"The Affordable Care Act And The Support Center = The AMC Pacer Of Health Care Programs"
A guy blogs his experience attempting to sign up, talking to some twit, and then deciding to pay the fine and get health care in Thailand. An excerpt:
My call to the customer service center was about as much fun as applying for unemployment benefits or getting a full body groping by the TSA at the airport. I talked to an agent named Kevin who couldn't listen. He talked over everything I said. When I spoke it was as if I'd said nothing at all. He fished around on the computer and with his southern accent that sounded very Ozark Hills he declared that his computer was down and had been for 2 days and that IT hadn't fixed it. He could do nothing for me. "I'm sorry Mr. Gilmore. Please call back and talk to another agent and maybe their computer will be working. Thank for calling and have a nice day." Then he hung up. Alright I'll have a nice day because Kevin told me to and I can look at that white screen to calm my nerves. That white screen might just be my key to good health. I'll let go all attachments and expectations staring into the emptiness.
Washington Post writers Amy Goldstein and Ariana Eunjung Cha on how federal signup site is "bedeviled by problems that go beyond what the Obama administration has acknowledged":
Even when consumers have been able to sign up, insurers sometimes can't tell who their new customers are because of a separate set of computer defects.The problems stem from a feature of the online marketplace's computer system that is designed to send each insurer a daily report listing people who have just enrolled. According to several insurance industry officials, the reports are sometimes confusing and duplicative. In some cases, they show -- correctly or not -- that the same person enrolled and canceled several times on a single day.
The ability of consumers to sign up for a health plan, and the ability of the insurers to know who they are covering, is key to the success of the federal law that will for the first time require most Americans to have health insurance starting Jan. 1. The Web site www.healthcare.gov is the main path for millions of Americans in 36 states to purchase new coverage.
...One insurance industry official familiar with the daily reports, known as "834s," said that they rely on relatively old technology.
Rather than transmitting a file whenever a consumer enrolls, the reports are sent to each insurance carrier in a daily batch at 6 p.m.
Also, the reports contain a "stack" for each consumer, so that if a person picks a health plan, then retypes his or her phone number, two reports are generated.
Beginning in December, health officials intend to run a monthly comparison of the federal list of enrollees against the insurers' lists. However, one insurance industry official said that the computer system needed to perform that comparison has not been tested.
The flawed enrollment reports result from one of several design and programming issues that have been emerging in recent days, according to technology consultants, health-care advocates and academics who have been monitoring the rollout of the exchange.
For some consumers, the confusion begins with the screen that lets them create a user name.
It asks users to "Choose a user name that is 6-74 characters long and must contain a lowercase or capital letter, a number, or one of these symbols _.@/-". It has been unclear to some whether they need a letter plus a number or symbol, or whether letters or numbers or symbols are sufficient.
Some consumers are discovering they cannot erase profiles they created by mistake, while others are encountering error messages telling them that profiles they created do not exist. Still others find that when they click on a button to move to another screen, they cannot tell whether the system is stuck or simply slow, because the site does not show them an hourglass or any other sign that a step is underway.
blog link via Lisa Simeone
For the program to work they need 7M enrolled. So far only a little 51K have signed up. That is 0.7% in the first two weeks.
Go Obamacare! Maybe the Democrats will finally get a clue, but I doubt it.
Jim P. at October 12, 2013 6:28 AM
Sounds like the rollout of any new program in a socialist country. Shoddy construction, followed by promises that the technocrats will eventually get the bookkeeping right and our glorious human experience will roar into the future.
doombuggy at October 12, 2013 6:42 AM
So, I'm wondering, and I'm looking...
Patrick, what's the cost of the ACA to you? The NPR calculator is right here.
Somehow, we never heard from you how it might be inaccurate, despite your protest.
Radwaste at October 12, 2013 6:52 AM
HHS has had 3-1/2 years to implement all the infrastructure needed with the ACA. They've had time to review the legislation and establish call centers, Web sites, regulations, connectivity with other federal agencies, educate and prepare state agencies, and all the other things necessary to implement such a large program.
The president should have [demanded and] been getting weekly briefings on how the implementation was going and what hurdles could be expected upon full roll-out. He should have been meeting with governors to build cooperation of their agencies with his.
He should have been touting the program in speeches and townhalls throughout the 3-1/2 years from its passage to its roll-out, encouraging people to sign up and building enthusiasm. Instead, he was issuing exemptions and waivers.
All the glitches came as complete surprises to everyone, including the people who should have had the insight that they were coming.
The Obamacare Web site cost an estimated half a billion dollars and is riddled with bad code. That's more than Facebook, Spotify, LinkedIn, and other high-traffic private sites. It took Facebook six years to cost that much.
http://www.digitaltrends.com/opinion/obamacare-healthcare-gov-website-cost/
Granted, those sites were not expected to hand a volume of millions right out of the gate, but their user base grew exponentially from the beginning and they kept up with that demand.
If corporate America had rolled-out a signature program this disastrously, heads would roll. Why does Kathleen Sebelius still have a job?
Conan the Grammarian at October 12, 2013 10:55 AM
Not a big fan of Ron, but whoever wrote the speech was a genius:
http://www.americanrhetoric.com/speeches/ronaldreaganatimeforchoosing.htm
Stinky the Clown at October 12, 2013 11:15 AM
The AMC Pacer was a marvel of engineering compared to Obamacare. Im betting the online enrollment doesn't last past January.
Isab at October 12, 2013 11:35 AM
I'm sure that this will become and example case for computer architecture courses eventually. "They Did What?"
This is also a prime example of the procurement process and how astonishingly broken it can be...
moreover, it's a cautionary tale on the absurd expectation that people have for how computer systems can be rolled out.
In the industry, there are two ways of making a system. one is to gather requirements, and iterate on what sorts of systems will be needed to make the requirement happen. That usually causes a revisit to the requirement to make it more realistic, based on the budget, and schedule need and so forth. Hash that out for a year, procure hardware, coded software, rinse lather repeat... because there is ALWAYS, ALWAYS going to be problems you didn't foresee, vendors that are full of s**t about what their product can do, and unforeseen interoperability issues.
Some YEARS later, after unit test, system test, end to end test, and User Acceptance Testing, you'll have a finished product, that hopefully bears some resemblance to what was originally intended.
The other way to do this, is to get a basic idea of what you want... find a system that does that pretty much, see if you can scale it up, and if so...
ADJUST THE REQUIREMENTS TO FIT THE AVAILABLE SYSTEM.
This seems like a bass-ackwards way of doing it, but complex computer systems really accreted over time. Modules are written and re-written based on certain changes, but they are small modules... importantly written within the framework of the system they are already in.
Whereas adding a report module from an outside vendor is often a headache, because getting the two systems to talk involves translation, and OI, you know what that means.
This is why large corporations sometimes re-write their WHOLE policy structure to fit, say SAP or peoplesoft, because that's the only way to not have to customize the software into oblivion.
But, both options aren't really available, now are they?
Because this is a LAW, and there is a ROLL OUT DATE, and you are trying to shovel 10pounds of s**t into a 5 pound bag.
Just like the updating of any federal system [like air traffic control] large systems take a long time to upgrade, and are exponentially more difficult that a small system.
But rolling out an insanely complex large system, whole cloth, in a short timeframe? When the procurement couldn't start day one anyway? When the vendor gives a lot of happyface pronouncements?
This will always be a big, ugly pig, no matter how much lipstick and perfume they load on it.
Computer systems are not a panacea, even if they aren't hamstrung by politics and incompetence.
What works for one person, might work for a hundred... but not a million, or 10mil. Things just don't work that way.
Comparing to Facebook is stupid, they're not selling anything. Comparing to Amazon is prolly better, but they have been upgrading and changing for years, and they don't have to labor under a procurement process.
Large systems are complex, government large systems? Insanely so.
SwissArmyD at October 12, 2013 12:00 PM
Swiss pretty much described the process every private company goes through. If the drop dead date is three months out the QA and beta testers are testing at least a month out. And quality assurance is testing both good and totally ignorant cases.
They had over three years to build this. That they couldn't get it close to right on day one is bad coding and bad design. That is a sign of total incompetence. So who is going to be terminated? Probably no one.
Fuck the fed.
Jim P. at October 13, 2013 12:25 AM
"Sounds like the rollout of any new program in a socialist country. Shoddy construction, followed by promises that the technocrats will eventually get the bookkeeping right and our glorious human experience will roar into the future."
Followed in a year or two by a brand new plan -- "It's going to work this time, we pinky swear!" -- and an all-out effort by the government-controlled media to convince everyone that the previous plan never existed. I expect the airbrushing to begin around next summer.
Cousin Dave at October 14, 2013 7:45 AM
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