HealthCare.gov what is wrong?

[HiHe]

Does any body have some technical insight?

[deceptikon]

Lowest bidder.

[Reverend Jim]

Also private contractor who is able to subcontract all the actual work offshore.

[blud]

400-600 million dollars is the lowest bidder? I would have liked to see that bid.

[mike_2000_17]

Roll out a new health-care program that will allow millions of Americans to get insurance, possibly saving their lives. Yeah.. the server is going to get overwhelmed. Why is anyone surprised?

[deceptikon]

Yeah.. the server is going to get overwhelmed. Why is anyone surprised?

Given that it's easy to imagine such a situation, I'm surprised that they didn't make sure the server (or server farm) was sufficiently beefy given the exorbitant cost of a single website. What we're looking at is just plain ol' incompetence.

[Ancient Dragon]

They're not the only ones who have such server problems. Diablo III was similar when it was first released over a year ago. Blizzard sold millions of copies before the release date but yet the servers couldn't handle the huge workload. The only way to test a system with millions of users at the same time is to test it live. Just because a program works at the desk doesn't mean it will work anywhere else.

[blud]

That isn't a real thing. You can simulate millions of users, you can simulate billions of users. I've done it. Blizzard was foolish, and healthcare.gov was foolish, saying that "it can't be tested" is speak for "we don't want to pay to test it properly".

[HiHe]

So it looks like the software was written offshore on the cheap, with minimal documentation and consideration for maintain ability. I feel sorry for the folks called "computer nerds from Silicon Valley" by the press that have to clean up this mess.

According to one press report the technology used was 10 years out of date. I wonder what that means?

[HiHe]

The blame game has started in Washington.
CGI Federal Inc. the main contractor receiving $450 million has put the blame on a subcontractor Quality Software Services Inc. for creating a bottleneck with their portal ($150 million). They also blamed the federal agency in charge for jumping the gun and putting up the website too early.

Too many cooks in the kitchen?

[Ketsuekiame]

Working in healthcare IT myself, I find it absolutely unbelievable that a single system, even with the "state exchange" system everyone is ranting on about, cost $634M. That is a staggering amount of cash! (Even if they built their own datacenters)

[Ancient Dragon]

If you've seen the sci-fi movie Independence Day then you would understand why it cost so much money. It's expensive keeping Area 51.

$634M is just a drop in the bucket compared to what it's going to cost for Obamacare.

[Reverend Jim]

$634M is just a drop in the bucket compared to what it's going to cost for Obamacare.

Time will tell. Remember that it's the opponents of the Affordable Care Act who are crying about how much it will cost. Let's look at some of the other claims they are making.

• If You Sign Up For ObamaCare Hackers Will Steal Your Life Savings
• The health care law rations care, like systems in Canada and Great Britain.
• The health care law has "death panels."
• Muslims are exempt from the health care law.
• The IRS is going to be in charge of a huge national database on health care that will include Americans’ personal, intimate, most close-to-the-vest-secrets.
• Congress is exempt from Obamacare.
• The health care law is a government takeover of health care.
• All non-US citizens, illegal or not, will be provided with free health care services.
• Under Obamacare, 75 percent of small businesses now say they are going to be forced to either fire workers or cut their hours.
• At age 76 when you most need it, you are not eligible for cancer treatment under the health law.
• The health care law includes a 3.8% sales tax on all real estate transactions.
• "Obamacare is . . . the largest tax increase in the history of the world."
• A hidden provision in the health care law taxes sporting goods as medical devices.
• Obamacare will question your sex life.
• An Obamacare provision will allow forced home inspections by government agents.
• Rand Paul says if you don't sign up for Obamacare you will go to jail

We already know how much revenue is being lost due to taxing the rich at a much lower rate than the middle class. Why don't we just wait and see the actual costs of the ACA rather than relying on the predictions of people who have been proven time and time again to be lying through their teeth.

[Agilemind]

$634M is just a drop in the bucket compared to what it's going to cost for Obamacare.

The most expensive part of health-care per patient per hour is Emergency Rooms (by far). Emergency rooms serve everyone even if they don't have health insurance. People without health insurance are more likely to end up in emergency rooms because they will put off preventative and early stage treatment because they can't afford it.

Everyone with health insurance is already paying for those who are uninsured when they end up in emergency. You just don't know it because it is hidden inside health insurance premiums.

Obamacare should bring those people into the system so the overall cost of those people should go down, since lower cost preventative & early stage treatment will be available to them.

[Ancient Dragon]

the overall cost of those people should go down

Yes, but whether the cost of health care for already covered individuals will also go down is questionable -- but time will tell. The last time I visited emergency room it cost medicare about $1,800.00 just for me to walk in the doors. I'd be interesting to see what the cost will be a year or so from now after obamacare is fully implemented.

Congress is exempt from Obamacare.

That's not just a claim, it is a fact. It was brought up publically several times during the government shutdown and debate about obamacare.

[mike_2000_17]

Agilemind is correct, as always ;)

And, another big part of the cost of health-care is administrative efficiency and bargaining power. The solution to solve most of the health-care cost issues is to find an insurer which is both efficient and has strong bargaining power... well, I guess we all know who that is: Medicare.

I'm referring, in part, to Steven Brill's brilliant piece in Time magazine which more or less reaches the undeniable conclusion that the best way to save costs to provide health-care is to lower the age of admissibility to Medicare, if not, make it an option for all, the so-called "Buy into Medicare" option that many people want, including a majority of Americans (about three quarters of Americans).

[Reverend Jim]

The last time I visited emergency room it cost medicare about $1,800.00 just for me to walk in the doors.

Mostly because a great deal of that cost goes into somebody's pocket as profit. That's why a hip replacement in the US costs about $60,000 while in Belgium it's just under $14,000.

That's not just a claim, it is a fact. It was brought up publically several times during the government shutdown and debate about obamacare.

Just because it was brought up does not make it true. From Politifact.com...

Even a few sitting lawmakers have repeated this claim, but it’s not true. Congress is not exempt from Obamacare. Like everyone else, lawmakers are required to have health insurance. They’re also required to buy insurance through the marketplaces. The idea is to have lawmakers and their staff buy insurance the same way their uninsured constituents would so they understand what their constituents have to deal with. Most Americans who already get insurance through work are left alone under the law; members of Congress have insurance through work but are treated differently in this regard. Recently, a rule was added so that lawmakers’ could keep the traditional employer contribution to their coverage. But they weren’t exempt from requirements that other Americans face. We rated this claim False.

[Agilemind]

Yes, but whether the cost of health care for already covered individuals will also go down is questionable

That depends what you mean by cost. If you mean everything that already covered individuals pay into the health care system (taxes for medicare + insurance premiums) then yes that should go down because the total cost of the system (including the uninsured) should go down and the number of people paying should stay level or even increase so the cost per person should go down.

However, when you factor in the fact that insurance companies are required to put the interests of their share-holders above those of the people they insure it is unclear whether it will actually happen but the fault for that is the insurance companies not the gov't program. If the USA ever manages to institute a universal public healthcare system (similar to the UK) that would ensure the savings would be passed on to all (pay less in tax increases than you pay for insurance) rather than to the few (dividends to insurance company share-holders).

Going one step further to a single-payer system like Canada can further increase efficiency & cut costs since the gov't monopoly has huge negotiating power and can determine the actual cost of each procedure and let the private suppliers figure out the best way to provide the procedure for that cost. The downside of course is that extremely talented doctors/surgeons/nurses tend to move to a country without as much gov't regulation cough USA cough because they can make a much higher salary for less work.

[ZZucker]

You have to consider that a good chunk of the $634 million contract price goes back to the polititians that made it possible that you got the contract. Not sure what the going cut in Washington is these days.

Does any body have some technical insight?

There is some issue with website.

I sign up but haven't got a chance to pick 1 yet.

[gabrielcastillo]

This new act is bs... let me decide what I want to do about my heath care, let me decide who has access to my personal information, let me decide who I want to give my money too. Penalty or jail for not signing up with a load a crap.. I'm sorry, but if you can not afford primium heath care, educate yourself and get a better paying job.. If you are disabled and can not afford priemium heath care, We as a people should provide with exceptions.. no drug abuse, no false claims, and a williness to help one self. I dont mind helping people, I just don't want to be taken advantage of. I have not complete HS, I have no college education.. I used google to learn how to use php/mysql/jquery/html windows, linux and build websites.. Not I get paid as a private contractor to troubble shoot and do maintence for more then 8 company's.. I am currently working ona hugh development project in california.. So, if I can do it, other can as well.. Most people are just lookin for a handout.. I was poor as a achild and I learned from early age to provide for myself.. Screw this new act.. yes will help some and will hurt others. Atleast give us the chance to make the decission for ourselves.

[Agilemind]

I'm sorry, but if you can not afford primium heath care, educate yourself and get a better paying job.

This is position only makes sense if there are more jobs than workers. If the situation is the reverse (as it has been in almost every single country for decades), then there is absolutely nothing anyone can do to guarantee they will get a better paying job. There will always be unskilled jobs which pay just the minimum wage, so as long as employment is < 100% then there will be people who have to take the minimum wage jobs because there aren't any better jobs available.

Even if every single person in the USA got a PhD or other professional qualification there would still be people working part-time at Mickey-Ds for $7.25/hour.

That is the reality. The question now is do the people who have to take minimum-wage part-time jobs deserve to have decent health-care?

[Agilemind]

Atleast give us the chance to make the decission for ourselves.

Don't 85% of people get healthcare through their employer? They don't get to 'choose' what healthcare they get.

[gabrielcastillo]

if you cant find a job create one! Employers provide heath care options, does not mean you have to except.. I understand both sides of the story, and I am willing to help others, but I am not ok with being told, I have no choice in the matter.

[Agilemind]

if you cant find a job create one!

Supply & Demand! Not everyone can create a job for themselves because there isn't an infinite demand for different types of work. Sure you can be an independent webconsultant but if 100,000+ people decide to do the same there won't be enough clients for all of you to make a living at it.

Alternatively you could end up with another dot-com bubble, where it looks like everything is fine so more and more people join but then the bubble bursts and tons of people end up broke & unemployed again.

[vegaseat]

Right now they are trying to improve the response time.

As far as I can figure out there is an insurance market place that lets you pick an insurance company and plan for your needs. However, everyone has to have maternity care and drug rehab in their plan. That's when the sparks go flying.

[Ancient Dragon]

Why would I, an unmarried man who is as old as the hills need maternity care? I'm exempt from Obamacare because I already have Medicare and TriCare For Life (US military medical care) which are covered under different laws. But if I didn't have those then I certainly wouldn't need maturnity care, unless of course someone is planning to get men pregnant :)

[Agilemind]

Insurance is based on the fact that the majority of insured persons won't use the majority of services they are insured for - they subsidize the unlucky few who do need to use them, otherwise insurance premiums we be no different than paying out of pocket.

And frankly, pregnancy almost always involves two participants one of which may be an unmarried older man. Why shouldn't he contribute to subsidizing the health care costs of the unmarried pregnant woman?

[Reverend Jim]

Both of my children are long since out of school and earning an income. Even though I have no further use for the public school system I still gladly pay school taxes because they help pay for a system which benefits society as a whole. Some might consider this a subsidy of a service for which they receive no benefit. I consider it an resposibility for being part of a civilized society. Likewise for that portion of my taxes that go toward maternity care.

[deceptikon]

Insurance is based on the fact that the majority of insured persons won't use the majority of services they are insured for - they subsidize the unlucky few who do need to use them, otherwise insurance premiums we be no different than paying out of pocket.

I'd be okay with that, if the services subsidized were something I could potentially use if unlucky enough to need them. Try grepping the legislation for instances of "women" and "men". Then cross reference the preferential treatment in each instance. Maternity coverage is merely the most obvious and easily defended of sexisms in the legislation.

Last I checked, there were well over 100 benefits unique to women (that men are required to subsidize, recall). Conversely, male-specific benefits was 0. This is hardly fair, and I question half the population being forced to pay for things they couldn't possibly use (ever!).

And frankly, pregnancy almost always involves two participants one of which may be an unmarried older man. Why shouldn't he contribute to subsidizing the health care costs of the unmarried pregnant woman?

Almost always? More like always, unless science has invented artificial sperm. I'd like to respond to the logic here, but I'm having trouble properly putting it into words. Sorry.