Obamacare

Obamacare's Website Gets Its First Performance Metrics. Will They Be Enough?

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Whitehouse.gov

For the past few weeks, the Obama administration has been promising that that the federal health insurance exchange portal run through HealthCare.gov will work "smoothly" for the "vast majority" of users by the end of the month. But the administration hasn't offered much detail about what that means.

For that, we turn to The Washington Post, which explains that the administration is focused internally on getting 80 percent of users all the way through the enrollment process. In a detail that is suggestive of the managerial failures that led to the disastrous rollout of the exchanges, The Post also reports that the goal is "the first concrete performance standard in the 31/2 years since the government began to design the health exchange." Prior to the launch of the site, the administration had no internal definition of what constituted a working site. And the contractors who built the exchange system apparently did not have clear expectations regarding their work either:

When HHS in 2011 invited contractors to bid on the chance to build HealthCare.gov, the department's "statement of work" did not include requirements typical of many IT contracts in which interested companies must spell out how the system would perform, according to an industry representative close to the project, who was granted anonymity in order to speak frankly. The agreement that CGI Federal, the company chosen as the main contractor, signed on Sept. 30, 2011, also did not contain specific performance criteria, success measures or response times.

Well, the site certainly behaved like one built without any performance criteria.

The revelation of this metric leaves us with several big questions. Is it achievable? And if so, how will we know whether it has been achieved? An 80 percent success rate leaves room for just enough failures that it will be hard to independently verify. And given previous reports by the Post and others that the site is not likely to improve enough to be working by the White House's end-of-month deadline, there's reason to doubt that the goal can actually be reached.

Even if it is achieved, will it be enough? The 80 percent target is simply for users of the exchange to be able to get all the way through the enrollment process. But it doesn't say anything about the accuracy of the enrollment or pricing data that is generated in the process. That could be a big problem, given that the site has been sending bad enrollment data to insurers and has also had trouble with the subsidy calculator that determines premium prices and subsidy levels.

Indeed, if the website becomes generally usable for those who want to enroll but continues to generate bad enrollment and pricing data, we could end up with large numbers of people who think they are enrolled in one plan, at a particular price, but whose enrollment information is never properly transmitted, resulting in mass confusion once new coverage kicks in next year. Hitting this particular goal, in other words, might not really fix anything, and could make things even worse. 

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  1. When HHS in 2011 invited contractors to bid on the chance to build HealthCare.gov, the department’s “statement of work” did not include requirements typical of many IT contracts in which interested companies must spell out how the system would perform

    There was no room for that garbage after all the “how well are you politically connected” questions.

  2. The agreement that CGI Federal, the company chosen as the main contractor, signed on Sept. 30, 2011, also did not contain specific performance criteria, success measures or response times.

    Well, that is how it works in the real world! How many of you haven’t said to a contractor “build me a house right out there, doesn’t matter the cost or the time it takes you”?

    1. Government does it all the time, think Big Dig or the High Speed Rail in California. They passed it based on vague promises and some nice watercolor pictures. It was only after they approved it did they start actually designing it.

      1. Ah yes, I believe those fall under the Deliver-Build-Design contracts.

  3. The 80 percent target is simply for users of the exchange to be able to get all the way through the enrollment process[…] [I]t doesn’t say anything about the accuracy of the enrollment or pricing data that is generated in the process.

    Be patient. One step at a time. First, let’s get the suckers… I mean the customers, into the process and then we’ll figure out the minor details.

    1. Note the weasel word “process” in “all the way through the enrollment process”. Since the dickhead politicians involved here don’t know jack about health insurance, they will probably mean by that “navigated through all the screens without getting the equivalent of The Blue Screen of Death saying you can’t continue to the end”, not “actually enrolled with a specific plan and rate and carrier and paid the first month’s premium and had that offer to enroll accepted by said carrier”.

      You know, actually ENROLLED.

      1. That’s my guess as to what will happen whenever the site “works”. You’ll see all kinds of nice stuff on your screen, and will get some kind of confirmation number, but the interconnecting systems won’t be in sync, leading to real chaos.

        “If you think you have your health insurance, you can keep it.”

    2. As a past QA tester, an 80% success rate would get everybody fired on anything I’ve ever worked on.

      The hits just never stop coming.

      ObamaCare is like Herpes

      1. I want 80% to be my new target as a developer. “Hey, we got 80% of your data over. Sorry we missed that guy’s allergy sheet and he died.”

        1. Not sure if you have your baby yet, so want to pass along that my wife and I hugely recommend epidurals. Holy shit do we.

          1. Congratulations! No, we are inside of 3 weeks. Everything else go well?

            1. Baby gave the hospital a scare so she and my wife are staying there (hospital is super awesome to let my wife stay so she can nurse), but is doing well and if all tests come back as expected/hoped on Wednesday we can bring her home. The delivery went great and my wife is doing very well, especially considering how annoying it is to have to pass through a secure door every time she wants to see her baby.

              1. I hijacked the border patrol thread with this stuff though, so I’ll stay away from extensive narrative here.

                1. Okay, I’ll check that one out.

        2. Congratulations to the two of you. May the delirium not wane ’til pass the day she brings home a 2032 version of an Occupy Hippie Democrat.

      2. ObamaCare is like Herpes

        Obamacare is nothing like Herpes.

        1. I’m betting that more people contracted Herpes last month than signed up for Obamacare, so Herpes is easier to get than an Obamacare plan.

        2. The act of getting Herpes is no doubt far more fun than trying to sign up for Obamacare.

  4. The Post also reports that the goal is “the first concrete performance standard in the 3-1/2 years since the government began to design the health exchange.”

    Racists!

  5. The true and only metric for the administration on this is for people to stop calling them fuckups.

  6. Ten percent of nothin’ is, let me do the math here. . .nothin’ and a nothin’, carry the nothin’.

  7. the department’s “statement of work” did not include requirements typical of many IT contracts in which interested companies must spell out how the system would perform,

    If you’ve ever worked in IT, getting people to spell out… erh, enumerate exactly what their requirements are is dash tricky business!

    Two kinds of people in the world:

    People who go to IT for solutions, and people who go to IT for therapy.

    1. There are 10 types of people in this world: those who understand binary, and those who don’t.

  8. OMFG. No SLA? Or an SLA in name only? Man, I really missed the boat by not getting into Government contracting. I have a friend who did 10 years ago. He’s livin’ large in DC.

  9. Find Your Health Plan Now: Instantly compare premiums for health exchange plans

    1. That site must have cost billions!

      1. This is a joke, right? I wonder if there’s anyone who still doesn’t know it was done by three guys in a weekend.

  10. Indeed, if the website becomes generally usable for those who want to enroll but continues to generate bad enrollment and pricing data, we could end up with large numbers of people who think they are enrolled in one plan, at a particular price, but whose enrollment information is never properly transmitted, resulting in mass confusion once new coverage kicks in next year.

    That would be hilarious. Is there any precedent for the Federal government remedying such a monumental screw up? What about their legal liability for incorrect pricing and fault data transmission?

    1. “Is there any precedent for the Federal government remedying such a monumental screw up?”
      Well, yeah! Obo will call a presser and issue a decree!

    2. That would be hilarious.

      I think you misspelled “inevitable”.

    3. What about their legal liability for incorrect pricing and fault data transmission?

      Legal libility? BWAHAHAHAHAHAHA!!!111!!!!!1!! Oh, I haven’t laughed that hard in years… oh, wait, you’re actually serious… – God-King Obama the Magnificent I

  11. Well, I promise it’ll work pretty good!

  12. So let me see if I have this right. The administration that had no clue what it took to build a website that integrated several government agencies and was the front end for 1/5th of the economy, has suddenly learned everything they need to know in the last three weeks. TOP MEN indeed!

    1. Nimoy really looks his age in that commercial.

      Still funny though.

      1. He looks ancient.

        I did like his “technically”.

    2. Made my day. Thx.

  13. Back in the 80’s Unisys won the IRS contract to build a new tax system from the ground up. Business mags back then reported that it was a complete failure.

    1. How right they were.

  14. PORTLAND, Ore. (AP) ? With all the problems facing the rollout of President Barack Obama’s health care overhaul, nowhere is the situation worse or more surprising than in Oregon, a progressive state that has enthusiastically embraced the federal law but has so far failed to enroll a single person in coverage through the state’s insurance exchange.

    Despite grand ambitions, an early start, millions of dollars from the federal government and a tech-savvy population, Oregon’s online enrollment system still isn’t ready more than a month after it was supposed to go live. The state has resorted to hiring or reassigning 400 people to process insurance applications by hand.

    http://news.yahoo.com/oregon-h…..39796.html

    California and Kentucky win the IT awards.

    1. Well at least Obama has created a job for Bartleby.

      1. I would prefer not to… have Obamacare.

    2. Two out of 15 systems turned out ok? Better than I expected, all things considered.

    3. Re: Palin’s Buttwipe

      California and Kentucky win the IT awards.

      As if that mattered at all.

      This Healthcare dot gov debacle is just the flies on top of the shit. Ecomomically, the whole plan cannot work because there will never be enough healthy and young customers singing in to sustain the sick and elderly. Obamacare is nothing more than a huge pyramid scheme with the same viability.

      But even if the purpose of this plan is to help usher in a single-payer system, you still have the issue of a country saddled with 222 trillion in debt and unfunded liabilities which means there is no way the country can afford another entitlement program.

      1. And since he just seems to be talking about the Federal government you can toss in about $50 Trillion more in State, Local, and Private sector debt.

        Call it $270 trillion in total debt against $16 trillion in GDP.

        Assume a blended interest rate of just 3% and you’re looking at annual debt servicing costs of $8 Trillion.

        Basically half of all economic activity in the country is going to pay off interest on past spending not generate any new wealth

    4. Despite grand ambitions, an early start, millions of dollars from the federal government and a tech-savvy population, Oregon’s online enrollment system…

      Oregon’s population is “tech savvy”? I’m trying to think of one major software, computer, aerospace, engineering or other “high tech” company that’s based there and can’t come up with one.

      1. Oregon’s tech industry is a shadow of Washington’s, let alone California, but the largest private employer in the state is Intel.

    5. http://cascadepolicy.org/blog/…..isparking/

      Detractors laughed when Cover Oregon said their biggest problem was parking. Obviously they were prescient about the 400 additional employees they are now hiring to process paper apps.

      And to add a cherry on the top of the steaming pile of shit, Cover Oregon is running new radio and TV ads as part of their $10M $21M $28M ad budget. Fuck that piece of shit Kitzhaber with a rusty shovel sideways.

    6. The state has resorted to hiring or reassigning 400 people to process insurance applications by hand.

      HAHAHAHA!

      RUNNERS! I TOLD YOU SO!

      1. The SEIU approves!

  15. 80 percent of users all the way through the enrollment process

    First, even if “all the way through enrollment” is even a worthwhile metric to chase, 80% is pathetically low.

    That said, I’m suspicious of the wording: why not say “enrolled in the exchange?” Is that 80% supposed to be 80% of . . . what, exactly? How is it tracked? People who have begun enrollment by filling out the first screen? Can you even track on a unique user basis the people who have started and abandoned?

    And regardless, what value is this, really? Isn’t the only number that matters how many people have actually acquired insurance? Even a “soft” definition of acquired that means “ordered/checked out, even if payment hasn’t yet been received?”

    1. Got to agree with you on that. Any B-school student will tell you an 80% fulfillment rate would get a COO fired.

  16. Prior to the launch of the site, the administration had no internal definition of what constituted a working site. And the contractors who built the exchange system apparently did not have clear expectations regarding their work either:

    That is… I uh… WHAT THE FUCK?! Haha, the level of incompetence here is astounding.

    Oh, and they require the site to work 80% of the time? Amazon requires its main site to have a 99.9% SLA.

    1. Three nines is actually a very lenient uptime requirement by the standards of high availability. Amazon probably has at least an internal five nines requirement as their entire revenue stream is their web infrastructure.

  17. When do the first alt-text metrics come out?

  18. Don’t worry! The failure of healthcare.gov is all the fault of evil cyber-hacking RethugliKKKans.

    http://www.examiner.com/articl…..b_articles

    1. Yeah, you wouldn’t want a website allegedly built to handle millions of people to have any contingency for DDOS attacks. After all, they only spent what – half a billion dollars?

      1. So true. The real outrage here is some fringe group trying to hack a large website (something I’m sure other websites never encounter). That’s a much bigger outrage than tens of millions millions of people being forced to use a website that doesn’t work.

  19. Does it really matter?

    1. What difference, at this point, does it make?

  20. Yeah I agree all the problems with the ACA are probably fixed now. It’s a Thanksgiving Miracles!

    1. Prediction:

      The administration will come out with a bunch of half-baked, irrelevant numbers that look good and will sell the fuck out of them.

      Actual performance will continue at a level that would embarrass a mid-90s startup.

      The administration will have another crisis of credibility, as the disconnect between their rosy-scenario sales job and reality becomes apparent.

      1. Actual performance will continue at a level that would embarrass a mid-90s startup.

        Hell, dinosaur companies with more inertia than a trainload of steel had better transitions to the internet.

  21. Im making over $7k a month working part time. I kept hearing other people tell me how much money they can make online so I decided to look into it. Well, it was all true and has totally changed my life. This is what I do,,,,,

    JOBS81.COM

    1. Let me guess…
      Official Obamacare Health Navigator?

      1. No, the identity broker they sell their data to.

        1. “identity broker” – I like that.

          I received a communication that I suspect is from a Russian identity broker!

  22. As has been mentioned elsewhere, getting this website build has taken longer than it took us to beat the Nazi’s. No, really, look it up.

  23. So, we now have a definition of “Good enough for government work.”

  24. Enrollment may be just the beginning of the problems. Expect your trips to the doctor, especially hospitals, to become a nightmare. My own experience is that is already happening. I went to the doctor knowing I had golfers elbow and I just wanted a prescription for PT. It felt like I was on an assembly line:

    1) front desk
    2) nurse takes me back to another “window”
    3) person at window 2 takes more info
    4) nurse takes me to get X-ray
    5) X-ray guy wants to X-ray both elbows. I literally had to yell at the guy to get him to understand it was just my right elbow (and frankly the X-ray was worthless for golfers elbow)
    6) nurse takes me to waiting room
    7) another nurse comes in and types on the computer, leaves
    8) doctor comes in, stays for 60 seconds, seems in a mad rush
    9) nurse takes me to the billing window
    10) check out

    The trip to PT was no better. I wanted to go just once a week, but they won’t bill at the “standard rate” unless you go twice a week. WTF. It’s my money. But in reality the doctors are controlled be the insurance companies who are controlled by regulations. Unless you go to a cash facility, you do not control your own health care.

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