Healthcare.gov Official Resigns, Website Still a Disaster 559
Nerval's Lobster writes "A government official who helped oversee the bug-riddled Healthcare.gov Website has resigned his post. Tony Trenkle, Chief Information Officer (CIO) for Medicare and Medicaid Services, which oversees Healthcare.gov, will reportedly join the private sector after he departs on November 15. A spokesperson for the Medicare agency refused to say whether he had been forced out, telling reporters: 'Tony made a decision that he was going to move to the private sector and that is what our COO announced yesterday.' Because of his supervisory role, Trenkle is considered a significant player in the Website's development; The New York Times indicated that he was one of two federal officials who signed an internal memo suggesting that security protocols for the Website weren't in place as recently as late September, a few days before Healthcare.gov's launch.Following Trenkle's resignation, Health and Human Services secretary Kathleen Sebelius admitted to the Senate Finance Committee that Healthcare.gov would require hundreds of fixes. 'We're not where we need to be,' she said. 'It's a pretty aggressive schedule to get to the entire punch list by the end of November.' Sebelius added that she was ultimately accountable for what she termed the 'excruciatingly awful' rollout. Healthcare.gov has experienced massive problems since its Oct. 1 debut. In addition to repeated crashes and slow performance, the Website's software often prevents people from setting up accounts. President Obama has expressed intense frustration with the situation, but insists the Affordable Care Act (ACA) backing the Website remains strong. 'The essence of the law, the health insurance that's available to people is working just fine,' he told reporters in October. 'The problem has been that the website that's supposed to make it easy to apply for insurance hasn't been working.' While the federal government won't release 'official' enrollment numbers until the end of November, it's clear that the Website's backers are losing the battle of public perception."
As an outsider. (Score:5, Informative)
Re:As an outsider. (Score:3, Informative)
Yet the KY site is running just fine and has good enrollment. That would indicate it's the website at the moment. You can't blame the law until it actually goes into effect and we see the results. Well you can blame the law but you'll just be another one of those haters you isn't using evidence based arguments.
Re:As an outsider. (Score:4, Informative)
Re:As an outsider. (Score:5, Informative)
That $600MM figure is, naturally, a fabrication. That's the total amount of all software contract work by the entire department of health and human services in the time-frame of 2009-2013. Needless to say, if you can't imagine what other outlays that might include, you're crazy. $93MM(the real number) is still a lot, but 9 women can't delivery a baby in a month.
Re:As an outsider. (Score:5, Informative)
Actually, I kind of agree with you; The law may be faulty, but sniping at the website problems won't fix the underlying flaws.
Economists know that every attempt at price controls over the last 4500 years (approximately) have resulted in shortages of the goods/services under control, and higher prices for those goods/services. All I needed to know about Obamacare was that it is a form of price control.
I'm 65 years old, and I've been tracking the results of Obamacare among the people I know. (NOT a scientific study.) So far, I'm seeing 8 instances of increased insurance costs (including two people who just qualified for Medicare/Medicaid) for every 1 instance of cost savings. It seems that some States, like NY, are benefitting from the increased competition created by allowing offers across State lines.
It is an Economic Principle that whatever you tax, you will get less of. Obamacare imposes about a 9% additional tax on each employee, and so it is probably going to lead to fewer qualifying jobs in the private sector. The number of part-time and temp jobs seems to be increasing here in Texas, but full-time work is hard to get outside industries such as Medicine and Energy.
Re:As an outsider. (Score:4, Informative)
"..they almost certainly spent a positively absurd amount of time(like a year or more) on nothing but QA."
every agile managed project I have done had an absurd low number of bugs on releas. as in less then 20.
And we are talking every where from 20K LoC to over a million LoC
Did you know facebook rolls out changes to production every 11.5 seconds?
Re:As an outsider. (Score:5, Informative)
The reason the law is so complex is that American health policy is made not by a process of examining the options rationally and picking out the best ones, but by a process of political compromise,
If we looked around the world for health care systems that are working (in terms of price, quality and service), we would probably pick something like the Canadian single payer system.
Instead, we had to accommodate every powerful interest group, campaign contributor, and free-market ideologue. Why do we need a private insurance industry? We don't, they just have a good lobby.
The free market health care system doesn't work unless you're willing to let people die when they can't afford health care. http://www.nejm.org/doi/full/10.1056/NEJMp1312793 [nejm.org] So how do the right-wingers get out of that? They come up with a system of subsidies (which they call tax refunds). In order to figure out who "deserves" to get what subsidy, they have to examine every applicant's income, expenses, and circumstances and apply arbitrary formulas.
Because it incorporates tax payments and other grants, you have a system which is as complicated as the entire tax system and a welfare application combined.
Then you have to please these economic theorists who believe (despite 40 years of evidence) that if people have to pay co-payments, they'll be wiser medical consumers. So you've just made a simple system complex. Then you have to provide "choice" of silver, gold, platinum and lead policies, so you have to do the same thing four times over.
By the time you've finished compromising with every interest group, you have an enormously complicated health care financing system, which may not even be precisely designed or logically consistent. So when you try to write code, you have to go back and clarify the policy that you're implementing in code.
Compare that to the Canadian system: You hand your Canadian Medicare card to the receptionist, and she swipes it. The government pays for it.
Re:And this is only sign-up (Score:2, Informative)
I have actually lived in countries that have simple payer systems (i.e. the government is the sole insurance provider) and it works great. That was a long time ago and you still had to submit paper forms but those systems have since gone paperless. I used to know doctors who didn’t even have a secretary. The system was completely streamlined and hassle-free.
Contrast that with the American insurance system which I know quite well because my wife used to work in doctors’ offices. The average American doctor needs a full time employee just to get paid. Dealing with the insurance companies is a nightmare.
But apparently, this unholy mess of a healthcare system is “the best in the world”, because jeebus or something.
Re:As an outsider. (Score:5, Informative)
You're entertainingly deluded if you think Canada is a single-payer system.
We have a tiered healthcare system, it's just that most people don't seem to acknowledge it.
I have partial coverage from my province. I have partial coverage from my employer. And I cover the rest out of pocket.
My mother-in-law, having turned 65, but is still working, has even more payers: the province, her employer's health care coverage, the provincially-mandated health care coverage (different pocket, not sure if she pays for it or not), and then the rest out of pocket.
There are health-related items that are fully covered by provincial plans, some that are partially covered, and many that are not covered at all. For the last two categories, private health insurance can cover all, some, or none of the extra costs. If you have multiple health insurance providers (e.g., two different employers for a household, usually they cover the employee and their spouse and kids, so you have two insurances covering the household), there is some sort of duking it out for who covers what, but, in the end, you usually end up with the higher percentage of the choices being covered somehow. And then, whatever is left, is your responsibility.
I go to the doctor with a cold. The province pays the doctor for my visit. He wrongly prescribes me some antibiotics. I go to the pharmacy, get the pills. The province doesn't pay for any of that (though they play a role in regulating the drug costs). My employer's health insurance pays some of the drug cost (the percentage widely varies on which drug it is) and none of the pharmacy fees (other insurances do pay for pharmacy fees). I then pay the rest, never less than 10% due to the plan I have with work.
If I then spend more than a certain percentage of my pre-tax income on health expenses, I can submit them against my taxes for a further refund, though I've never hit that amount, personally. I'm sure lower incomes could easily hit that.
If I go to the optometrist's, the province pays nothing for my visit, but all of my children's visits as they're all under 18 years of age. I submit to my employer's health insurance for my visit and any and all prescription eye wear that results, including for my children.
If you cannot get health insurance from your employer, or you cannot afford to get insurance on your own (here in Alberta, there is a cheap provincial-run insurance available for purchase, not sure about other provinces, and no idea what kind of coverage it gets you), you get to pay full costs for chiropractic and vision care. Dental visits are also not covered, or any orthodontic care. If you're poor, you're going to be stuck with bad eyes and bad teeth. Even in Canada. Because you're in the bottom tier of health care. Which itself is because we have tiered healthcare.
Sure, emergency access is paid for. But same in the US - effectively. If you can't afford it in the US, the hospitals eventually absorb the cost, by law. In Canada, the government absorbs it. However, if you can't produce your healthcare card, you're still responsible to pay for it - tourists and out-of-province patients don't get free rides. (However, when I was in Toronto a couple months ago, had I required health care during that time, my home province would have covered the costs same as if I were at home. Which, again, means not everything is covered.)
Re:As an outsider. (Score:4, Informative)
Re:As an outsider. (Score:4, Informative)
So if a 34 year old single male's plan doesn't currently cover maternity costs and birth control pills but covers everything else with a good network, low deductibles and manageable co-pays he be say thank you for a bill that now covers his birth control pills but will have much more restrictive networks, higher deductibles and higher co-pays because... well .... just because.
There are millions of plans that work quite well and are very comprehensive that do not meet the random requirements of the ACA. The Lead to Aluminum fallacy is just what people like you try to sell yourselves.
Re:As an outsider. (Score:2, Informative)