ObamaCare Runs Into Computer Trouble


ObamaCare's state based health insurance exchanges are already facing serious political resistance: Several Republican governors, including Florida's Rick Scott and Louisiana's Bobby Jindal, have said they won't create exchanges; others, like New Jersey Gov. Chris Christie, have put exchange creation on hold until the Supreme Court rules.

But even states that have agreed to create exchanges are running into sizable technical hurdles building the required IT infrastructure, reports Politico:

Even states that are solidly committed to pursuing an exchange are facing major logistical challenges in building the computer systems that will be able to handle enrollment when exchanges open for business in 2014.

That's largely because the system that will actually connect people to the right coverage will have to "talk" to many other systems, and the systems don't use a common language. This includes a yet-to-be built federal "data hub" with tax and citizenship info, the enrollment systems of multiple private insurers selling exchange plans and — hardest of all — state Medicaid enrollment systems, many of which are not yet fully computerized.

Even if all the states that have taken the biggest steps to launch exchanges — fewer than 20 at the moment — were charging full speed ahead, there's a lot of concern that they'll have to switch to a "partnership" exchange model, with the federal Department of Health and Human Services running key functions. That's because their IT systems could fail final tests in the months before the exchanges open in 2014. And that would mean losing some of the ability to customize the enrollment process for a state's needs.

I tend to think that in the midst of all the political controversy surrounding the law, people have underestimated the logistical challenges of implementing ObamaCare. These sorts of technical concerns haven't garned the same level of attention as, say, they Supreme Court challenge to the law, but they've been around for a while, and they're fairly serious: In "Rogue States," my October 2010 feature looking at state implementation of the law, I noted early worries about whether the technical requirements for the exchanges would actually be feasible. Nearly two years later, we have more details on the particular challenges states attempting to build exchanges are actually facing, but we don't have a lot of answers about how or when they'll fix them—or, for that matter, any real assurance that they will.  

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  1. No biggie, just spend more taxdollars. That fixes everything.

  2. My reaction was,

    1) "Gee - who but a technical IT GENIUS could have foreseen that implementing an overarching program that controls every aspect of an already-complex thing like medical care in a nation of 300M people might run into some mega-huge-gigundo issues regarding the IT systems required to make something like that work. Oh, and it'll cost BILLIONS. Mark my words. Who could have known that?" And:

    2) What wylie said.

    Jesus fucking H fucking Christ fuck. FUCK!

    As Daughter #1 said: "Fuck Joe Biden and socialized health care."

      1. So she diagnoses fucking or that's one of her services? I am confused.

        1. *moans, wet slappy noises, more moaning*

          "Yep, that's certainly a case of fucking. That'll be $4200."

      2. She's a social worker. The apple really doesn't fall far from the moron, it seems.

        1. I can assure you, I have much better taste in women.

        2. That means whore, right?

          1. No, whore's get paid.

    1. Obamacare + Battle.net = Skynet.

      1. Nah, Skynet doesn't take every Tuesday morning off for server maintenance.

        1. I think that is exactly why they were never able to figure out how to kill Conner after their first plan of paying Rock Hudson, the hottest star for a gal with father issues at the time, to fuck Linda Hamilton a few weeks before she met his father fell through.

  3. Having watched the integration of the state HR/Payroll system in FL (late, overbudget, and unable to perform minimum requirements for at least a year after "delivery"), I am shocked, shocked! To find out that they've created an IT nightmare completely free of standards, protocols, or minimum functionalities.

    I could probably make several hundred thousand dollars a year doing little and delivering nothing for the next decade if I wanted to get back into the field. But I don't, because I like not hating my life.

  4. Slightly off topic: Woman 'choked and scratched boyfriend because he refused to marry her'... but she claims injuries were from 'rough sex'


    1. Mmm. Yes. As a juror I would want to uh, see for myself whether such injuries could result from consensual sex with her.

      1. "Her boyfriend told authorities he was unsure about marrying Karoly because of her violent temper and that she had punched him in the past when they argued about her visa."

        1. For a second I was like, "arguing about her visa, and they're not even married? Run, run away!"

          Then I read the article... "immigration visa".

          1. She's Hungarian, so we might finally get some use out of that English-Hungarian phrase book.

            1. My nipples explode with delight.

    2. Ah. I suspect the judge would want an in camera inspection of the, uh, evidence.

    3. I saw the picture. He made the right decision.

    4. Are there any stories in the dailymail that dont involve pussy? So far today yall have posted forced pussy, public pussy, flying pussy and now violent pussy, all from the dailymail. geez.

  5. Oh, I love when the government regulates building a piece of software, without specifying a data-format for said exchange, not providing ANY requirements/specifications, and not mandating that insurance providers create a standardized API for the states' systems to call. I am really curious how the exchanges are going to get the data - they aren't going to write several hundred "screen-scrapes" that manually crawl EVERY insurer's state-level site (I hope not) - and there is currently no spec/requirements...This is going to be a blunder of epic proportions from the programming side of things.

    1. What's the problem? As long as they use best practices everything will be fine.

      1. Man, I've been away from TDWTF for too long.

      2. "Best Practices" are kind of the "Top Men" of IT, aren't they?

        1. No, they're the things that get completely ignored because the doctor isn't happy.

        2. Nah, they're kinda like the tired old men yelling at kids to get off their lawn but who everyone still respects for some reason because they fought in Vietnam or something.

          Really most actually IT professionals realized about a decade ago that the idea of "Best Practices" was an oxymoron because no 2 projects were ever similar enough for everything that went well on the first to be a good idea to do on the second forget trying to scale that across an enterprise with different unrelated platforms or even worse across an entire industry. However management still tries to hang on to them (sometimes under a different name) because they kinda like the idea of having everything simplified down to a single set of dictates.

  6. This sort of thing is hard enough when you're working within one entity and everything is well-planned and understood from the beginning.

    The idea of doing this across government agencies withers my taint.

  7. Shouldn't the picture have been Robocop?

    "There will be... trouble."

    1. Robocop is my new dating criterion.

      "Why would someone pretend they don't know what Robocop is? Because they're fucking crazy."

      1. I don't think that's an effective commercial for a dating service.

  8. Cool, but where's the Game of Thrones thread?

    1. The finale was pretty meh. Other than seeing Dany's dragons burn that warlock alive and the White Walkers, nothing terribly exciting happened.

      1. As someone who hasn't checked out GoT yet but probably will someday, I really shouldn't read H'n'R.

      2. YOU'RE PRETTY MEH. But yeah, other than those two things...

        1. I understand that it's difficult to produce such an expensive show, but the fact is that it suffers due to having to cram all these different storylines into just 10 one hour episodes.

          The only two storylines that have any urgency right now is Dany and what is happening beyond the Wall with Jon Snow and the White Walkers.

          1. The White Walker that capture John Snow had a very charming accent.

          2. I liked last week's siege episode.

  9. I think another issue here is that people magically thought this would "Create Jobs" without looking at the industries that were actually suffering major unemployment.

    IT and software never really hit that much of an employment hit. Other industries like construction and housing certainly did.

    A poor politician might look at the total unemployment and say, great, this will solve that. Unfortunately, people who know how to build roads don't know squat about how to build a computer system.

  10. Wait, you're telling me that pseudo-markets designed and created by governments are inefficient and possibly unworkable? Why wasn't I informed? If only some economists had studied the issue, we could have avoided this.

  11. This sounds like intended consequences.
    "It is impossible to build 50 systems, so let's just build one universal federal system that everyone can use."

    1. This sounds like intended consequences.

      that is pretty much the description of all things associated with this administration. It's not bad policies or misguided choices, it is purposely-made decisions that are expected to result in bad outcomes. Can't enact transformational change if you do not totally fuck up the existing system.

    2. Having worked on the FSAFEDS eligibility and enrollment systems I can categorically tell you that there is no way in hell they could ever implement an exchange in less than a decade. Hell it typically took 3 - 6 months to get sign off on a text change that they asked for.

  12. I tend to think that in the midst of all the political controversy surrounding the law, people have underestimated the logistical challenges of implementing ObamaCare.

    Well when you evaluate based on intentions rather than results shit like this will happen. Democrats are good at projecting the alternative of not doing what they want as the end of the world while throwing in red herrings about how so much better European countries are with their healthcare system.

  13. as someone who writes custom code for a manufacturing company, trying to integrate disparate systems is a mess. The "lawmakers" who came up with Obamacare, like much of the management here, just say "make it so" without understanding the difficulty and hours needed to even do simple system integration.

    1. "I ask you to kill Superman, and you can't do that one, SIMPLE thing?"

      That's what I use with my mgt in the old auto bidness. Some of 'em even get it...:)

    2. The "lawmakers" who came up with Obamacare, like much of the management here, just say "make it so" without understanding the difficulty and hours needed to even do simple system integration.

      They understand it very well. All those hours and difficulty represent Jobs created or saved.

      They just broke a shit ton of IT windows. Someone's gotta sweep all that up and put new glass in.

    3. Yeah, even if there were no coordination issues with the insurance companies and various government agencies who would have their hands in the system I would estimate that it would take a team of between 100 and 150 (Developers, QA, PM's, BA's, DBA's, Network Admins, System Admins, and associated management) at least 3 years to get it up and running for a trial period. Then when you factor in the inevitable delays caused because somebody changed their spec or won't be ready with an integration point on time and you're probably looking at closer to 6 years for the initial trial and 8 years before it is ready for full scale use.

      Even that assumes that you have a couple of kick ass system architects designing the thing and holding everyone to that coherent design vision.

  14. I wonder how lefties--who regard themselves as the smartest people in the room--could possibly think this will work well, especially after seeing the way that sensitive data in government databases gets compromised on a daily basis.

    1. they don't think it will work well. A good case could be made that they it will, in fact, turn to shit. But they count on the apathetic and stupid who believe anything govt says means free puppies and rainbows.

    2. When it turns out that it doesnt work, when healthcare is unobtainable, the bureaucracy unworkable etc. they will say that someone, probably the republicans, fucked up or sabotaged their perfect shiny plan. It wont be their fault because....well fuck you.

      1. WRONG WRONG WRONG! They will react to the failure of a government plan in the same way the government always reacts to their failures "We didn't go far enough the first time!"

  15. This is going to be quite awesome come Jan. 1 2014. I kind of hope that Obama is still in office for this cluster so that he takes all the blame when 50M or so people can't buy health insurance.

    1. The republican bickering is what made it fail.

      1. If only the Democrats had written the law all by themselves, and forced it through Congress with legislative tricks and an almost perfectly party-line vote! Oh, wait....

      2. "It was those Republican governors who refused to implement the exchanges in a timely fashion and instead chose to play partisan politics with our country's healthcare system..."

        1. Needs more "dragging women screaming out of clinics into the street."


          1. "This bill is a direct intrusion into the relationship between patient and physician.

            God liberals fucking suck. They suck so hard they could enrich plutonium with their suckitude.

            Liberalism: A direct intrusion into the relationship between patient and physician.

        2. That's going to be tough to sell when the systems in states that did implement the system aren't working as well. I have no doubt they will try this stuff, but the blame is going to fall on whoever happens to be in the WH or governor's mansion at the time.

  16. See that makes no sense at all dude.


  17. My head is about to explode. I've invented a software framework that would deal with all their technical issues, so give me the big juicy contract and I'll take care of it for you. But wait ... what? ObamaCare? Oh.

    Then my head doesn't explode because I know the contract will go to a company like Accenture Ltd. that's been in on big government scams before, ultimately charging 10s of billions of dollars for national database systems that could actually be run on a single PC. Accenture Ltd., BTW is a spin-off of Arthur Andersen, Andersen Worldwide that is now based in Bermuda, a well-known offshore tax and privacy haven.


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