Someone should be fired over Obamacare rollout

[Arkie]

Originally Posted by Fedaykin

The only way an insurance model works is if everyone who *might* need it (which in the case of health care, is effectively 100%) pays premiums. And everyone pays for other people's health care one way or the other.

And everyone pays for other people's health care voluntarily or through coercion.

[Pony Boy]

Originally Posted by BBII

You're right in that the worst problem was that the feds put off many really significant decisions until the last possible moment, including the decision to hide plan pricing until registration was successful.

Yes, "You must add this item to your shopping cart to see the unbelievable low price" .......

[UltimateHoboW/Shotgun]

[Rohirrim]

Ted Cruz says the reason the website doesn't work is because it's being run by "...the Nigerian e-mail scammers." http://politicalticker.blogs.cnn.com...lly/?hpt=hp_t2

[bowtown]

Cruz is the definition of a psychopath.

[UltimateHoboW/Shotgun]

Originally Posted by Rohirrim

Ted Cruz says the reason the website doesn't work is because it's being run by "...the Nigerian e-mail scammers." http://politicalticker.blogs.cnn.com...lly/?hpt=hp_t2

Realllllllllllllyyyyyyyy? Where did you find this interesting quote? MSNBC, CNN Aljazerra?

[ant1999e]

[Ol#7]

The software code was db2 technology which is a 30 year old technology not built for the web. It should have been written with browser friendly html5. He used a Canadian company CGI that was fired by Canada for their incompetence.

[elsid13]

Originally Posted by Ol#7

The software code was db2 technology which is a 30 year old technology not built for the web. It should have been written with browser friendly html5. He used a Canadian company CGI that was fired by Canada for their incompetence.

Let's get the facts straight.

1. First DB2 is database not a presentation or business logic layer and IBM has redesigned to support Web Operations. It not the best DB but it is industrial standard. They reused code and wrote their own, but it doesn't look like the government paid for EA upfront that are required for operation like this.
2. The CGI that won the competition is NOT a Canadian Company. The CGI America company that won is wholly owned subsidiary, because CGI America bids and win us DoD contracts, the law don't foreign direct control.
3. CGI won competitive acquisition managed by the Federal Acquisition Regulation (FAR). Past Performance is limited to only work that done in US and rated by CPAR systems. Cost and Technical Capability are usually higher evaluation factors then past performance.
4. Obama wasn't involved in the selection of the vendor.

I love the fact that Politicians and Media type that have no idea about development or deployment are making statements like they understand the technology or the process.

[Fedaykin]

Originally Posted by Arkie

And everyone pays for other people's health care voluntarily or through coercion.

No, it's always through coercion. Higher taxes, grossly inflated prices, etc.

[Fedaykin]

Originally Posted by Ol#7

The software code was db2 technology which is a 30 year old technology not built for the web. It should have been written with browser friendly html5. He used a Canadian company CGI that was fired by Canada for their incompetence.

You know what's worse? They could have built it on Oracle which is 40 Year old technology!!!!

Oh, and "browser friendly HTML5" Do you even know what HTML5 is or are you just parroting something you heard? They are using some parts (the commonly supported ones that are actually useful to their business case) of HTML5, but to claim that HTML5 is "browser friendly" is just silly. Many common browsers *cough*IE*cough* don't even remotely support the full HTML5 spec, which isn't even finalized yet (and, stupidly, never will be by design)! So, to be fully HTML5 buzzword compliant, they would actually be reducing the usability of the site, or having to implement multiple versions of it.

All the morons running around parroting the idiocy of "OMG they're using OOOOOLLLLLD technology" are just showing how easily the ignorant can be fooled.

The problems with that site have exactly nothing to do with using "old" technology.

[BroncoBeavis]

Originally Posted by Fedaykin

The only way an insurance model works is if everyone who *might* need it (which in the case of health care, is effectively 100%) pays premiums. And everyone pays for other people's health care one way or the other.

Wrong. The insurance model only works if people who might need it purchase it before they're certain they WILL need it. Obamacare snaps this fundamental and immutable concept in half.

This is, of course, why treating health care as an optional, insurable thing is completely insane. Everyone will need health care; including non-trivial care.

Everyone also needs food and housing. You can't go around insuring everything people need. Because that's not what insurance does.

The only way treating health care as an optional, insurable thing makes any sense whatsoever is if we are willing to just let people (including lots and lots of children) suffer and/or die. Are you willing to do that?

Tens of millions of people will remain uninsured under the "A"CA. Are you going to be willing to let them suffer and die? If not, what exactly did the "A"CA accomplish, other than breaking the first principle I mentioned above?

[BroncoBeavis]

Originally Posted by Fedaykin

You know what's worse? They could have built it on Oracle which is 40 Year old technology!!!!

Oh, and "browser friendly HTML5" Do you even know what HTML5 is or are you just parroting something you heard? They are using some parts (the commonly supported ones that are actually useful to their business case) of HTML5, but to claim that HTML5 is "browser friendly" is just silly. Many common browsers *cough*IE*cough* don't even remotely support the full HTML5 spec, which isn't even finalized yet (and, stupidly, never will be by design)! So, to be fully HTML5 buzzword compliant, they would actually be reducing the usability of the site, or having to implement multiple versions of it.

All the morons running around parroting the idiocy of "OMG they're using OOOOOLLLLLD technology" are just showing how easily the ignorant can be fooled.

The problems with that site have exactly nothing to do with using "old" technology.

There's more to this thing than a shiny front-end website. The ugly stuff is guaranteed to be locked in the back. If you've ever looked at the systems CMS uses to this very day, you'd know it to be true.

[BroncoBeavis]

Originally Posted by Pony Boy

Yes, "You must add this item to your shopping cart to see the unbelievable low price" .......

Hah. Sad, ain't it.

Truth of the matter is, they don't want you to know how expensive "Affordable" really is.

[Fedaykin]

Originally Posted by BBII

Wrong. The insurance model only works if people who might need it purchase it before they're certain they WILL need it. Obamacare snaps this fundamental and immutable concept in half.

Did you miss the part where I've posted dozens of times that my opinion is treating health care as an insurable thing is idiotic? Hell, even the post you are responding to implies that.

Everyone also needs food and housing. You can't go around insuring everything people need. Because that's not what insurance does.

Unlike health care planning, no on is silly enough to think they don't need food and housing. It's a fundamental problem with human nature; we as a species are very, very bad at planning for the future.

Tens of millions of people will remain uninsured under the "A"CA. Are you going to be willing to let them suffer and die? If not, what exactly did the "A"CA accomplish, other than breaking the first principle I mentioned above?

Nice try, but we have not fundamentally changed the social contract like a purely market driven health care system would.

[Fedaykin]

Originally Posted by BBII

There's more to this thing than a shiny front-end website. The ugly stuff is guaranteed to be locked in the back. If you've ever looked at the systems CMS uses to this very day, you'd know it to be true.

So far I've seen no evidence that the problem is outdated technology. All of the ignoramuses complaining about the tech used are pointing at either the front end, or now the supposed use of DB2. In both cases, the technology being pointed at is actually quite reasonably modern and/or suited to the purpose.

Seriously, when someone says ZOMG they are using DB2 which "is a 30 year old technology not built for the web" then you know they don't have the first damn clue what they are talking about, and are just parroting some other idiot.

[BroncoBeavis]

Originally Posted by Fedaykin

Did you miss the part where I've posted dozens of times that my opinion is treating health care as an insurable thing is idiotic? Hell, even the post you are responding to implies that.

You're wrong. Because you think the market can be set aside. But it never is. Regardless it's still tough to reconcile "You can't insure health" with support for a law that says "Insure your health, or pay the price!"

Unlike health care planning, no on is silly enough to think they don't need food and housing. It's a fundamental problem with human nature; we as a species are very, very bad at planning for the future.

Yes, that's a human flaw. As demonstrated best by our federal government. "It's hard to plan, so let the Federal Government do it for me." is One... hilarious. And two... at odds with individual liberty.

Nice try, but we have not fundamentally changed the social contract like a purely market driven health care system would.

The social contract should always be a matter of negotiation. Otherwise you're just electing unqualified people to tell everyone what they need all the time.

[Fedaykin]

Originally Posted by BBII

You're wrong. Because you think the market can be set aside. But it never is. Regardless it's still tough to reconcile "You can't insure health" with support for a law that says "Insure your health, or pay the price!"

Quick quiz, what is my position about ACA?

Yes, that's a human flaw. As demonstrated best by our federal government. "It's hard to plan, so let the Federal Government do it for me." is One... hilarious. And two... at odds with individual liberty.

The social contract should always be a matter of negotiation. Otherwise you're just electing unqualified people to tell everyone what they need all the time.

More like. "I don't realize I need to plan (or can't), and when I don't I affect others".

When you have a group of people that, though action or inaction (or inability) are harming the whole, you don't think it's indicated for that whole to do something about it?

I'm a pragmatist, not a ideologue. There are basically three choices:

1.) Let people suffer and die and have minimal up front costs.
2.) Keep people from suffering and dying at enormous cost -- what we currently do (only slightly mitigated by the ACA)
3.) Keep people from suffering and dying at a cost somewhere in between. -- what we should to be doing.

#1 is full of personal liberty, and also full of suffering (and also financial costs). I prefer to act against the suffering.

[BroncoBeavis]

Originally Posted by Fedaykin

Quick quiz, what is my position about ACA?

Outright defund/repeal?

More like. "I don't realize I need to plan (or can't), and when I don't I affect others".

When you have a group of people that, though action or inaction (or inability) are harming the whole, you don't think it's indicated for that whole to do something about it?

True in every aspect of life. But I've never heard it argued that someone should be forced to buy life insurance because if they die their family might become a burden on the rest of us.

I'm a pragmatist, not a ideologue. There are basically three choices:

1.) Let people suffer and die and have minimal up front costs.
2.) Keep people from suffering and dying at enormous cost -- what we currently do (only slightly mitigated by the ACA)
3.) Keep people from suffering and dying at a cost somewhere in between. -- what we should to be doing.

1. One of the main problems in health care is that people can often suffer and die with either minimal cost or extreme cost. Even at the end of the road, people will make vastly different end-of-life decisions based on whether a third party (say Medicare) is paying the bills, or whether they are.

2. ACA does absolutely nothing to mitigate cost. It works overtime to hide cost. Which is problem #1 with our health care system and the employer-based model today.

3. You're magic-bulleting this point. Yes, cost is pretty much THE problem. But that problem isn't getting solved by obfuscating payment. When the consumer consumes, he needs to CARE what it costs. The provider needs to know he cares what it costs.

Reinstating this cost-conscious relationship will drive costs down. And drive innovation at the same time.

Single payer can only fix prices and enforce quotas. Those are the only tools in its arsenal. It's one size-fits-all and yet still does little to motivate efficiency.

[Fear the Hawk]

Originally Posted by BBII

2. ACA does absolutely nothing to mitigate cost. It works overtime to hide cost. Which is problem #1 with our health care system and the employer-based model today.

Six Ways Obamacare Will Lower Your Health Insurance Costs

How is this possible?

Because, the magic of Obamacare is simply basic economics.

Here are six economic reasons why the Affordable Care Act marketplaces reduce premiums.

More Competition. Generous subsidies and an individual mandate create a lucrative pool of formerly uninsured consumers. Insurers will compete with each other to gain market share, driving premium prices down.

Less Adverse Selection. The Achilles’ heel of the individual insurance market is adverse selection. This occurs when one side of a transaction lacks the necessary knowledge to make the transaction. Insurers typically lack precise information about the health profiles of their customers, but they do know the people most likely to buy health insurance are often the sickest. As a result, they raise prices to cover risk, which increases prices for everyone in the market. Obamacare’s individual mandate ends the cycle. Put simply, if everyone is required to buy health insurance, insurers can afford to charge less.

Lower Transaction Costs. Information is a key to market efficiency. For the invisible hand to match supply and demand, consumers must make informed decisions, which has traditionally been quite difficult. In the new marketplaces, insurers are required to present their offerings and benefits in standardized formats. Prices will be clear and simple to compare.

Lower Administrative Costs. Under the ACA, the share of premiums insurers spend on actual medical services, as opposed to administrative costs, will be subject to a floor. If insurers spend less, they are required to rebate the balance to plan participants. Consequently, insurers will have less ability and incentive to pad premiums, creating savings for consumers.

Rate Review. The ACA empowers the HHS and state regulators to review premium increases. Insurers can be required to justify unreasonable increases, which will be made public. Although regulators do not have the power to limit rate increases, public shaming may have the same practical effect.*

Better Quality. Even in the absence of premium reductions, consumers will see savings and an improvement in the quality of coverage. What your premium buys you is more important than its price sticker, and under the ACA, consumers will get bigger bang for their buck. Qualified marketplace plans are required to cover all essential health benefits, including preventive services.

http://tcf.org/blog/detail/six-ways-...nsurance-costs

Obamacare cost-cutting: CNBC explains


A number of provisions of the Affordable Care Act, many of which have already gone into effect, are directly aimed at reducing the growth of health-care spending, which accounts for nearly one-fifth of the overall U.S. economy.

-------------------

The law also encourages hospitals, primary care physicians and other medical providers to join forces in so-called Accountable Care Organizations, whose goal is to coordinate care for their patients and, if they meet certain quality targets such as keeping those people healthy and out of the hospital, get paid more by Medicare.

Obamacare also created the Independent Payment Advisory Board, which is empowered to recommend reductions in Medicare spending, in years in which Medicare per capita costs exceed specific targets including overall medical prices. Those reductions will take effect unless Congress comes up with another reduction that saves the same amount.

Obamacare's provision that insurers' policies cover things such as preventative care for customers is also geared to reducing overall long-term costs. The theory is that people who can obtain preventative care, and actually do with, will be less likely to suffer chronic health conditions that could end up costing much more.

http://www.cnbc.com/id/101065202

I think that last paragraph is the most important. Until now, people without health insurance waited until the last minute to get medical attention and then showed up in ERs when their illness was at an advanced stage and required expensive care. Those same folks will now be insured and able to go to a doctor well before their diseases get out of control. Early treatment will lead to cost savings.

[cutthemdown]

Obama will have to give a delay to the individual mandate. Which will be funny because he shut govt down refusing to give one.

[Fedaykin]

Originally Posted by BBII

Outright defund/repeal?

Try going back and reading what I've written about it..

True in every aspect of life. But I've never heard it argued that someone should be forced to buy life insurance because if they die their family might become a burden on the rest of us.

Should people be forced to carry auto insurance? Why or why not?

And, of course, we do have a social safety net for people who lose the person supporting them so not really sure what point you think you have there.

1. One of the main problems in health care is that people can often suffer and die with either minimal cost or extreme cost. Even at the end of the road, people will make vastly different end-of-life decisions based on whether a third party (say Medicare) is paying the bills, or whether they are.

End of the road isn't the problem. People with chronic illnesses are very, very expensive to treat. How many people with diabetes do you think would say "**** it, i'll just die".

2. ACA does absolutely nothing to mitigate cost. It works overtime to hide cost. Which is problem #1 with our health care system and the employer-based model today.

Yes it does. This has already been addressed dozens of times, see TLB's post for the latest.

3. You're magic-bulleting this point. Yes, cost is pretty much THE problem. But that problem isn't getting solved by obfuscating payment. When the consumer consumes, he needs to CARE what it costs. The provider needs to know he cares what it costs.

Reinstating this cost-conscious relationship will drive costs down. And drive innovation at the same time.

Single payer can only fix prices and enforce quotas. Those are the only tools in its arsenal. It's one size-fits-all and yet still does little to motivate efficiency.

You're trying to apply non-mandatory, non-emergency consumer market principals to something that is not that kind of market. If you cut your finger off, do you comparison shop or find the nearest medical facility regardless of cost?

When you get cancer, do you shop for the cheapest doc, or the one that has the most chance of treating you successfully?

Right now we spend 2x as much as most other first world countries many of whom have single payer and or other types of socialized medicine, so the idea that the only way to reduce cost is to put the cost in front of the "consumer" doesn't even remotely follow the evidence.

[Meck77]

Originally Posted by cutthemdown

Obama will have to give a delay to the individual mandate. Which will be funny because he shut govt down refusing to give one.

It's a total joke. My saying the last couple months has been "Be careful what you wish for. The people are getting it!"

I'm going to focus on what's important and that's fishing!


Yeah go out and buy insurance! If you don't you will get fined! Oh never mind the fact you can't buy the expensive garbage!

[BroncoBeavis]

Originally Posted by Fedaykin

Try going back and reading what I've written about it.



Should people be forced to carry auto insurance? Why or why not?

For the privelege of driving on public property, they're asked to carry liability coverage. For damage they're likely (at some point) to inflict on other people's property.

A Health Insurance mandate is like forcing everyone to buy full coverage on all vehicles. Even if you leave it parked in storage. And with basically the same price whether you drive a Ford Fiesta or a Maserati. Because if you happen to get in an accident, you might stiff the body shop on repairs. And body shops hate bad debt as much as everyone else.

I should stop talking because someone somewhere is dreaming up a new federal program.

And, of course, we do have a social safety net for people who lose the person supporting them so not really sure what point you think you have there.

We're talking insurance mandates here, not safety nets. Bad luck for me has societal costs across the board. Should all of them be insured?

End of the road isn't the problem. People with chronic illnesses are very, very expensive to treat. How many people with diabetes do you think would say "**** it, i'll just die".

I think you're conflating chronic illness with terminal. To what end, I'm not sure.

You're trying to apply non-mandatory, non-emergency consumer market principals to something that is not that kind of market. If you cut your finger off, do you comparison shop or find the nearest medical facility regardless of cost?

Emergency Care is a pretty insignificant slice of the overall pie. Building a socialized system around this tiny minority of health care dollars is pure folly.

When you get cancer, do you shop for the cheapest doc, or the one that has the most chance of treating you successfully?

Uncle Warren can fly to Switzerland (hypothetically) if need be and spend hundreds of millions of dollars on the world's finest care. Do you think he'd shop around? You bet your ass he would. He'd find the world's best of the best. Do I have a right to that doctor and kind of treatment? Of course not.

Price is ALWAYS a consideration. Whether that makes you comfortable or not. And it's better when it's the consumer's consideration that matters as opposed to some convoluted regulatory preference scheme. At least to the greatest extent possible.

Right now we spend 2x as much as most other first world countries many of whom have single payer and or other types of socialized medicine, so the idea that the only way to reduce cost is to put the cost in front of the "consumer" doesn't even remotely follow the evidence.

Nobody's arguing that socialized systems can reduce costs. But they do so by rationing. Which is great, so long as you don't mind chillin' for a year or so with a bad hip so the feds can make their budget.

The person making those decisions doesn't know you at all. Doesn't really care whether you live or die. Might slightly prefer the latter, since you're kind of a burden once you reach that point, anyway.

As I've said before, I'm not opposed to a low-level Tier of "safety net" care for people without other options. But this idea of putting people struggling to make ends meet on a expensive and still high-deductible federally mandated plan doesn't solve anything.

The fundamental problem is health care is out of control and unaffordable. Insurance is not designed to make that which is unaffordable affordable. It spreads risk. That's all it does. At the well-known expense of higher average costs.

[Arkie]

Originally Posted by ant1999e

"This country looks like it was poised to turn bluer than a Smurf’s balls after dry humping a bottle of Windex."