X4E-Q
It is well known that Americans are idiots, and a simple name change somehow makes one plan more attractive.
Re: (Score:2)
It's fifty bucks less, out of YOUR pocket, AFTER the subsidy is applied. I suppose that if I were to bend over, place my head between my knees, and forcefully insert my cranium into my rectum, eventually the lack of oxygen could make me forget that this "affordable" health care actually costs about double what my less affordable healthcare used to cost.
Re: (Score:2)
There never have been any exceptions. Getting something from the government comes out of your pocket, one way or another.
Yeah, getting a college education from the government comes out of your pocket -- after you're making 5 times as much as you were before without the degree.
After WWII the government sent a generation of veterans to college. They graduated, became engineers, scientists, entrepreneurs, started businesses, started whole new industries. They paid the cost of their college education back into the economy. Some people said every dollar paid back 5 to 1 or 10 to 1, in increased taxes alone.
And they didn't have any
Re: (Score:2)
*Those* people (the young and working poor) are going right on Medicaid, or getting heavy subsidies.
So, umm... still freeloading on the system. /me bangs head on desk...
Re: (Score:2)
*Those* people (the young and working poor) are going right on Medicaid, or getting heavy subsidies.
To get Medicaid, you must make less than 133% of the poverty level, which is about $13,000/year. So they're not going on Medicaid unless they're really broke. If they have a chronic disease, they're going to be paying about $8,000 a year. Otherwise the young are subsidizing the system.
So, umm... still freeloading on the system. /me bangs head on desk...
When they had got exacerbations of conditions like asthma, couldn't breathe, went to the emergency room like the libertarians do, got oxygen, ran up a $4,000 bill, couldn't pay it, and went bankrupt, that would arguably be fre
Re: (Score:3)
You're confused.
you do know that over half of those those "getting free ER care when they get sick" are illegal aliens? I've got another solution for that little problem that doesn't need "Obamacare".
Let's kick the freeloaders back to Mexico
Re: (Score:3)
Not a strange coincidence at all. People who want to be taken seriously in their complaints will call it the ACA or affordable care act, sometimes with the PP or patient protection in front of it. If they call it Obamacare, they are treated like a partisan loon and ignored.
The Media, they changed up the terms several times now, I suppose this time it is more because Obama started saying they will call it something else when it starts working so if it gets called something else, it must be working right? You
Re: (Score:2)
Wrong, even the White House news release emails call it Obamacare. Ask the millions of subscribers.
Re: (Score:3)
Nonsense, you live in alternate reality between your ears. "Obamacare" is still widely used, even by the White House.
Here is email sent by White House to *millions* of subscribers, proof the White House calls it "Obamacare"
Delivered-To: xxxxxxxxxxxx@gmail.com
Received: by 10.182.126.162 with SMTP id mz2csp322729obb;
Wed, 18 Dec 2013 09:17:23 -0800 (PST)
X-Received: by 10.42.70.83 with SMTP id e19mr1357266icj.75.1387387043143;
Re: (Score:2)
Y'know, I'd assumed it was well known that every government program is named exact opposite of what it actually is, e.g. "Patriot Act." Misdirection of stupid people is de rigueur. Now, call it the "Financially Penalize Citizens For Not Buying a Retail Product Act" and I'm 100% behind it!
Article is +1 (Score:5, Informative)
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
Re: (Score:2)
A standard business problem (Score:4, Insightful)
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.
Re: (Score:2)
Re: (Score:2)
Good luck getting requirements that are written in law revised or waived.
Ever have a requirement that you could point to and say: "Strike that requirement and I can cut the schedule in half" Yet it is still a challenge getting everyone to agree on changing it. Now imagine the people you are negotiating with is Congress.... and they have to pass a law in order to agree with the changes... and any attempt to re-open the requirements attracts hundreds of lobbyists trying to figure out how to change the req
More of a government contracting issue (Score:5, Informative)
Patient decision aids (Score:4, Informative)
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)
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
What about the wheelbarrow? (Score:3, Interesting)
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?
Re: (Score:3)
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
Learned about Chinese Wheelbarrows (Score:5, Funny)
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.
Not "wheelbarrows." (Score:2)
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.
the amazing unicycle with sidecars and yoke (Score:3)
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.
Just extend Medicare to everyone (Score:2)
Re: (Score:2)
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.
Congress Imposed a hard deadline (Score:2)
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
Driverless cars and google glass. (Score:2)
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
Re: (Score:2, Informative)
So a massive goverment take over of insurance regulation, with tens of thousands of pages of regulations, with constantly changing rules because what they came up with originally isn't working is "capitalism".
I think you need a dictionary.
Re: (Score:2)
Correction: A massive insurance industry takeover of the government.
With tens of thousands of pages of regulations. When we could have had a single payer system.
Developers are but the least part of the problem (Score:4, Insightful)
True, the code for that ill-fated website was really out-of-this-world in term of lousiness, but in the whole scheme of things the developers play but a very minor role in that disaster.
The ones who should shoulder the most blame are the people who awarded the entire project (without proper bidding process) to a totally incompetent company due to political reason ( read: cronyism )
The ones who should shoulder the second largest portion of the blame are those who, despite receiving untold millions in funding, they hired totally incompetent people to be in charge of that project.
Re:Developers are but the least part of the proble (Score:4, Interesting)
> It was awarded to a company that specialized in landing government contracts. To the person in the bidding process, it would appear to be awarded to a company with a proven track record.
In other words, the entire system is corrupt just as the OP implied.
Re: (Score:2)
As for AWS - after three weeks of Googling, I still could n
Re: (Score:3)
But as this chart shows, the total has quintupled in the past seven weeks, and has more than doubled in the past four, thanks mainly to brisk uptake in the state-run marketplaces. If these trends continue, the projection for March 31 is still well within reach.
Quintupling every 7 weeks, if these trends continue, there will be 200 billion enrollees by the end of 2014.
Let's see what the naysayers say then!